DESCRIPTION:
In late 2018, Samina Cepal went in for her routine pap smear, but her visit turned out to be anything but routine. It led to a CT scan, a pelvic ultrasound and a diagnosis of cervical cancer. Samina underwent a grueling regimen of chemotherapy (cisplatin) and radiation therapy, simultaneously. She experienced acute fatigue, weight loss, hair loss and despair, but three months later, her doctor said she had no evidence of disease. These days, Samina can exercise, which includes vigorous use of a hula hoop, and has regained her appetite and her pre-diagnosis weight.
Samina Cepal referred to her annual pre-Christmas pap smear as her gift to herself. She had never experienced anything abnormal with any of her previous pap smears, and had every reason to think this visit would be no different. However, when the nurse noticed bleeding, she wanted Samina to be seen by a doctor. The doctor ordered a pelvic ultrasound and said it appeared Samina had cancer. A subsequent biopsy revealed she had Stage 3B cervical cancer.
In early 2019, Samina began a regimen of chemotherapy, which morphed into a simultaneous regimen of chemotherapy and 28 doses of radiation therapy. While Samina now makes her home in Birmingham, United Kingdom, at the time she was living in her native island of St. Lucia. Limited resources forced phases of her treatment to take place in Martinique and Guyana.
Her treatment regimen concluded with brachytherapy, which included painful insertion into her vagina. Samina barely had any energy but was determined to survive because she wanted to be there for her two teenage sons.
Three months from the time she was diagnosed, she was stunned to hear from her doctor that there was no longer any evidence of disease. Samina had little strength, but she found a way to fly home to St. Lucia, in time to be present at a celebration of her son’s eighteenth birthday.
Samina is amazed when she thinks of how much she has overcome to return to almost the same level of health she enjoyed prior to her diagnosis. She enjoys long walks, gets to workout and exercise, and really enjoys using her hula hoop.
Additional Resources:
Cervivor: https//:www.cervivor.org
TRANSCRIPTION:
Bruce Morton: This is the Cancer Interviews podcast, and I’m your host, Bruce Morton. Our guest thought she was going in for a routine pap smear. However, that visit was the start of a sequence of events that led to a diagnosis of Stage III cervical cancer. She is Samina Cepal of Birmingham, United Kingdom. Hers is a story of hope and survivorship, and now it’s time to hear that story. Samina, welcome to Cancer Interviews.
Samina Cepal: Thank you.
BM: Samina, before we get to the story of your journey, we would like to learn a little bit more about you, and your life away from cancer. So, if you would, tell us a bit about where you are from, what you do and have done for work and what you like to do for fun.
SC: As you said, my name is Samina. I am from the beautiful, warm Caribbean island of St. Lucia. I became a nurse in 1998. I have two lovely sons, was married for a very long time. What do I like to do for fun? I like to hulahoop for fun. I hulahoop every day. I like going on very long walks, and that is basically me.
BM: Samina, for all of us diagnosed with cancer, there was that point when things regarding our health went from normal to abnormal. In your case, when did you get an idea that your health was taking a turn for the worse?
SC: Bruce, well is a strange thing because there was never anything unusual. I was well. I was living my best life. What I did every year in December was to get my pap smear done. It was my Christmas gift to myself. The holidays were coming in 2018 and because I had been a nurse for so long, I would just call one of my nurse friends at one of the health centers and say to them it was time for my pap smear, and 2018 was no exception, so I just showed up for my routine pap smear. I had not missed any pap smears in the past and I had not had any abnormal pap smears prior to that time, so I was fine, I was well. No signs of illness, nothing was wrong at that time.
BM: But at some point, the doctor must have seen something that you found disconcerting.
SC: When I went for the pap smear that day, when she put the speculum in, she said she thought I wasn’t getting a period. And I told her I wasn’t getting a period. Then she said I had just started bleeding, and I saw this look of concern on her face. I wanted to know what was going on. That’s when she said she needed to get a doctor. At that time, I felt a bit of physical discomfort, still not aware of what was about to happen. She pulled a doctor out of a clinic. The doctor came, examined me and said he wanted my friend to do a pelvic ultrasound, “now.” Again, she said I was bleeding, that there are huge clots, and that is where the story started.
BM: And what happened next?
