As an Owen High senior, Hali Ledford watched through tears as a hairdresser cut her mother's long, brown locks before they were lost to chemotherapy.
Sherry Ledford was diagnosed with stage four cervical cancer in the spring of 2008; despite a full hysterectomy, she died less than a year-and-a-half later. Even with short hair, Hali recalls, her mother was the most beautiful woman she'd ever seen.
"I got through my first year of college at UNCA, and mom got sicker," she wrote in her testimonial for the American Cancer Society. "I didn't think my time with her would ever run out, but it did. That summer she got really sick and couldn't fight anymore. On July 27, 2009, I lost the most important person in my life."
January is Cervical Cancer Awareness Month, reminding women about the importance of regular pelvic exams for HPV and cervical cancer prevention. Every year, Ledford tries to increase awareness of the disease that took her mother's life.
"The first January that my mom passed, I made teal-and-white ribbons and handed them out to all our family members to wear on our shirts, because you don't see that ribbon often," Ledford reveals. "People are used to seeing the pink ribbon for breast cancer or red ribbon for AIDS awareness, but when people see that ribbon and ask, ‘What is that for?’ you can say 'cervical cancer awareness,' and then they know."
In 2011, about 12,710 new cases of cervical cancer were diagnosed, and 4,290 women died from the disease, the American Cancer Society estimates.
Between 1955 and 1992, the cervical cancer death rate in the United States dropped 70 percent due to increased use of Pap smears. Regular pelvic exams can help doctors catch cell abnormalities before they become cancerous and diagnose cervical cancer when it’s more treatable. During the exam, doctors look at the cervix, the lower portion of the uterus where it joins the top of the vagina, and collect a sample of cells using a small brush.
Ledford believes regular checkups could have caught her mother's cancer before it was so advanced. "She wasn’t getting them regularly. When I talk about cervical cancer awareness, one thing I stress is for women to have regular Pap smears, because it does save lives," she explains. "If my mom had had one just a year earlier, she would probably still be here."
Many women postpone gynecological visits because of the potential discomfort and awkwardness surrounding pelvic exams. "People don't like to think about, talk about or have doctors do anything about 'down there,'" notes Amy Lanou, associate professor of health and wellness at UNCA.
Misconceptions can also hinder reproductive health. "There are myths, like you only need gynecological exams if you're sexually active. But those parts are still there and being used even if you're not," she explains.
Another source of confusion is the role of HPV, a common sexually transmitted infection. Although more than 99 percent of cervical cancer diagnoses are related to HPV, the virus doesn’t cause the disease, and not all cervical cancers are related to sexual activity, the Cancer Society stresses.
Another barrier could be the recent change from recommending annual Pap smears to one every other year, starting at age 21. Lanou believes that may have been a mistake. "I understand, from a public-health standpoint, why they've done that: to save money. And there’s not a big difference between a year and every other year. But I think individuals hear they don't have to have it as often, and that decreases the importance of it."
Anyone nervous about getting her first Pap smear should try visiting Planned Parenthood with a friend for support, she suggests. "They're there to help you, and doctors are too, but somehow it's just a little friendlier. There are people there who aren't the doctor or the nurse who will understand what’s going to happen," Lanou explains. "People hear Planned Parenthood and they think it's all about contraception or abortion, when really it's about good gynecological care."
For Ledford, the fear of cancer outweighs a few minutes of discomfort. "As uncomfortable as a Pap smear is, going through cancer treatments is a million times worse," she points out. "It's not only hard on yourself, it's difficult on everybody around you. Once you've seen someone go through cancer, it's always in your head."
Last March, as part of her own healing process, Ledford got a tattoo on her back honoring her mother and promoting cervical cancer awareness. "It never fails. Someone will ask me what the history behind my tattoo is," she notes. "I'm more than proud to say, 'This is a cervical cancer ribbon, and the dove is for my mom.' Usually someone will follow that up with, 'Can you tell me more?' And I'm glad to say yes."
— Megan Dombroski is a senior journalism student at UNCA.