severe cervical dysplasia/ CIS

gyn says severe cervical dysplasia/CIS...recommending hysterectomy. My thoughts on this as I study it more and more is that it has progressed fairly fast. I have another appt this wed. to discuss it, but it seems to me that going from normal to this in a year and a half is fast. Anyone have a thought on this? I would appreciate some input.
L3

I had my TAH/LSO on 10/29 for CIS. Have you tried any other treatments yet? If you aren't sure about having a hysterectomy, please discuss the other options available with your doctor. I had a LEEP/Cone biopsy back in June. A LEEP or cone is an extremely effective treatment for dysplasia and early stage cervical cancer. In most cases, it is the only treatment that is needed. Unfortunately, in my case, all of the CIS was not removed during this procedure (I did not have clear margins according to the path report).

I also consulted a gyn. oncologist after my LEEP to get a second opinion. After my cervix healed from the LEEP, he did another colposcopy which came back with severe dysplasia still. At that point, his recommendation was to do another LEEP. However, based on further discussions with him and my regular gyn, we decided the best course of treatment for me was a hysterectomy. I had multiple gyn. problems that needed treatment as well. According to my path report, it was not severe dysplasia, but carcinoma in situ.

Typically, the progression of dysplasia to cervical cancer is very slow. It may be that your previous paps did not include any bad cells, which is possible if the bad cells are higher up in the cervical canal. I hadn't had paps in a few years before I had one in May of this year. My doctor tried to ease my guilt by saying it is possilbe that my dysplasia/CIS would not have been caught with a regular pap because it was very high in my cervical canal.

I would recommend that you consult a gyn/onc. for a second opinion if you are unsure about the hysterectomy. There are other options that can be tried multiple times and can be very effective.

Good luck to you!

's Chandra! Welcome to Hystersisters !

Do you have any previous history of abnormal PAP's? It seems to be common to try to treat the problem first with a cone biopsy. Then, if the margins come back clear, you are monitored closely for a couple of years until it is determined that you appear to be "cured". If the margins do not come back clear, then sometimes treatment continues with another cone, sometimes it is treated with a hysterectomy.

The cone serves a dual purpose. They use it for treatment. Also, it lets the docs know exactly how extensive the involvement is. Occasionally, we hear about a woman who went in for a cone and found out that her dysplasia was really cancer. It doesn't happen often, so don't panic, but it does happen. If it's cancer, then the surgical procedure is frequently different than it is for a condition of dysplasia. So it's important to know ahead of time what's in there.

I had a normal PAP in August of 2000, and then an abnormal one in November of 2000. While most of the time, cervical cancer/dysplasia is slow-growing, sometimes it's aggressive and moves quickly. It seems to depend on what exactly is causing the dysplasia, and it also depends on each woman and how well her immune system works. There are lots of variables.

I would also suggest that you request a referral to see a gynecologic oncologist. They are the experts when it comes to female cancers and precancers, and they know the most current treatment and surgical procedures.

Good luck! Please let us know how things turn out!

I had many of the same problems as you.

Have you been tested for HPV? If so what were the dna numbers for it.

They (scientests?) have found a direct link between cervical displasia/cervical cancer and the HPV virus. This is what I have. It made the decision for a hysterectomy before invasive cancer an obvious one for me. #16, 18, 31, &41 are the ones that they have a link to. I had the worst ones 16 &18. They are actually working on a vacine for the virus. I did some reasearch and found out all the news I needed to know about this virus.

Hope I can help

Marcy

I have been tested foir HPV....came back negative. I had a bad expirience many years ago, and they are attributing the damage and bruising to my insides I suffered as possible link.

I have had same problem. Pap was normal one year (and all previous ones) then I had severe dysplasia with carcinoma-in-situ the next. That was a year and a half ago - treated with LEEP. Normal paps again every 4 months, then found recurrence on colposcopy biopsy. Just had cone biopsy but they couldn't find it.

WAITING for a referral to a oncology hospital. They have a multi-discipline preinvasive clinic that can provide medical AND emotional advice.

Get copy of your path report and get another opinion if possible.

Take care. Let us know how your appointment goes.

I'm confused, Scaredkat. So, you had an abnormal PAP again recently? And then they did the colposcopy with biopsy? And the biopsy showed what?

Here's why I'm asking: in the past when I had abnormal PAP's the doc did a colposcopy with biopsy. When the biopsy came back positive I was treated with cryotherapy (because the biopsy is typically taken of the external surface of the cervix, and that is generally treatable with cryo). Now, in the instances where the biopsy came back negative, then I went on to have a cone because they figured if it wasn't on the outside, then it must be on the inside. But it sounds like your biopsy came back positive. Can you clarify this?

Jeanine:

I was at my "last" visit to my gyn in Sept., so he was doing a routine pap and colposcopy (biopsy) to make sure everything was fine so I could return to my regular DR. The results from the Sept. pap were normal. The results from the (colposcopy) biopsy (endocervix and cervix at 12) show HSIL. Because of the biopsy results only, I then went on to have a cone biopsy last month. The cone biopsy results do not show dysplasia (inflammation, benign changes).

I guess my question is, does your doc think there should be some up in the cervical canal? Why is he troubled that the LEEP didn't show anything? Perhaps there's just nothing there. Just because it's on the external cervix, does not mean it's necessarily also on the internal cervix.