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PAP smear after endometrial ca? PAP smear after endometrial ca?

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Unread 11-30-2010, 04:49 PM
PAP smear after endometrial ca?

Hello Everyone:

I'm a new "sister" scheduled for TAH/BSO + lymph node removal on January 5. Of course I could use ANY advice you can offer but I did have a specific question.

My initial understanding is that the cervix is always removed during this type of surgery (which I had assumed) but I was somewhat surprised when I asked my doc @ f/u (he is a ONC/GYN and comes HIGHLY recommended so I really have no doubts about his ability). Apparently I will need quarterly PAP smears/gyn exams. That got me wondering, which then got me researching.

From what I see, sometimes the cervix is left intact, and even when the cervix is removed, pap smears are sometimes taken from the vaginal tissues. My initial biopsy result showed it was probably stage 1, grade 1, but of course that won';t be determined until after the surgery.

My question is--has anyone had this experience--total ab hyst w/cervix removed for endo cancer AND follow up paps? Or does it seem more likely that he will leave my cervix intact? NOTE: I'm also a br ca survivor who took Tamoxifen.

Sorry this is such a long post!!
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Unread 11-30-2010, 05:14 PM
Re: PAP smear after endometrial ca?

They normally do take the cervix since it's part of the uterus, but yes at the followup exams they do a visual plus vaginal vault pap smear. The area they smear is where recurrences are most likely to occur, if they do occur. Sorry you are dealing with another cancer, but I'm glad you found us. Best wishes on your surgery and recovery.
Unread 11-30-2010, 05:16 PM
Re: PAP smear after endometrial ca?

Thank you...for the prompt reply and the encouragement. I think I will be consulting this site for quite a while. I'm glad I found you guys, just hope I don't post too often I get on people's nerves. The fact is I am really intimidated by this. Lumpectomy & ax node diss was a lot less scary....
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Unread 11-30-2010, 06:20 PM
Re: PAP smear after endometrial ca?

Don't worry about posting too often - it won't get on anyone's nerves. (At least I hope not because I post a lot myself, lol.)

I have endo cancer and my cervix was removed. My GYN-onc told me followup will include an exam and pap smear every 3 months for the first two years. My cancer had gone all the way through the uterine wall and into the fatty tissue behind it, very close to the top of the vagina, and he said that was where it's most likely to recur.
Unread 11-30-2010, 06:24 PM
Re: PAP smear after endometrial ca?

thank you! I appreciate when people take the time to respond. Even tho I consider myself self-taught when it comes to breast cancer I'm brand new to gyne cancers. I did buy two books--Through the Land of Hyster and Sudden Menopause. Even though the Tamoxifen essentially put me into medically induced menopause, I fear that I will feel some of the symptoms of menopause more intensely after the surgery.
Unread 11-30-2010, 09:11 PM
Re: PAP smear after endometrial ca?

Maricella -

As mentioned paps are normal after endo cancer. The way my gyn-onc described it is for early stage cancers the first place it would recur is at the vaginal cuff.

I just completed my 2 years which had me seeing my gyn-onc every 3 months. He or his PA would do a Pap smear, visual, abdominal palpation and a rectal exam. The rectal because there is less tissue between the intestines and the vaginal cuff so they could feel any recurrence sooner.

Don't worry about asking too many questions. We are here for one another.

Also check the resources tab there are several links to information on endometrial cancer.

Unread 12-01-2010, 03:05 AM
Re: PAP smear after endometrial ca?

Thanks! btw...I absolutely love your quote. I try to live by it, but I don't know what movie it is from??
Unread 12-01-2010, 06:55 AM
Re: PAP smear after endometrial ca?

Welcome to the land of HS. You will get wonderful info from this group. They were and still continue to be a wealth of information on just about any topic...
This surgery can be a bit scary... most of us had never had surgery before. But with knowledge comes power... I learned a lot of things to ask prior to my surgery that I would never have thought of.. Do not hesitate to come here with any and all questions.
Unread 12-01-2010, 03:43 PM
Re: PAP smear after endometrial ca?

Hi Mariella. I am also a breast cancer survivor, as well as having had endometrial cancer. I didn't take tamoxifen, however. I have had frequent pelvic exams and vaginal vault smears since my hysterectomy. Gradually, my doc, is lengthening the time between visits and paps. I also have regular CT scans and chest x-rays---also less frequently as time goes on. It wasn't determined until after my hysterectomy that mine was cancer, but thankfully it was early stage and grade and no additional treatment was necessary. I did a mastectomy and a year of CMF chemo for my breast cancer, twenty seven years ago.

Wishing you a classic surgery and an easy recovery. Please come to this site and ask away. There are many compassionate women here who are always ready to answer a question or lend a supportive shoulder.

Barb A.
Unread 12-03-2010, 02:22 AM
Re: PAP smear after endometrial ca?

As the others have said, calling it a "pap" smear is an error - its a vaginal cuff smear and usually they clearly mark on the paperwork as they send it to the lab (because they are looking for endometrial cells, a few of which would be normal on a real "pap" smear with cervix & uterus, and for us even one endometrial cell is abnormal).

I have found that the smears are more uncomfortable and take longer than a pap ever did. They usually try to really get the brush up into all the crevices... It's not the highlight of my day, but not the worst thing ever.

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