Precancerous cells: One woman’s warning not to delay a Pap smear

When her doctor told her of precancerous cells after childbirth, the young woman ignored the warning. Decades later, she was diagnosed with terminal cervical cancer and now stresses the importance of not delaying Pap smears.
March 25, 2021
Kelly Brassette, with her daughters and her daughter's friend in Oregon. Faced with cervical cancer, Kelly's message now is to not ignore warnings of precancerous cells or delay your Pap smears.
Kelly Brassette with her daughters, Katie and Ally, and her daughter’s friend. Diagnosed with cervical cancer, Kelly’s message now is to not ignore warnings of precancerous cells or delay your Pap test. Photo courtesy Kelly Brassette.

Kelly Brassette is living in the moment, not for tomorrow, not for the day the COVID-19 pandemic ends, not for someday. She lives now.

At 47, she knows that time is a diminishing resource; there’s always less of it to waste. And so she strives every day to enjoy the now and to let her husband and two daughters know that she loves them. Dearly.

For those of us who aren’t part of her family, she has another message: Don’t ignore your doctor. And women, don’t skip getting your Pap smear, like she did.

Precancerous cells found after childbirth

Diagnosed with terminal cervical cancer, Kelly knows it’s far too late to rewind the clock. If she could, she’d take it back to 1999 when she was pregnant with Ally, her youngest child. Back then, truth be told, she didn’t get along with her obstetrician. When he sent her a letter in the mail saying she had pre-cancerous cells, she ignored it.

“Well, I was a kid, 24 or 25 years old, so you just put it in the drawer and it doesn’t exist,’’ she said. “I should have gone back to him and I didn’t go back to him, so that’s on me. So what I would say is, get your checkups and listen to the doctor and if you ignore it, it’s not going to go away, it’s just going to get bigger.’’

Eleven years later, in 2010, Kelly knew something was wrong.

“I was just bleeding all the time, and I am not a doctor person, I never get sick, I don’t get colds or strep – nothing. So to just go to the doctor was tough, but I did.  My gynecologist, I think he knew instantly, but of course, he had to verify his suspicions. He said, ‘If you get the postcard everything is good. If not, I’ll be calling you, and we’ll go from there.’” 

The risk of cancer is real

She had cervical cancer. A radical hysterectomy was scheduled, followed by a second surgery to remove her ovaries. After those surgeries, doctors believed there was no evidence of disease and she was, by all accounts, in remission, though there was always a possibility that the cancer could come back.

Kelly Brassette with her family in Bali. After her first child, he doctor told her he found precancerous cells but she ignored him.
Kelly Brassette with her family on Bali, an Indonesian island. Photo courtesy Kelly Brassette.

“That’s the stinker,’’ Kelly said. “You just need one little cancer cell to escape, and that’s that.’’

Several years later, Kelly began to feel bad. She had pain in her abdomen and trouble eating. When her husband, Paul, mentioned during an appointment with a doctor that Kelly had a growth on her belly button, the expression from the physician changed.

“He said, ‘You need to go to the lab right now.’ Kelly recalled. “It was a Sister Mary Joseph tumor, and that’s not a good sign.’’

Her daughters, Katy and Ally, were 21 and 15 when she learned the cancer had returned with a vengeance. Dr. Dirk Pikaart, her gynecological oncologist, delivered the bad news that she had Stage 4 cervical cancer that had spread to her liver. There was no way he could give her an exact timeline of how long she would live. He explained that data indicates that the sooner a person is diagnosed, the better their chance of survival.

That was in 2015, and each day since, she’s been purposeful about how she spends her days, who she spends them with, and her legacy.

“This sounds weird, but cancer has brought so many positive things,’’ she said. “The expectation for everyone around me is that you have tomorrow. But I don’t have that, so every day is important.’’

After the diagnosis, she and Paul, whom she had been married to for only a few months, decided the only thing they could do was just get through it. The first step was getting through six weeks of chemotherapy. Kelly did not want to lose her hair. She believed that if she lost her hair and looked sick, it would consume her. She and Paul researched “cold caps,’’ a technology for cancer patients that helps avoid loss of hair.

“Chemo was eight hours; it was all day. The cold caps were minus 30 degrees to minus 40 degrees, and we would walk into chemo with two coolers full of these Cold Caps,’’ she recalled. “We must have looked a mess, and I had maxi pads on my hairline so I wouldn’t get frostbite on my forehead and on my ears.’’

The cold caps worked, and Kelly retained her hair.

“It was phenomenal because when I looked in the mirror, I just saw me and that was good. That really helped, and I think for the kids’ too,’’ she said.

