Vanessa Malinis was building her dream career - managing clothing stores in Ocean City and the Virgin Islands - when she sought help last February for what she assumed was a minor gynecologic problem. In St. Croix at the time, the former Miss Teen Maryland went to a specialist on the island searching for answers.
Why was she bleeding so much? the 26-year-old wanted to know. Her period had lasted on and off an entire month, she complained, and was unusually heavy and painful. Malinis was treated for an infection with antibiotics. Then, when she didn't feel any better, the doctor prescribed birth control pills to control her abnormal bleeding. When the pain and bleeding continued, however, Malinis flew to Puerto Rico for another opinion. At that examination, the gynecologic oncologist discovered a large tumor in her cervix. A biopsy revealed it was cancerous.
Immediately Malinis returned to her parents' home in Brooklyn Park. She sought treatment at Mercy Medical Center where gynecologic oncologist Dwight Im determined radiation and chemotherapy were necessary before surgery.
"Everything was going so well in my life," she recalls. "The whole thing was so traumatic: I went from spending my days kayaking and windsurfing to radiation and chemotherapy."
"Having a hysterectomy was a really big thing for her, a really tough decision knowing that she wouldn't have children because there was no way to save her eggs," says her best friend, Cara Kolakowski. "Even the day of the surgery she was debating it."
In mid-July, the radical hysterectomy revealed she had one of the most aggressive forms of cervical cancer and that it had spread. The young woman underwent a devastating regimen of chemotherapy as well as additional surgery in September to repair a blockage in her intestine caused by the radiation.
But the tumors have continued to grow.
Realizing that conventional drug therapy is not going to save her, Malinis has become intent upon a new mission: Spreading the word that cervical cancer is preventable. For several months, as her strength has declined, she has been raising public awareness on TV and in community newspapers of the importance of annual Pap smears. She seeks to remind women - especially teen-agers and young women who are sexually active - that they need the regular check-ups she neglected to get.
She still intends to fight the cancer, she says, using herbal medicines and such alternative therapies as reiki.
"She's really strong," says her mother Mary Lou Malinis. "She is inspiring others who have cancer. And she has said `This cancer is not going to beat me. I'm going to be the sole survivor of this.' Every night before she goes to sleep she says, `Mommy, I'm not going to die on you.' "
Vanessa Malinis cautions that she was a smoker, one of the risk factors for cervical cancer, as well as being someone who had only had sporadic Pap smears, the tests which can show cervical cancer at an early and treatable stage. And like many young women, she figured cancer was something older people got. Although it occurs most often in women over the age of 40, it also strikes women in their late teens and 20s.
"Because it is sexually transmitted, cervical cancer is more prevalent than other forms of gynecologic malignancies in the young," says Dr. Im, associate director of the Gynecologic Oncology Center at Mercy Medical Center. "Women think, `I'm a teen-ager' or `I'm 21, why should I even think about cancer?' And although we don't know why, in these young women cancer is much more aggressive than in the elderly."
According to the American Cancer Society, risk factors for cervical cancers include sex at an early age; sex with multiple partners or sex with men who have had multiple partners; HIV infection; and smoking. Condoms do not protect against human papillomavirus (HPV), the sexually transmitted virus responsible for nearly every case of cervical cancer.
Regular gynecologic exams and Pap smears can help prevent the cancer from developing and may also detect changes caused by infections. In the Pap test, the physician removes a sample of cells from a woman's cervix and vagina. The samples are analyzed for abnormalities.
"The great majority of women in the developed world who get cervical cancer haven't had Pap smears in the past five years," says gynecologist Cornelia Trimble, who directs the lab for treating patients with abnormal Pap smears at Johns Hopkins Medical Institutions.
The most common symptoms of cervical cancer are abnormal bleeding, which may occur between regular menstrual periods or after sexual intercourse, douching or a pelvic exam.
Vanessa Malinis is now trying alternative medical solutions to fight her cancer. A fund has been set up to help her pay for anything not covered by her medical insurance. Those who would like to contribute may send a donation to the Vanessa Malinis Cervical Cancer Fund, c/o Laura Newton, Allfirst Bank, Mail Code 120-015, 5738 Ritchie Highway, Baltimore 21225.
Johns Hopkins is looking for women who have received diagnoses of abnormal Pap smears classified as high-grade lesions to serve as volunteers for a study.
These women will be treated and have blood drawn as part of the study, which is designed to help speed the development of a vaccine to prevent human papillomavirus (HPV), a virus causing cervical cancer. All participants will be paid.
The study is directed by Cornelia Liu Trimble, head of the hospital's cervical dysplasia and colposcopy service. For information, call 410-614-4495 or go to www.hopkinsmedicine.org and enter "cervicaldysplasia" in the search window.