Cervical Cancer question

My best friend just called me and said her sister had an abnormal pap last week. The nurse told her she probably had Stage IV CC.

I have tried to understand the stages of CC but my brain does not compute. I still believe that Stage IV cannot be DX with just a pap test.

I do know there are a few pre-cancer dx like CIN or something.

Is it possible to have CC dx at Stage IV with just a pap. Also, the reason I think they are misunderstanding is that the nurse told her she needs to do something within the next 6 months. Does not make sense to me. If the nurse thinks it is cancer I am sure she would not say check on it within the next 6 months.

Any ideas?

No definately they would not say check it in 6 months. And she can't diagnose CC based on pap alone, there needs to be a biopsy which first you would have a colposcopy. I am willing to bet that the nurse meant High Grade Dysplasia. If it were Stage IV CC, well that wouldn't be good and it can't be diagnosed that unless there were a surgery to stage the CC.

I would also say that they would be doing a referral to a gyno oncologist ASAP.

hi, gaga. right you are....a pap alone cannot indicate a stage of cervical cancer. a pap is a screening test and in order to get a diagnosis, further information is needed. as ialwaysworry wrote, the next step would be a colposcopy and biopsies, as well as referral to a gynecologic oncologist.

	Quote:
Originally Posted by GaGa My best friend just called me and said her sister had an abnormal pap last week. The nurse told her she probably had Stage IV CC.

You're right (as usual). That kind of diagnosis wouldn't come from a PAP (screening) test. I also kind of doubt that the nurse would be delivering news of a Stage IV diagnosis. (And if she is, I'd be getting the heck out of that office!) Most likely she's dealing with a grade of dysplasia (or pre-cancer).

Either way, please share with her our usual mantra regarding seeing a GYN/ONC.

BTW, this is so like you to be concerned with someone else's well-being in the midst of your own serious issues. That's why we love ya'!



monami

I just wanted to write to say I agree with what the other ladies say. The pap only identifies abnormal cells. Then, in my experience a colposcopy and possible biopsy is ordered. At that time, the doctor might do an ECC (endocervical curettage ) (and I HIGHLY recommend those . . . that is how my doctor found my adenoscarcinoma in situ - or it wouldn't be found for another year or more!). After the colposcopy and/or biopsy and/or ECC then the doctor might do a cone biopsy or LEEP or something similar. I think it is at that point that the cancer diagnosis is given. That's how it worked for me.

I suggest they call back to the doctor's office and ask them to tell them again what the pap found. It is likely they just misunderstood, or the nurse explained it poorly. Either way, let us know how things turn out!

I think the other ladies are correct. I wasn't diagnosed by a pap, those can only detect abnormal cells. My ob/gyne removed a polyp from my cervix and sent that for a biopsy. From there they said possible cancer-cencer, definately pre-cancer. Further testing showed cancer-cancer. (can't think of any other way to explain it lol) The staging for CC is done visually prior to surgery. The determine this by the size and depth or the tumor, which is determined by various tests.

I think if it were stage IV CC they'd have her in to see an onco ASAP to begin discussing a treatment plan. (I believe anything after 1b2 skips surgery and goes straight to radiation/chemo)

You guys have confirmed what I thought. I talked with my friend and she will explain this to her sister. It is so hard to understand all of this until you have lived it.

One of my nurses I just had in the hospital told me she had an abnormal pap and was going that same day for further testing. I just feel telling someone to check into it within 6 months just doesn't make sense to me. I am recommending Lana check into this sooner. She had just quit her job and lost her health insurance but after the bad pap she signed up for Cobra to cover her until she gets more.

I can always count on you guys.

Thanks,
Juanita

Hey hon, you might want to email this to your friend. Stage IV is the last stage of CC. I copied this from http://www.ehealthmd.com/library/cer...C_staging.html

Staging of Cervical Cancer

"Staging" is a method that has been developed to describe the extent of cancer growth. The stage of cervical cancer describes the tumor's:

Size

Depth of penetration within the cervix

Spread within and beyond the cervix


Staging allows the physician to customize cancer treatment and to predict how a patient will fare over time. In general, the lower the stage, the better the person's prognosis (expected outcome).

The physician uses all available findings to choose a stage that best describes the woman's condition.

Cervical cancer is staged by information that is obtained through:

Biopsy (removal of tissue for examination)

Information gathered from the pathology report that accompanies a biopsy

Cystoscopy (visual examination of the urinary tract with a camera-like instrument called an endoscope)

Abdominal ultrasound (which uses high-frequency sound waves to produce an image of the inner body)

Computed tomography (CT) scan (a computer-assisted technique that produces cross-sectional images of the body)

Magnetic resonance imaging (or MRI, which uses powerful magnets to create finely detailed images of body tissue)


Staging With The Figo System

Cervical cancer staging is usually described in terms of the FIGO system, a staging scheme developed by the International Federation of Gynecology and Obstetrics. The FIGO classifications are grouped within basic stages labeled stage 0 through stage IV (0-4):

Stage 0 - Carcinoma in situ. Tumor is present only in the epithelium (cells lining the cervix) and has not invaded deeper tissues.

Stage I - Invasive cancer with tumor strictly confined to the cervix.

Stage IA - In this earliest form of stage I, a very small amount of tumor can be seen under a microscope.

Stage IA1 - Tumor has penetrated an area less than 3 millimeters deep and less than 7 millimeters wide.

Stage IA2 - Tumor has penetrated an area 3 to 5 millimeters deep and less than 7 millimeters wide.

Stage IB - This stage includes tumors that can be seen without a microscope. It also includes tumors that cannot be seen without a microscope but that are more than 7 millimeters wide and have penetrated more than 5 millimeters of connective cervical tissue.

Stage IB1 - Tumor that is no bigger than 4 centimeters.

Stage IB2 - Tumor that is bigger than 4 centimeters. Tumor has spread to organs and tissues outside the cervix but is still limited to the pelvic area.


Stage II - Invasive cancer with tumor extending beyond the cervix and/or the upper two-thirds of the vagina, but not onto the pelvic wall.

Stage IIA - Tumor has spread beyond the cervix to the upper part of the vagina.

Stage IIB - Tumor has spread to the tissue next to the cervix.


Stage III - Invasive cancer with tumor spreading to the lower third of the vagina or onto the pelvic wall; tumor may be blocking the flow of urine from the kidneys to the bladder.

Stage IIIA - Tumor has spread to the lower third of the vagina.

Stage IIIB - Tumor has spread to the pelvic wall and/or blocks the flow of urine from the kidneys to the bladder.


Stage IV - Invasive cancer with tumor spreading to other parts of the body. This is the most advanced stage of cervical cancer.

Stage IVA - Tumor has spread to organs located near the cervix, such as the bladder or rectum.

Stage IVB - Tumor has spread to parts of the body far from the cervix.



The lower the stage number, the less the cancer has grown and spread. For example, a "stage I" cervical cancer is relatively small and has not yet spread beyond the pelvic area. By contrast, a "stage IV" cancer is much more serious, as it has already spread to the lymph nodes (the body's drainage system) as well as to other locations.

Bravo, Vega!!

Staging does differ between cancer types, and this is great clarification for everyone. Thanks for posting it!!


monami