SC: That was the 17th of December, 2018. Because of the time of day, I couldn’t get the ultrasound, so I had to wait until a day later; but I had another friend who was working at my gynecologist’s clinic. She agreed to come into the clinic early the next morning. I knew at that point that something was wrong. I didn’t know what it was, but something was wrong. This gynecologist had seen me for years. I told him about the bleeding from the day before. He put the speculum in and his face changed. That’s when he told me I had cancer. He was holding my hand and was very gentle about it. He brought in my friend from another room and we cried together. Then the doctor returned and did a biopsy, and he asked me to take it to the lab. I walked out of his office like a zombie. It took me half an hour to remember where my care was parked. I drove to the lab, gave them the sample and said I needed the results urgently. That was on a Tuesday. By Wednesday I had to do the ultrasound, but learned to do it, I had to go to another island, but by then I knew what was going to happen. I had been in oncology long enough to know, so I called the oncologist and let him know what happened. He called a gynecological oncologist and was told it was Stage 3B cervical cancer. I called my mom, who is also a cervical cancer survivor, explained to her my diagnosis. Then I called my sons and told them what the situation was. I spoke to my sister, my dad, everybody who mattered. I said this is what’s happening, and we are going to fight, and I need my village to fight with me because I knew I couldn’t handle it alone. This was Christmas 2018. The doctor said we would start the chemotherapy after the first of the year, but I said we needed to start right away, and if he couldn’t find a nurse, then he would be my nurse; but I called a nurse friend, and she said she would be able to do it. So, on New Year’s Day, 2019, we started the chemo. I had one round of cisplatin, which is a whole other story by itself. About two or three days later, I traveled to Martinique to get the CT scan and MRI done. I was back in another two or three days. I was feeling sick. I was starting to feel weak. I didn’t know if it was the knowledge of the cancer or the stage of the cancer. A lot of things were going on. I was feeling severe abdominal pain. These were the first two weeks of January 2019. By January 17, I was able to source the Cancer Institute of Guyana in South America, and I went there. I got on a plane by myself, and I just went. The oncologist told me I would never have another period and that my vagina would never get wet again. I was alone in the office trying to process all this. I was 41 years old, going into menopause. My prognosis was poor, and I was alone. Anyhow, we started treatment. I had 28 treatments of radiation therapy. By then, my hair was coming out in big pieces. Everywhere I had hair on my body, it was falling out. By then, I wasn’t able to eat, but when I did, I had vomiting and diarrhea. I lost so much weight. Every Wednesday I underwent chemotherapy. So, it was chemotherapy concurrent with the radiation therapy. The only time I had off was on the weekend. I was not prepared for how burnt my vaginal area would be. The other thing with treatment was that I was not allowed to have a shower. I could only wash myself from the shoulders up, but the rest of me could not be touched by water. One could only imagine how bad I was smelling. That is the truth. Those are some of the realities that people don’t talk about, but they were painful. I cannot remember having that amount of pain in my life. I started in Guyana in January 2019. Then in February, I had my first session of brachytherapy. It is internal radiation. They put something like a skewer, and it is pushed into your vagina, which is already a burnt, roasted, black, smelly area. As it moved around, I could feel the pain. I just cried and cried. The second one was on March 6, and it was just as painful as the previous one. One time the pain was so acute, I just passed out. I could hardly eat or drink, I just kept fighting because I needed to complete this treatment. I needed to be there for my sons. My last brachytherapy session was on March 13, and I remember those dates so clearly because I remember my son was turning 18 on March 16. I was in Guyana, and I wanted to be home with him for his birthday. I had CT scans, I had a whole set of tests done, and the doctor said to me, “You are good. There are no abnormalities detected.” And I thought, that was what what I was fighting for. That was for my sons. So, on March 15, when I went in for my final checkup, I asked if I could go home. He said to me if I thought I was strong enough and if I thought I was brave enough, and if you think you can, you can go home. On the morning of March 16, I got on a plane, and I went back to St. Lucia. This was three months after being diagnosed. Everything happened in that three-month window. I had chemotherapy, I had brachytherapy, I had radiation therapy. I fought and I survived.
BM: We are confident you’ll be able to learn some tips and tools to help you through your cancer journey, but first we’d like to invite you to please give us a ‘like,’ leave a comment or review below and share this story with your friends. Kindly click on the ‘Subscribe’ button below and click on the bell icon, so you’ll be notified the next time we post an interview. And if you or a loved one are facing a cancer diagnosis, please click on the link in the Description and Show Notes below to check out our free guide, “The Top Ten Things I Wish I Knew When I First Got Cancer.” Finally, we want to remind you that we are not distributors of medical advice. If you seek medical advice, please contact a licensed healthcare professional.
Samina, you were in the unusual combination of being a patient and being a nurse. What challenges did that combination present?