Kelly works as an autism and significant support needs coach with Academy School District 20. She says her co-workers and leaders in the school district have been phenomenal. She counts her blessings every day.

“My kids, they keep it real. There have been so many things that have happened, and they don’t let me wallow,’’ she said. “They don’t let me use it as a crutch. You know how great kids are. They’re like, ‘Mom, come on. You’ve played the cancer card plenty of times – get over it.’ They say it with love.’’

Kelly knows that her cancer is not going to go away. She has a CT scan every three months, and she hasn’t had chemotherapy since December 2019. She said cancer has helped her rekindle a relationship with her brother who, before the pandemic, visited every three months or so from California.

Dr. Pikaart, who has been a gynecological oncologist for 11 years, said each person he cares for has a different experience when battling cancer.

“It is interesting to watch people as they deal with the diagnosis of cancer and the phases of going through it, and whether they are curable or not,’’ Pikaart said. “I’ve noticed that cancer patients get a different window on the world, or different perspective so to speak, and I think I’ve learned a lot from patients like Kelly over the years.

“They realize what is really important, and they see life differently because they are forced to deal with the fact that they’re not going to live forever. Most of the time, when a person is forced to do that, they figure out what’s really important in life and it’s usually not what a lot of us are concentrating on. It’s not our material possessions and having this or that — it’s more about and family, relationship with God and those around them.

“I think it’s valuable to pay attention to some of these patients and watch their growth and maturity as they go through it. I have the privilege to do that quite often.’’

Pikaart says there is wide variability on how people do after being diagnosed with cancer.

“There are people like Kelly who live way beyond the median survival rates described in studies,’’ he said. “Statistics are often misunderstood. The way I explain it to patients is that the median survival is not how you will do, but how the average person in the same situation does. Most patients do end out near the middle of the curve, however, the reality is that half of the people do better than average. Our goal is to treat aggressively so that you end out better than the average or above median survival rate. We want patients on the far end of the curve or beating the odds.’’

The longer a person survives the more options they may get over the span of their treatment and lifetime. In the past couple of years, we’ve had some breakthroughs in immunotherapy that has become available for cervix cancer patients.’’

Kelly is certainly getting farther and farther on the end of the bell curve.

“She is beating the odds,” Pikaart said.

Kelly Brassette with her daughters. After Kelly gave birth to her youngest daughter, she ignored a letter from her doctor telling her she had precancerous cells. Now her message for others is to not delay their Pap tests.
Kelly Brassette with her daughters. After Kelly gave birth to her youngest daughter, she ignored a letter from her doctor telling her she had precancerous cells. Now her message for others is to not delay their Pap smears. Photo courtesy Kelly Brassette.

Cervical cancer screening

Pikaart says screening for cervical cancer is paramount and has helped reduce deaths as a result. He added that human papillomavirus (HPV) vaccines may help to reduce the rate of cervical cancer as more and more people become vaccinated.

“When I think about Kelly, if we could have prevented her from ever needing to come see me, it would’ve been the best-case scenario,’’ Pikaart said.

Kelly says that what is important now is sharing as much time with family as possible. She advises people to make a list of what is important to them and to work on that every day.

“I have made so many lists, what is important, bucket lists. What do I want to do? How do I want to be remembered and once you see it you can kind of go off that,’’ she said. I think that I have changed. Cancer has changed me a lot — not that I was a bad person, but I think I was maybe more selfish or self-absorbed, and so to do that soul-searching of how do I want to be remembered?

“I want to be kind, and I want to be remembered as just a good person, so that’s kind of reshaped me, it reshapes everything.’’

She knows she will miss some of her girls’ milestones, and it is why she has a calendar and is filling little boxes with mementos.

“I’m going to miss their weddings and their babies and all those things,’’ she said. “So instead of letting yourself go down that path, because it’ll tear you up, I got little boxes and I’m filling them up with 25 years of gifts.

“And I got those little envelopes and letters, so what am I going to say on their wedding day? What am I going to say? I’m just planning ahead. I’ve knitted little baby blankets and those things. It’s just stuff but it makes me feel good. And then when they’re opening it, they can remember.’’

About the author

Erin Emery is editor of UCHealth Today, a hub for medical news, inspiring patient stories and tips for healthy living. Erin spent years as a reporter for The Denver Post, Colorado Springs Gazette and Colorado Springs Sun. She was part of a team of Denver Post reporters who won the 2000 Pulitzer Prize for breaking news reporting.

Erin joined UCHealth in 2008, and she is awed by the strength of patients and their stories.