Ben Knight:

Usually it’s men who have the reputation for putting off a trip to the doctor until it’s too late, but when it comes to women’s health, both patients and doctors can also get a bit squeamish talking about things like genital pain. As a result, some women either don’t raise it with their GP, or if they do, they might not be getting the right diagnosis and that can have some pretty nasty results. So, the push is on to get rid of the cringe factor on both sides. Kathy Swan reports.

Child:

That was my daddy.

Carer:

You think Dad did it? Okay. I believe that. What about that?

Astrid Sweres:

I am a mother and a mother of three grown children. I’m a grandmother. I’m a career woman.

Kathy Swan, Reporter:

Astrid Sweres is making good recovery from major surgery.

Astrid Sweres:

I have lichen sclerosus. It doesn’t sound nice. It isn’t nice. In my 40s, probably about 15 years ago, I became aware that I had a terrible crawling itching sensation in the vulvar region. I went to see my GP and the GP said it is probably thrush.

Kathy Swan:

She went from GP to gynaecologist to dermatologist, taking four years to get the correct diagnosis for her not uncommon chronic skin condition that in rare cases becomes cancerous.

Astrid Sweres:

I was in so much pain and agony that they recommended I see a surgeon and I saw Professor Grant and he said I just don’t think there’s anything else we can do. We’re going to have to give you a radical vulvectomy, just remove all the affected skin. I had some positive biopsies. It was starting to turn cancerous. So it is not a very nice feeling I can tell you.

Peter Grant:

How you have been since the surgery?

Astrid Sweres:

Well, it’s been absolutely fabulous. I’m sleeping really well now and have absolutely no pain.

Kathy Swan:

About seven weeks after surgery, Astrid Sweres is relieved and happy with the work of her surgeon Peter Grant at Victoria’s Mercy Hospital for Women.

Peter Grant:

We just need to have another look and make sure everything has healed fine and then we’ll organise for the dermatologist to see you again.

Kathy Swan:

As a gynaecological oncologist, Peter Grant knows well that his area of expertise is difficult for some.

Peter Grant:

It’s been known for years and years and years that there is a huge gap between symptoms and diagnosis in vulvar cancer and that’s a combination of factors. One is the reluctance of women to present with a very personal problem that requires examination and also a reluctance on the part of some of the medical carers to actually look and get a right diagnosis rather than just say, “Well, here’s some cream. Use that. It’s probably this or this or this.”

Bettina Arndt:

Doctors have a real problem in this area. I mean, A) there’s the embarrassment. It is something most of us don’t like to talk about. Patients have difficulty talking about it and doctors have difficulty discussing.