An excerpt from Pet Goats and Pap Smears.
Joy is a vibrant twenty-six-year-old woman who comes in for a physical. On her exam, she shows me a worrisome mole on her left shoulder. I recommend she return for removal. After the excision, I call her back to my office for results.
“You have a melanoma. We got it just in time, but I’m sending you to a dermatologist who will perform a wider excision—just to be safe. You should be fine.”
She’s concerned, but relieved. “What should I do?”
“We don’t know the exact cause of melanoma. It’s not like other skin cancers. You can get melanoma in areas of the body that are not exposed to the sun. A friend of mine [the illustrator of this book] developed melanoma inside her vagina—on her cervix!”
“So what do I do?” she begs.
“Keep your immune system strong. Avoid sunburns and carcinogens. Eat healthy. We’ll do skin checks every year.” As Joy’s physician and friend, I’m also relieved. Melanoma can be fatal and metastasizes quickly. Had she waited a year, she could be dead.
Joy returns for her annual exams. It’s been four years since her melanoma removal.
I call her with results the following week. “Your Pap smear looks great, but your test for human papillomavirus (HPV) reveals a high-risk strain that can predispose you to cervical cancer.”
“What should I do, Pamela?”
“Don’t worry. Though ninety-nine percent of cervical cancers are caused by HPV, most HPV infections resolve spontaneously. And most sexually active adults have had HPV. It’s the most common sexually transmitted infection in the world.”
“Weird. A sexual infection can cause cancer?” she asks.
“Yes. HPV-induced cancers can occur in the vagina, vulva, anus, and penis. It’s also linked to cancers of the tongue, tonsils, and throat!”
“So what can I do to prevent getting cancer from the HPV infection?”
“There is an HPV vaccine that is approved for males and females age nine to twenty-six and is best given before any sexual activity. Since you’ve already been exposed, keep your immune system strong. Avoid smoking, alcohol, and carcinogens. Eat healthy. Be monogamous. The fewer partners the better! Come back next year and we’ll do your Pap and HPV test again. Your body could clear the infection on its own.”
“Is there anything else I can do?”
“Are you religious?”
“I have a spiritual practice,” Joy says. “One of the things I do is meditate. Sometimes at an altar, such as my love altar.”
“After your meditation, I’d like you to do a prayer to clear this virus from your body.”
“Great. That’s a wonderful idea.”
A year later, Joy is back for her physical, repeat Pap, and HPV test.
“How are things going?”
“Oh, I’m in love! We are living together and things are great!”
As I perform her exam, I share the latest breakthroughs in Pap smear technology. “Joy, when I first trained, we had to twirl a small wooden spatula around the cervix and smear cervical cells and mucus onto a glass slide. Then we had to spray it right away with lots of hairspray!”
“Yuck!” she says.
“It was disgusting. I spent years coughing up hairspray fumes after Pap smears.”
“But why hairspray?” Joy asks.
“It’s a fixative for the cells. But some samples were still not adequate for analysis at the lab. So we’d have to call patients back for another smear and spray.”
“Oh, that sounds awful,” Joy says as I’m doing her Pap.
“Now we use a liquid Pap test. We rotate this little wiggly broom around the cervix and then swish it in this container of preservative solution. The lab can retrieve as many samples as they need from the liquid. They can do your Pap and HPV test, plus test for gonorrhea, chlamydia, herpes, cystic fibrosis—all from this tiny jar!”
“Amazing!” Joy exclaims.
“And no hairspray!” I add.
As Joy gets dressed, I label her specimen, drop it into a biohazard bag, and hand it to her.
“Here’s your Pap. Take it home. Drop it off at the lab down the street in the next thirty days. You don’t need to refrigerate it. Place your Pap on your prayer altar. You and your partner can do a special prayer together every night to release the HPV from your body.”
“We’ll do it, Pamela!” she says.
One month later I call Joy. “Did you do your Pap prayer?”
“Yes. We did it every evening and it brought us closer together. I really appreciated that we were able to connect spiritually.”
“Great. You’ve got a normal Pap smear and no HPV!”