Navigating Cervical Health: A Young Woman's Perspective on Cervical Cancer

Written by Melissa Schenkman, MPH, MSJ

Timing is everything.

It’s a phrase we’ve often heard, and it could not be truer than in the case of women’s healthcare.

While we are very fortunate that today’s cervical health screenings are advanced with Pap smears and HPV vaccines, the timing of the availability of the vaccines and confusion over changing guidelines for when to get a Pap smear have led some women to miss getting the preventive care they needed at the right time.

Avitall Grant-Noonan is one of those women.

Like many of today’s older millennials, the now 38-year-old Inventory Analyst was already in her 20s when the HPV vaccine (which was recommended for 11-12-year-olds) became available to the public. On top of that, in 2000, Pap smear screening guidelines changed from every year to every three years after age 21, depending on a person’s risk factors.

Those are two possible reasons behind the results of a newly released report from the American Cancer Society showing cervical cancer cases on the rise in women in their 30s and 40s, having had a steady increase from 2015 to 2019.

For Grant-Noonan, keeping up with those screenings and her health overall got put on the backburner after becoming a young mom to a child with special needs. With no family history of cervical cancer and little knowledge about disease, it was not something that was on her radar.

It was not until her and her husband were unable to get pregnant, she had a miscarriage in 2019, and then continued to not conceive that her tests revealed why. She had stage III cervical cancer.  

Now, she spends much of her time advocating for cervical healthcare for young women and cervical cancer awareness.

“There is a huge stigma that the world has put on top of cervical cancer. It is said that people get it because they are promiscuous, and that is untrue. It comes from HPV, and we are all exposed to it at one point or another. So, we all have the potential to get cervical cancer in our lifetime,” Grant-Noonan emphasized.

“It’s like people hold something over it and that you cannot talk about it. I say ‘No, we have to talk about it. It’s something that needs to be spoken about.’”

Physical and Emotional Challenges of Diagnosis and Treatment

In 2021, Grant-Noonan and her husband were newlyweds after dating for years and were anxious to have a child together. So, when she was unable to successfully conceive, she sought answers from her regular OB-GYN.

“I knew something was going on and that something was not right. I’m at the age where I should be able to get pregnant without an issue, and I felt like something was growing,” Grant-Noonan said.

She felt like her current gynecologist was not listening to her, so she sought a second opinion. That second opinion saved her life.

After getting two normal Pap smears, her new gynecologist decided to dig further for answers, and performed a colposcopy—a procedure using a lighted microscope called a colposcope that magnifies the tissue lining the cervix and the vagina, making it possible to see abnormalities and take tissue biopsies.

The test finally gave her answers, but not the ones she would have ever expected. She had Stage III Cervical Cancer, and at 35 years old, Grant-Noonan was blindsided by her diagnosis.  

Grant-Noonan and her husband around the time of her diagnosis.

Her gynecologist oncologist at Miami Cancer Institute put her in touch with a fertility specialist to see if it was possible to preserve her eggs before starting treatment. The specialist said it would take three months to save some embryos.

When Grant-Noonan went back to her oncologist with this news, his response was: “You don’t have three months. We needed to start treatment yesterday. You can go ahead and wait three months, but you probably won’t be around to see a child grow up.”

Grant-Noonan and her husband were completely taken back by this statement, and made the decision right then to seek treatment immediately. His support throughout her treatment and survivorship has been instrumental.

“The fact that I’m never going to be able to carry our child was really hard for me. I still struggle with it. I cried and cried, but my husband was there all the time,” she recalled.

“He said to me, ‘That’s not a dealbreaker. If we cannot have a child naturally there’s other ways Avi and eventually, we’ll get to that. Once we know you are okay, and we know you’re going to be around for a long time, we’ll get there. We don’t need to worry about that right now.”

That gave her the level of support she needed to get through all she would have to endure and overcome. Within three months’ time, she was prescribed six rounds of chemotherapy with cisplatin (of which her body could only handle four), 52 rounds of external beam radiation, and five rounds of internal radiation, also known as brachytherapy.  

She describes brachytherapy as the most brutal thing in the world and barbaric, and shared that a group of women are currently working on creating a device that makes it less painful to endure.

The life-saving treatments took her directly into early menopause and between that, the loss of her fertility, and isolation at the time of treatment which was at the beginning of the COVID-19 Pandemic, all of it took a huge toll on her mental health.

Yet, thanks to the support of her husband, mom, dad, sister, brother, and friends, she made it through.

They ensured she never attended any appointment alone, ate healthy, took regular walks, and very importantly had a standing manicure and pedicure appointment every two weeks—crucial for helping her maintain a positive self-image throughout the process. Her boss also assured her from the start that the job she had for more than a decade was going nowhere, and he would call just to see how she was feeling.

