Suzanne Fernando insists it was not a surprise when she learned she had cervical cancer. Eight months into her second pregnancy, her daughter Aaron was delivered by emergency Caesarean after doctors found a tumour the size of a fist in her cervix.
But she had a family history of cancer - albeit mainly on the male side - and had been feeling unwell for months. "I got chronic fatigue, sickness and excruciating pains in my tummy. Deep down I had a feeling that it was serious, but I kept it to myself - my only thought was to get through the pregnancy and get my daughter born," she recalled.
Aaron is seven, but for almost a month, Mrs Fernando barely saw her, because immediately after the birth, she began to haemorrhage and doctors were forced to carry out a hysterectomy to save her life. "It was a month before I finally came to in the hospital."
Grateful to be alive, Mrs Fernando was able to breastfeed her baby as midwives had cup-fed Aaron so that she could do so.
But she had to embark on a gruelling course of chemotherapy and radiotherapy. The tumour did not respond to this treatment, and she underwent an even more intrusive procedure - spectrum therapy - in which radioactive rods were laid directly on the tumour, rendering her immobile on a ward for 24 hours at a time.
Finally, the tumour shrank and eventually, Mrs Fernando was given the all-clear. It was only then that she realised the effects the aggressive treatment had had on healthy organs and tissues surrounding the tumour. "It had shrunk various other areas too. Over the years I've had to have reconstructive surgery and numerous operations to repair the damage."
Mrs Fernando is now in remission but after hearing her story few would argue with the verdict of public health minister Shona Robison: "Women who have survived have a very strong message that they want girls to be protected. Government ministers just can't put the message across like that," she said.
Ms Robison will join Mrs Fernando and her family today at the launch of the Scottish Government's campaign to promote the HPV vaccine which protects against cervical cancer.
Indeed, Mrs Fernando's views on the subject are understandably robust. "I would say, basically, look what happened to me. If there is any chance of preventing anyone being diagnosed with this horrible, horrible illness, you should take what's available.
"Why wouldn't anybody take precautions against such a horrible disease? It's a major breakthrough, and I'll certainly get my daughters vaccinated when they are old enough."
The HPV vaccine protects against two strains of the human papilloma virus, which are the two commonest causes of cervical cancer. North of the border, the lifetime risk of a woman developing cervical cancer is one in 124, despite an extensive screening programme. In 2004, 282 new cases of cervical cancer were diagnosed and 102 women died of the disease.
The vaccine is to be offered from September, to girls aged 12 and 13 in every Scottish school, and to pupils in S5 and S6 as part of a "catch-up" programme.
The £64m immunisation programme uses the vaccine Cervarix, manufactured by GlaxoSmithKline, and it will protect against strains that cause more than 70% of cervical cancers. A similar scheme is being carried out in England and Wales.
The campaign launch will be at a roadshow in the Paisley Centre - the first of a series over the next month, in shopping centres in cities and towns across the country - backed by a TV ad campaign airing for the first time tomorrow, with a mosaic of girls' faces and the slogan "together we can fight cervical cancer".
Shopping malls have been chosen because the government feels they offer the best location for reaching out to teenage girls and getting information to parents. The advert and roadshow aim to get across key messages about the purpose of immunisation, and what they involve - three injections over about six months - and the fact that they are taking place in schools.
Rina Duff is school nurse team leader in East Renfrewshire and one of the nurses on the national group that has been planning the vaccination programme. She concedes that school nursing is under-resourced, but says that recent press coverage suggesting that nurse shortages will derail the operation is wrong.
"I've been in school nursing for 21 years. We are always going to be short of nurses, because it doesn't get top priority when nurses are needed for heart operations, for example. It is a mammoth task, but this is one school nurses are very good at," she said. "School nurses will be helped by their colleagues in the community. Community nurses will help them do it and in some areas we will use bank staff."
Even in Scotland's largest secondary, Holyrood in the south of Glasgow, where 457 girls are in the three years initially being offered the jabs, the work will be done in a morning, Mrs Duff predicted confidently.
The aim is for girls to get pre-immunisation talks, while information, consent forms and a DVD will be sent home for them to discuss with their parents.
"When they read all the information, I think they will be enthusiastic. I don't know of any parents who have said No, I won't get it for my daughter'," Mrs Duff added.
It seems take-up vaccine is likely to be high, despite some criticisms. Medically, these have centred on the suggestion that the panel advising the government has "missed a trick" by opting for GSK's Cervarix, rather than Gardasil - the Merck vaccine chosen for immunisations in the US and Australia. The latter protects against two additional strains of the HPV virus but ones which mainly cause genital warts rather than cancer.
Some doctors argue that the scheme is costly and will save a limited number of lives given that effective screening has already reduced the lifetime risk of cervical cancer for women as long as they can be persuaded to attend.
It remains to be seen how enthusiastic parents will be. Only 70% of girls aged 12 to 13 in a recent trial in Manchester received the vaccine, as reported in the British Medical Journal. Only 8% of parents sent a refusal, but one in five failed to return consent forms.
Researchers said they had high hopes that the take-up rate could be increased with the kind of publicity campaign the Scottish Government is undertaking.
Some parents have also expressed concern that the vaccine - which in essence protects against a sexually transmitted disease - would encourage promiscuity. The Catholic Church in Scotland was reported last year to oppose routine immunisation. However if that was ever true, it is not now. Ronnie Convery, spokesman for Archbishop Mario Conti, says Catholic schools will be actively participating: "My understanding is that it is greatly to be encouraged. It is not an encouragement to promiscuity - it can strike anyone," he added.
Mrs Fernando agreed. "This isn't just for people who may have multiple partners. I didn't and I don't expect my daughters to either - that's not why I want them to get the vaccine."
Ms Robison added: "Surveys have shown very strong parental support and we have no reason to think there will be many refusals."
© All rights reserved. Reproduction in whole or in part without permission is prohibited.



