What happens if you have an abnormal Pap test
If a woman has an abnormal Pap smear, her gynecologist may test for HPV or do a colposcopy, a procedure in which a doctor uses a special scope to closely examine the cervix and take samples.

If this test reveals cells that are abnormal but not precancerous, a woman can have this tissue removed. If cancer has developed and spread more deeply into the cervix, it may still be possible to have the tissue removed—and many woman can go on to have children. But when the disease is more advanced, more extensive surgery is necessary, along with radiation.

That was the case for Smilow. Childless, she was offered the opportunity to take part in a research study to have the tumor removed but retain fertility. Some of the women in the study had become pregnant, but there were no long-term results on the risk of their cancer recurrence. “I did a lot of soul-searching,” Smilow recalls. “I knew that if I was going to have a child, I didn’t want to then die of the disease, so I decided to have a radical hysterectomy.”

She had the surgery and underwent a course of radiation. She was also given the option by her physicians to receive chemotherapy, but she chose not to for several reasons. Chemotherapy drugs available at the time did not specifically target cervical cancer. In addition, the drug of choice was cisplatin, which can sometimes cause deafness. Smilow, a singer and musician, wanted to keep her organs as healthy as possible for as long as possible and didn’t want to risk hearing loss.

Smilow recovered from the surgery, married her boyfriend, and adopted a daughter. But seven years after her diagnosis, doctors found several tumors in both of her lungs. She underwent two surgeries to remove the tumors, which left her with diminished lung capacity. “The next year was emotionally very difficult,” she recalls.

But the disease didn’t return. Smilow has rebuilt her lung capacity by singing and swimming. Her career as a performer and composer has taken off. And she revels in being a mom.

“I feel really good about all the decisions that I made,” Smilow says. “I’m really happy that I was a strong partner in directing my own health care, including the decision to reject chemo. I think that as a result I’m in really good physical and mental health.”

“The only thing I would have done differently in this entire scenario, if I could change anything, would have been to have annual Pap smears,” she says. “I get annual letters from my dentist letting me know that I need a checkup … there’s no excuse for women across this country to not get a letter from their doctor indicating that it’s time for their Pap smear. It’s a simple fix.”