By Jacqueline Murphy, In Memory Of The Late Emma Hannigan

Earlier this week, we learned of the tragic passing of one of Ireland’s most loved authors Emma Hannigan, having fiercely battled breast cancer for over 11 years since her diagnose at the age of just 34. A few years previously, she learned that she was a carrier for the BRCA1 cancer gene, which manifests into either breast or ovarian cancer in over 80% of those who carry it. She proceeded to undergo a double mastectomy along with the removal of her ovaries and Fallopian tubes, in the hope of decreasing the likelihood of developing either form. Unfortunately, despite her efforts, Emma was diagnosed with cancer in 2007 and fought the illness 10 times, until her passing earlier this month.   

Last month, I turned 20. Just like every other young woman my age, some of my biggest worries and concerns include achieving my desired college exam results, tackling hormonal breakouts, managing financially as a student, and maintaining a healthy balance between all the different relationships in my life. Something else that worries me – and may come as a surprise to some – is getting cancer.

While only a small percentage of cervical and breast cancer cases are diagnosed in women under the age of 25, they also hold some of the worst survival rates if they’re not detected early on.

During a pharmacology lecture I attended last week, my lecturer mentioned that when she was studying at third level around 20 years ago, she was told that the probability of getting cancer in your lifetime was 1 in 4 – fast forward to 2018 and the statistic she gave us is 1 in 2.  At present in Ireland, Cervical Check only offers smear tests to women age 25-60, despite the fact that it is the most common cancer in women under 35 and statistically, 10 Irish women under the age 25 will die from cervical cancer each year. Similarly, breast cancer cases are most common in women age 40-55, but because of the presumption that it doesn’t affect younger women, cases that do occur in those age 25 and under often fall beneath the radar or are misdiagnosed and due to late detection, rarely have a good prognosis when they are discovered.

Symptoms & Early Detection

Cervical cancer is cancer of the cells lining your cervix. Developing slowly over a number of years, at first it develops abnormal changes, which are called precancerous, and then leads to cancer itself. The main symptoms of cervical cancer include abnormal vaginal bleeding (i.e, bleeding in between your periods, after sex or after the menopause), blood-stained vaginal discharge that may have a foul smell and discomfort or pain in your pelvis.

In its early stages, breast cancer usually has no symptoms, but as a tumor develops, warning signs can include a lump (usually painless, but not always) in the breast or underarm that persists after your menstrual cycle, a noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt, a change in the nipple such as a nipple retraction, a burning sensation, or ulceration and unusual discharge from the nipple that may be clear, bloody, or another colour.

Self Checks

At present, the only recognised way of detecting HPV (human papilloma virus) which causes cervical cancer is by performing a smear test on the neck of the cervix. Because such tests aren’t available to Irish women under 25, monitoring any changes such as abnormal bleeding and pain in your pelvic/lower abdomen is key. You should be extra vigilant if your mother, aunt or other close female family member has been diagnosed with cancer of the cervix or other reproductive organs. Less worrying/life threatening conditions such as ovarian cysts, PCOS and endometriosis and even something as simple as a vaginal tear due to intercourse can present similar symptoms to those outlined above.

Don’t assume the worst case scenario, but if you have your doubts, it’s always a good idea to visit your GP – better to be safe than sorry, eh?

With breast cancer, there are generally more external symptoms than with cancers of the internal reproductive organs, so self checks are easier to perform. It’s a good idea to get to know what’s normal for your breasts. That way, you can check in with your doctor if you notice something unusual, such as a lump, skin change, or discharge. One boob being slightly bigger than the other is actually extremely common in most women and usually doesn’t indicate anything sinister.The quickest and easiest way to perform a self check on your breasts is when you’re in the shower.

Feel for changes in the breast. It helps to have your hands slippery with soap and water. Check for any lumps or thickening in your underarm area. Place your left hand on your hip and reach with your right hand to feel in the left armpit. Repeat on the other side.Check both sides for lumps or thickenings above and below your collarbone. With hands soapy, raise one arm behind your head to spread out the breast tissue. Use the flat part of your fingers from the other hand to press gently into the breast. Follow an up-and-down pattern, moving from bra line to collarbone. Continue the pattern until you have covered the entire breast. Repeat on the other side.

Contraception & The HPV Vaccine

Some studies suggest that there’s a link between breast cancer and taking oral contraceptives, due to the high estrogen levels in some forms of the pill. If there’s a history of breast cancer in your family or it’s just an area of concern for you, it’s best to discuss with your GP when choosing the best method of contraception for you.

The HPV vaccine, which became more widely administered in Ireland from 2011 onwards, has been a controversial topic, as some believe it has more risks than benefits to the young women who receive it in their early secondary school years. Proven to greatly reduce the risk of developing cervical cancer later on in life, it’s definitely something all parents of young girls should consider.

Just like with all vaccinations, a slight risk of side effects/complications is present but in the vast majority of cases, the HPV vaccine is administered hassle-free and could potentially save the life of your sister, daughter or best friend.

Cancer in females under 40 is stealing the opportunity for so many career goals to be achieved, snatching young mothers from their children and forcing families to say goodbye to their precious women, far earlier than they should have to. If there’s one thing you do today, make it that you sit down with a cup of tea, grab one of the wonderful women in your life and get talking about the importance of early cancer prevention and detection.

Emma’s latest book, Letters To My Daughters, reached #1 in the Irish book charts in the weeks before her death and has so far raised over  100,000 for Breast Cancer Ireland. It can be purchased both online and in bookshops nationwide, with a number of providers donating all profits to BCI.

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