4th procedure on CIN and scared...

Hi everyone I am new to this website so please bear with me, this is a lot thatt has happened in a year. I hope I don't confuse anyone.

On Nov. 3, 2003 I found out I had HPV (the high risk type), and had CIN II. I had a LEEP/Hot Cone in Jan. 2004. I had my follow up pap in April and those results were abnormal, the doctor wanted to wait to see if it was inflammation from the surgery before doing another biopsy. So I waited and in Aug. had another pap come back abnormal, than a biopsy done showing CIN I and severe inflammation. So the doctor did a cryrofreeze (sp??). I just had another pap two weeks ago andfound out last week it was abnormal as well. *SIGH* so now the doctor wants to do a LEEP in a week and a half and just skip another biopsy all together. I am very very nervous cause this past week I had an appointment with my primary doctor and he found lymph nodes on the back of my neck and wants me to come back in a few weeks. If they are not gone than he was to send me to a surgeon.

Is there anyone who has been through this and can offer some advice I am very nervous and don't know if the lymph nodes are anyway related to the gynological issues, and what can I do I am nervous and don't want the LEEP done if they can't get it which has been the case. And if it can be past the cervix an they don't know it.

Any replies would be great....thanks all..

's Welcome to Cancer Concerns!

I'm sorry you are going through so much right now. Breathe! Breathe! It's always easier to get through this when you can keep your thoughts straight and your breathing pattern even.

I have had a long history of cervical problems. It's been a very frustrating experience, but right now I kind of feel like I'm on top of the fight.

Keep in mind that different docs do things in different ways. As a general rule, my doctor always waited about 4 months after a procedure before doing another PAP. He just wanted to make sure that all was healed and that any possible inflammation was resolved so that we wouldn't confuse any of the issues.

It is standard practice to do a biopsy after an abnormal PAP. Now, a cone is a type of biopsy, but typically the traditional biopsy is done first, then depending on the results a cone might follow. Now, if I'm reading your post correctly, it's only been about one month since your cryo--is that correct? Isn't it possible that you might still have some inflammation from that procedure? CIN I is very mild and will often times reverse itself without treatment if given enough time. And may I ask--when you had the cone done in January, and they found you had CIN II, did you have clear margins? That might give you another piece of information to help you decide what to do at this point. If you didn't have clear margins, I can understand why your doc would think it very important to go forward with the cone right away.

These are just things for you to think about. I am trying to provide you with some information that will help you ask the right questions so that you can feel comfortable with the course of treatment you might pursue with your doctor. Additionally, you might like to consider requesting a second opinion from a gynecologic oncologist. They are the experts when it comes to female cancers and precancers, and they know all the most current treatment and surgical procedures.

Good luck! I hope you are able to find the answers you are looking for. Please feel free to continue asking questions--we will all try to help as much as we can by sharing our experiences and information. Then, you can take all of that back to your doc and determine what's best for you.

Keeing you in my thoughts and 'ers.

's

Jeanine gave you very good advice and information. I can't really add anything to it except to offer my ers and best wishes.

God Bless

Hi, hms7056


I dont have ANY experience with this at all....but I wanted to drop by and give you a and to let you know that I will be hoping everything works out GREAT for you!

Thanks for all your thoughts and helpful advice.

Jeanie, thank you so much and, to answer your questions...I had a cryro in the summer june/july can't remeber correctly (sorry ) and I had the follow up Pap this month. (The doctor usually waits three months for a follow up Pap). I did get to talk to the nurse pracitioner today and she said it was back to what it was in the beginning at CIN II. The lady I had talked to last week was the doctor's assistant. I had called for the results and she could only tell me it was mild low grade (this stuff is so confusing) and The nurse practioner would call me this week and that the doctor wanted to do a LEEP. I was told the biopsy would be a watse of time so to speek because they already know it is abnormal and they are saying I should be monitered very closely (as if that helped any)

So there is more...When the nurse called today I asked her all of my questions which she did answer. BUT this is where it gets confusing. Back in the summer when I had an abnormal pap they did a biopsy. I received a phone call and was told all the CIN was gone but I had imflammation. When I got to the doctor I told the nurse I didn't want anything done until I talked to the Doctor because I was unclear of what was going on. He came in and told me that the CIN was in fact still there along with inflammation.

