Trying to understand my early diagnosis

Hi:

I am not very far in the process, so far I had 1 abnormal pap followed by a bad coloscopy followed by 1 visit to the gyn oncologist. I have an upcoming cone biospy with a pending hysterectomy but dont know what will be removed until the results of the cone biopsy comes back.

I asked my oncologist what the coloscopy showed and her answer was "at least cervical adenocarcinoma in SITU with possible invasion"

Now here is my questions:

When trying to understand this I thought adeno means not yet cancer, but carcinoma is cancer, SITU means contained but if contained why would it be possible invasion? Sounds like these words cancel out the the other. Which would be good because then I would have nothing but I am sure that isn't the case

Has anyone had this diagnosis that might be able to help me understand it?

I am pretty new to this as well but I believe carcinoma Insitu aka CIN goes in four stages stage 1-3 are generally considered pre-cancerous. So you want to know your stage, and you want to know if it is invasive or not.

When they do the biopsy they will also test the margins which is the tissue around the cells they find, from this they can tell if it is in fact spreading beyond the biopsy area. So ask about the margins as well when your results come in. In my case the LEEP cleared the cells out they could see but I had questionable margins within the endocervix. So I chose the hyster to just get those babies out of there.

Lots of information in the cancer forum even though you don't have cancer at the moment.

*hugs* to you, I know this is so much to take in. Just read read read between now and your surgery and there are lots of us here in your shoes sister!

Bethanie

It can be confusing sometimes when all these medical terms are thrown around. I will try to help out.

There are 2 kinds of cervical cancer: squamous cell (involving the outside of the cervix and the lower end of the inside of the cervix--most cervical cancers are this type), and adenocarcinoma (involving the glandular cells further up inside the cervix).

"In situ" does indeed mean "in place". It is contained within the "skin" of the cervix (the very topmost layer of the cervix) and has not invaded down into the body of the cervix. If it were just plain "carcinoma" that would mean you have an invasion. But the "in situ" part means it isn't a true cancer--it has not invaded anything yet (NOTE: there is some disagreement on whether or not an in situ condition is a true cancer or not. My gyn/onc says it's not cancer until it has invaded something, others say in situ is a cancer. Either way, it's important to get it treated.)

Now for the "possible invasion". Essentially, they don't know for sure if you have invasive cancer or not, but they do know for sure that it's at least in situ. The cone biopsy will provide the information they need because they will get a large sample of the cell population and will be able to tell whether or not it's invasive. Depending on the results of your cone, they will then decide which surgical procedure is most appropriate for you.

I am so glad to hear you are seeing a gyn/onc. They are the experts with female cancers and precancers and they are extensively trained in the most current treatment and surgical techniques.

Good luck! I hope your cone brings back the best possible news. Please keep us updated on how things are going.

I think adeno is a cancer that starts in the glands. Somebody will correct me if I am wrong. I don't think it is a pre-cancerous condition and you can have eitehr squamous carcinoma in-situ or adenocarcinoma in-situ which are both pre-cancerous conditions. But squamous and adeno are two different types of cancer.

Thanks very much Jeannie and Bethany!!

Bethany I see your surgury is scheduled the day after my cone biopsy. At this point I can't even imagine being at that point yet. Im still trying to digest the news (I just found out Wednesday 9/3)

At this time I was planning on getting the cone biospy done on a Wednesday and returning to work on Monday. Have you had one? Is that do-able? My job is alot of brain work nothing physical.

Thanks again for answering so quickly

Toni

Yes, that should be do-able. I had both of my cones on Friday's and returned on Monday.

Good luck!

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Originally Posted by QAManager Thanks very much Jeannie and Bethany!! Bethany I see your surgury is scheduled the day after my cone biopsy. At this point I can't even imagine being at that point yet. Im still trying to digest the news (I just found out Wednesday 9/3) At this time I was planning on getting the cone biospy done on a Wednesday and returning to work on Monday. Have you had one? Is that do-able? My job is alot of brain work nothing physical. Thanks again for answering so quickly Toni

Oh Toni you have no idea on rushing lol. I had a pap in Dec of 07 assumed all was okay because I never got a call. On July 29th my gyno called me personally to tell me they had lost my pathology report and only just found it amongst their final checks and balances. Her words were "I need to see you yesterday". When I ask what this meant for me her words were "you have cervical cancer". I was whisked into the office that afternoon had a colposcopy and a Leep done all in a matter of 30 minutes. By the following week August 6th I was in a Gyn/Oncos office getting my second opinion where I was told I DID NOT have cervical cancer I had precancerous cells and voila we planned the surgery that day.

Thankfully I had a vacation scheduled so it bumped it out to the 25th of this month. So I had time to let it finally sink in. So in a matter of a week I went from the "C" word to a hyster, to the pre cancerous diagnosis to yet another suggestion of a hyster due to my age and the questionable margins.

The LEEP and Cone are two different things but I would imagine the same side effects. I took a day off because of some slight discomfort, similar to menstrual cramps only a bit stronger. I was fine after that, just noticed if I moved about to much I spotted more and cramped more. Just take it easy for a few weeks lifting etc. My gyn/onco told me no sex for 4 weeks and they SHOULD NOT schedule surgery sooner than a month after a procedure on the cervix. He told me this after I explained the ex gyno wanted to get me in for a hyster one week after she had done the LEEP. Can you tell she is fired? lol

Oh and I would suggest you start a note pad to jot any questions down you come up with along the way. Obviously what stage, ask about the margins if they are clear or not, what type of cells, what type of hyster he/she recommends and why, how long you will be in the hospital, what is the recovery time etc. If you have to have radiation or chemo you want to know that ahead of time again when will it start what type of treatment etc. will they be leaving the ovaries, if not will they be giving you HRT's again what type and why. I had about 20 questions and they were all answered at my appt. with the g/o. I am sure some of the other girls will chime in and add more to your list of things to ask and things to be aware of.

Hi QAManager, what these ladies have said is right. Adenocarcinoma in situ is the highest level of precancerous cells of the glandular cells (the upper 2/3 of the cervix which are not scraped during a pap or seen during a colposcopy).

I was diagnosed with adenocarcinoma Ia1 back in April. My doctor did a colpo and an ECC. It came back AIS (adenocarcinoma in situ). She then did the cold knife cone biopsy which came back with the cancer diagnosis. I then went to a gyn/onc who told me I was going to have a hyst one way or the other, but because it was caught so early I had a few options. I had 2 different lesions removed on 2 different cone biopsies (one each). Neither was larger than 1.6mm x 1mm deep (a dime is 1mm thick). By the time she did the hyst, there was "no sign of residual cancer." I didn't need any chemo or radiation since it was found so early.

I'm so glad you are seeing a gyn/onc. I suggest you write out a list of questions to take to the doctor. Be sure to leave room to write the answers. Also, always ask for copies of the pathology reports. They will help you understand what is going on.

I'm glad you are here! This is a WONDERFUL community!

If you have any questions, let us know <Oops! Please keep all offers of support on the board per site guidelines.>

	Quote:
Originally Posted by Peaceful Storm Also, always ask for copies of the pathology reports. They will help you understand what is going on. I'm glad you are here! This is a WONDERFUL community!

Yes it is, you added one more thing I had forgotten the Path reports.

Peaceful and others are always there for us new gals and is full of a wealth of information, help, encouragement and patience.