Grant-Noonan being supported by family during one of her treatment appointments.

Transitioning to Life After Treatment

Life after treatment took some time to adjust to because Grant-Noonan thought she could back to life full-speed ahead like she did before. She was used to taking care of her daughter and husband and working full time, but she quickly realized she was in for a marathon and not a sprint.

She started suffering from anxiety and even panic attacks because of how much and how fast she tried to going back to doing everything. Therapy, which was key in helping her cope with toll of chemotherapy and radiation, also helped her recognize this, and to take things more slowly.

Understandably, she still struggles with the loss of her child and her fertility, but through time and therapy has gotten to a place where she can feel genuinely happy for other women when they announce their pregnancy.

That said, cancer changed her perspective on life as a millennial in a really profound way.

“Everybody tells you life is too short, but once you go through something like I have gone through life is really too short. It can change in an instant! So, I have realized you have to enjoy every single moment,” Grant-Noonan emphasized.

She pointed out so many of us worry about money and wait to save up to do things, but do not do it.

“If you want to go on a cruise or go to Europe, go, book that trip. Do not sit around and say ‘I don't want to do it right now because I don't have money.’ We all know money comes and goes. We all have credit cards. Put it on a credit card. You know what? The time is now,” she said. “Don’t sit around and wait for tomorrow because what if tomorrow doesn’t come?”

It's what she lives by now.

“You have to enjoy every single minute because at the end of the day that is what’s going to stay with us. And if we don’t enjoy the time that we have here on Earth, what are we doing?”

Grant-Noonan, her daughter, husband, and one of their dogs.

Perspectives as a Survivor

As soon as Grant-Noonan entered the survivorship phase of her cancer journey, she knew she wanted to be a cervical cancer and health advocate. Yet at first, she did not know what kind of footprint she wanted to leave.

She joined Cervivor, a group for women with cervical and other gynecological cancers. They’ve become a lifeline for her. Last year, she attended Cervivor school in Seattle and it was amazing.

“I learned how to advocate and be a better advocate. I learned how to use my story for women to learn and to educate others about HPV and cervical cancer, and to also be a beacon of knowledge for others,” Grant-Noonan said.

Once she came back home to Miami, she made it her mission to get proclamations from Miami-Dade County and the State of Florida to proclaim January Cervical Cancer Awareness Month. The state proclamation was a long shot, but she got it!

Ironically, as life would have it, she has been fundraising for many years for the Miami Dolphins Cancer Challenge, something that has taken on a whole new meaning since her diagnosis. This will be her ninth year serving as team captain for the challenge and last year her team raised $11,000!

She is also working to raise money for cancer research at the University of Miami’s Sylvester Cancer Center, working to get the “game changer”—a van designed for doctors to provide pap smears to patients on-the-go—making the screenings more easily accessible.

She is working to bring the van to Florida International University to make it easier for students to have access to Pap smears for early detection, and working companies in Florida to bring the van to them for on-site screening access for employees.

Grant-Noonan proudly holding the proclamation from Miami-Dade County proclaiming January as Cervical Cancer Awareness Month. She advocated for the proclamation and recognition of the awareness month both at the city and state level.

How Young Women Can Be Proactive About Cervical Health

Another big part of Grant-Noonan’s advocacy work is bringing parents and young women a reality check when it comes to HPV vaccine.

As an advocate and a parent who has given her daughter the HPV vaccine, she publicly dispels misconceptions about the shot like how only girls can get it (not true boys can too) and that it promotes promiscuity. As she has explained to many, the vaccine does not give kids a license to be sexually active with whoever they want, instead it’s an investment in their health.

“You always want to be the proactive parent and give your child the extra protection that they might need later on in their life,” Grant-Noon told me. “I always tell them ‘You never want your child to go through the cancer that I went through, especially if it’s a girl.’”

She cannot stress enough how incredibly important it is for young women to make the time to get recommended cervical cancer screenings—pap smears and HPV tests. And how it is vital for young women to be proactive by educating themselves about cervical cancer risk factors and signs, always being in tune with their own bodies, and to be their own advocates when they have concerns.

 “Always stand up for what you believe. If you feel something's going on with your body, and your doctor’s not listening, change the doctor. If you look for another doctor and that doctor is not listening, find another doctor. Find somebody that will listen to you,” Grant-Noonan emphasized.

“I was told I was too young for cervical cancer, and I had cervical cancer. If you go to the doctor and request a cervical cancer screening, and they say, ‘You are too young,” demand the things you are requesting. Same thing with mammograms,”

This is why she is such an open book in talking about her story. She hopes it will lead to closing the chapter on this painful and challenging disease.

“I want us to be the last generation to deal with cervical cancer,” she said.

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