SC: It was so humbling. You go from being the advocate. You go from looking out for the patient. I was an oncology nurse, and there I was, on the bed, and no longer the nurse. At that point being a nurse didn’t matter. All the experience I had, all the knowledge I had, it didn’t matter. I was the patient. I was the one diagnosed with cancer. At the beginning, the words couldn’t even come out of my mouth. I had encouraged so many people along this journey. I had been the one to tell so many people to keep fighting, and I found myself in the worst position of having to fight, and having my hair fall out. So many times I told patients, it’s only hair. It will grow back. Now my hair was falling out and I had to tell myself that it’s only hair. I had to encourage myself. So many times I told patients they had to eat, and now I couldn’t eat. There I was depending on somebody else to wash my body. There I was going t radiation ad having to expose my body. I had no privacy. But I can tell you the experience has made me a much better nurse. I have learned to be a lot more empathetic, and I understand better what a patient is going through. I understand why patients behave the way they do.
BM: But after all you went through, you made it. You made it to survivorship. How exciting was that?
SC: Up to that point, I thought cancer was the most difficult thing I would ever have to encounter in my life. So, when my son turned 18 that Saturday, I showed up. My car was parked at the airport. I showed up and I had just enough strength to get in my car and drive home. I was crazy to have done that, but I did it. When those kids saw me, those kids could not believe it. One of them, “You are alive, you are so alive,” and we all started crying. My son, Chaz, I just held him because I was afraid this would be my last birthday with him. I mean, I knew that I had survived cancer, but it would take a little time to understand that I was well, I have overcome, I have survived, and it can only get better from here. This was March 16, 2019. Unfortunately, on August 31, my son, Chaz, was driving home, was involved in a crash, and died. Up until that morning, I thought cancer was the most difficult thing in my life; but this was me, five months post-cancer, still not altogether well, my hair had not grown back properly, and I was as skinny as a stick. There I was, having dealt with all of this, and now for me, it was cancer survival and grief. But I have to tell you, if I had not survived cancer, there is no way I would have been able to survive m son’s death because I felt like I had fought the worst fight of my life and it strengthened me to fight through that part of it, the grief. So, it was cancer and grief and survival in 2019.
BM: Samina, we are going to bring this to a close, but I do want to ask you something I suspect a lot of viewers and listeners would like to know. If you could classify your health, pre-diagnosis, as 100 percent, how would you classify it now? What can you not do now that you could do before you were diagnosed?
SC: I cannot have a child because I no longer have a womb, but otherwise I am well. I exercise, I work out. I am healthy. I am able to do everything that I was able to do pre-diagnosis. I am well, and this is not me pretending, and just saying this. I am absolutely well. I have had thyroid disease a long time. I take my medication, so I have been living with that. I am fine.
BM: That’s priceless. Thank you, Samina, for sharing a story of grief, hope and survivorship. Thanks for being with us on Cancer Interviews.
SC: Thank you, Bruce, for this opportunity.
BM: That will conclude this edition of the Cancer Interviews podcast. Until next time, we’ll see you on down the road.
Additional Resources:
Support Group:
Cervivor: https://www.cervivor.org
SHOW NOTES
TITLE: Samina Cepal, Cervical Cancer Survivor – Birmingham, United Kingdom
In late 2018, Samina Cepal went in for her routine pap smear, but her visit turned out to be anything but routine. It led to a CT scan, a pelvic ultrasound and a diagnosis of cervical cancer. Samina underwent a grueling regimen of chemotherapy and radiation therapy. She experienced acute fatigue, weight loss, hair loss and despair, but three months later, her doctor said she had no evidence of disease. These days, Samina can exercise, which includes vigorous use of a hula hoop, and has regained her appetite and her pre-diagnosis weight.
Additional Resources:
Cervivor: https://www.cervivor.org
Time Stamps:
02:06 Samina’s cancer journey began with what she thought would be a routine pap smear.
05:11 She is told to undergo a pelvic ultrasound.
06:11 Doctors said she had cancer.
08:23 She was given a specific diagnosis of Stage 3B cervical cancer.
09:23 Describes her chemotherapy regimen, which included cisplatin.
12:34 Samina said her treatment placed her in excruciating pain.
13:59 Said her brachytherapy regimen was extremely painful.
16:35 Recalls how she learned she had achieved survivorship.
19:42 Samina says it wasn’t easy being a patient while working as a nurse.
23:59 Says she was thrilled to have overcome so much to attain survivorship.
30:12 Samina is asked to compare her present health to her health before her diagnosis.
KEYWORDS (tags):
cervical cancer
pelvic ultrasound
chemotherapy
samina cepal
radiation therapy
cisplatin
pap smear
ct scan
brachytherapy
mri
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