Ok so this brings me back to today's convo with the nurse. After I was done asking her the questions she tranferred me up front to make the appointment, which I thought was for the LEEP, but turned out to be a visit with her this friday to "discuss" the surgery. I am not sure why she wanted to see me again when I have already had this surgery before and know what to expect and to do. I am also feeling like they are holding out info. from me til I get there because of what had happened this past summer.

I am only 24 and have never been through this til now. I am guessing I should get a second opinion but I am nervous of making the doctor upset. I still want him to do the procedure but feel a second opinion is needed. Any advice?

Thanks again to any who read and give advice it is so much appreciated and thanks for the prayers I do believe in God very much, and believe everything in life happens for a reason. My thoughts and prayers are with everyone as well

It can be very frustrating to feel like you are getting mixed-up information! You might like to have an appointment just to go in and ask them to go over each pathology report with you in detail so that you know exactly what your history is. This may be important to you as you are making further medical decisions in the future.

I have to be honest and say that I've never seen any medical website advocate skipping a biopsy and jumping right to a LEEP just because a PAP came back abnormal. I reviewed a few sites today (just to check again for you), and what I gathered was that a PAP is only an indicator and the biopsy is the definitive diagnostic procedure. And no one wants to have any additional procedures, and I'm sure that chances are that the biopsy would indicate that a LEEP is possibly in order. But what if it didn't show that? What if it came back CIN I? Many docs only monitor CIN I rather than intervene, just to see if the body can step up and take care of it on it's own. It's just something to think about and discuss with your doctor. As you said, you're only 24. You don't want to have any more invasive procedures than are absolutely necessary at this point. You're very young and have an entire future ahead of you that could incorporate many things, including future fertility.

As far as a second opinion, well, it's my opinion that if a doctor gets upset that you are requesting a second opinion, well then s/he is not the doctor for you. I believe that doctors should be encouraging their clients to take charge of their health and do whatever is necessary to feel comfortable with the recommended procedures. If you need to have 3 or 4 doctors confirm that that's the best course of action for you, then go see 3 or 4 doctors. A good doctor is not going to feel threatened by a second opinion. My doc offered me the opportunity to seek a second opinion. That is the mark of a good doctor (in my book anyway).

I don't think you're out of line asking to see a gyn/onc at this point. You have a recurrent situation here. You are young. I think you're entitled to get a specialist's views on this.

Keep us posted on what's happening. You're on my prayer list.

Hi hms7056!
Your story sounds a lot like mine. Last November I had an abnormal PAP showing CIN III. I went in for the colo/biopsy and my doctor decided to do a LEEP, which I did in Jan 04. My results from the LEEP were all clear margins, so the doctor was confident that we got everything and I would just need to be very diligent about following up. I went for my three-month check-up in April and again it came back abnormal. I went in for another colo/biopsy. My doctor couldn't really see much dysplasia, but she still biopsied a couple spots she suspected could be the culprits. They indeed were CIN II so I had another LEEP done in July. This time it said that there were WIDELY clear margins. So again, my doctor is fairly confident that I am in the clear now. However, I am waiting on the results from my first follow-up PAP following the last LEEP (I went to the doctor last Tuesday, so I am waiting to hear anytime) and I am nervous as can be waiting. My doctor usually only calls when something is wrong, so every time the phone rings or I have a message on my phone I am freaking out. Waiting is definitely the worst part of all of this!

Were your margins clear after they did these procedures? Knowing this might help you feel much more informed and prepared to discuss your health care. You definitely should seek a second opinion if you are more comfortable. My doctor offered that before my second LEEP, but I just wanted to get the cells gone and I knew my doctor was trying to be as conservative as possible with removal of tissue, and still eliminate all the dysplasia. I am only 27 and have no children, so the less of my cervix that they have to remove the better so it makes me nervous just waiting things out, etc. You should not feel bad about requesting a second opinion before another procedure, that only makes sense especially because things have been a little confusing up till this time. Perhaps on Friday when you are having the discussion about surgeries, you can also ask what your other options are. My options before my second LEEP were: 1). Wait and see, closely monitor it to see if it goes away; 2). Another LEEP; 3). Get a second opinion. I actually did call one gyn/onc but they wouldn't see me because I didn't have actual cancer yet, which I thought was kind of weird. But, if you have ANY, even the tiniest bit of doubt, definitely seek another opinion. I wish all the best for you and please keep us posted on how you are doing.