From imbalanced hormones, to PCOS, to cervical caner

Karen Mohammed-Dias is a survivor. Although she questions the word and its meaning in her situation, she is nevertheless a survivor. She was diagnosed with Stage 1B1 Cervical Cancer in 2018 and because of its early detection, she was able to have surgery and successfully remove her cancerous cervix.
To this day, five months after her surgery, she is still grappling with the fact that she may never see a child of her own and if she had asked more questions, then maybe it could have saved her some trouble. She is slowly accepting that she may never know the answers to those questions and is forging ahead.
Looking back on her journey, Karen said that she has always worked hard to ensure that she could afford the best possible care whenever she fell ill. That meant that she would be visiting the best of the best private doctors to ensure that they have all the answers to her questions. However, as she found out that was just a figment of her imagination. She chronicled her journey pre cancer to post cancer and this is part of what she wrote:
“In 2009/2010 or thereabout, I visited a private gynaecologist with the complaint of irregular periods – once every 3-4 months, as far as memory serves. I was then gently informed that I had what is called ‘Imbalanced Hormones’ and was written a prescription for Mircogynon (an oral birth control pill). It sounded odd, as I wasn’t told how contraceptives were going to help me with this kind of issue. However, I accepted and left, because I paid and expected him to know what he was doing. It worked! I was happy. I felt normal again. Without questions, I used the pills for approximately 8-9 years.
“In 2017 while still taking the pills, my period came twice in one month. That confused me a bit since the birth control pills are meant to regulate your cycle (as I now understood). I went to the pharmacist and asked for something to stop the bleeding. Thankfully, she advised me to go do an ultrasound instead, to ensure it wasn’t the cause of something more serious. I subsequently visited Eureka (Medical Laboratory) to have my ultrasound done, and found out I had a condition known as PCOS – polycystic ovarian syndrome – where you ovulate a lot less.
“Upon advice at home, I sought a second opinion. Of course I’m going to go to a private doctor, this sounds serious, I remembered thinking. Here we are at doctor number two, who took me off of the birth control pills and told me to return when my period does. I bounced in there three months after, all happy that progress was made, only to be sent to do all sorts of blood tests and ultrasounds – this was not cheap, but necessary, I reminded myself. I did all that was required of me, to come back to the conclusion that I had PCOS.
“I was placed on Metformin – a known diabetic medication, Metformin likely plays its role in improving ovulation induction in women with PCOS through a variety of actions, including reducing insulin levels and altering the effect of insulin on ovarian androgen. (I only know this because this time I researched). So, I’ve accepted that when I’m ready to have a child, it won’t be easy, I knew that much. I walked away with my meds, but with no deadline on when to quit these.
“My cycle became regular with the use of Metformin, I’m happy again. It was time my husband and I thought of starting a family. I needed a gynaecologist I was comfortable with, happy with. I was out of options, as you hear horror stories when you ask for opinions.
“In May 2018 after my birthday, I decided to find myself a doctor, seriously this time. I wasn’t getting younger. My cousin recommended her gynaecologist to me, said she was pleased with him during her pregnancy.
“Day one, I explained my known history to him, and I told him I was there to see if the PCOS was gone, and wondered what my next step was for starting a family. He advised the discontinuation of the Metformin, and encouraged weight loss. I was instructed to get undressed behind the wall, for a physical examination. At that point, I was asked one question, ‘have you ever done a pap smear?’ Answer, ‘No.’
“He didn’t seem too pleased. Upon visual observation, I was told that I had a mass in my cervix and he wanted to do a biopsy to ensure it was non-cancerous. He did say I didn’t have to take his word for it, that I should get a second opinion if I wanted to. Prior to that, I was instructed to return with my husband to discuss this before making arrangements to have a biopsy done. Within the following week, the biopsy was performed, and the results were out the next.
“My husband and I returned to the doctor number three; unfortunately, it’s what we feared – cancer. He advised me of all the possible treatments and operations, but admitted that he needed to hand the case over to the oncology department at GPHC [Georgetown Public Hospital Corporation], as it was then a case he no longer had control over.
“As my husband and I were clueless as to our whereabouts at GPHC, my gynaecologist volunteered meeting the oncologist-gynaecologist with us. After reviewing all tests and results, I was again physically examined. I was sent to do blood tests, a chest x-ray, and a CT scan; to determine whether the cancer has spread, and size of the tumour. Thankfully, it had not metastasised and was just confined to the cervix – early, but not that early to avoid what had to happen next.
“I was advised I’d have to have a radical hysterectomy done where the surgeon takes out the uterus and the ligaments (tissue fibres) that hold it in place. The cervix and an inch or two of the vagina around the cervix are also removed. ‘But, can’t we take the cervix out and try to have a child, and then we do the hysterectomy?’ I asked. I was told this was possible but if I did and needed radiation after, I’ll no longer be fertile.
“My procedure was scheduled for two months after, as I needed to wait until an oncologist specialist would have been visiting GPHC – apparently this happens every few months. I had two months to deal with the acceptance of the present, what my life will be like after a hysterectomy, what it meant, and long-term side effects. Everything I could possibly find to educate myself, I read. The surgery was done successfully.
“Ladies, use my life-threatening scenario, to avoid this happening to you. Ask as many questions as you need to. There are no stupid questions. If you don’t know what to ask, suggest some close relative or friend to go to your doctor’s visit with you.”
Karen advises that every woman get their yearly check-ups and young girls be afforded the opportunity to get the HPV vaccine which she could not have gotten.
At 29 and almost four years into her marriage, there are now complications because of her not being able to conceive. She says she is thankful for the support of her husband and those around her during her illness and the continued support, as she is still doing everything to ensure that she is in complete remission.