Cold Knife Cone and D & C for AGC

I just had my consult on Monday with my new Gyn/oncologist. I referred myself to him after reading so many posts on this site urging women to seek a Gyn/onc. I am so glad that I did!

On June 7, 2012, I had a that pap come back ASCUS and AGC of endocervical origin. I had an ultrasound on June 20, 2012 that reported uterine fibroids and ovarian cysts (simple, corpus luteum and hemorrhagic.) Somehow, I fell through the cracks of the system and didn't get my results until after the 4th of July. On July 13th, I had a colposcopy, ECC and endometrial biopsy. I waited on pins and needles, and googled my brains out until I got the results the next week. They were all negative. I didn't feel to good about the negative results after all of the googling that I had done. I found one recent study that indicated that about 50% of women who had AGC paps and were then told to come back in a year for another pap then had invasive lesions.

By now, I was getting so nervous that I request a CA-125 test, it came back low at 10.

In the meantime, I began to have some strange sensations in my lower abdomen...tugging/pulling feeling, "zingers" that felt like they were inside my vagina, always on the left side, mild cramping and a dull throbbing sensation. I went for a follow up ultrasound, and one of my ovarian cysts had doubled in size, and they found nabothian cysts in my cervix. That was on August 6th. I freaked out about the changes in my ultrasound that included the nabothian cysts, recalling a paper that had talked about the misdiagnosis of adenocarcinoma as nabothian cysts. This time I didn't wait to hear from my regular gynecologist, I called Mayo, explained my tests and fears, and got put right in for the next week with the Onc/Gyn.

I had all of my tests forwarded to him. I got there, they had me undress from the waist down. He came in to talk to me (never even touched me!). He said that he had reviewed my pathology results and he would like to schedule me for a Cold Knife Cone (CKC) biopsy and D & C. I asked how soon do you want to do it? He checked his calendar, he would have done it the next day, but he was booked. I am scheduled to have it done on 8/22. He told me that depending on what he sees when he gets in there (they use frozen section pathology on the spot), and if he has clean margins, then that is all that he will do. He asked if I would give my consent to a transvaginal hysterectomy if he felt the need. I said YES!! (So relieved to not have transabdominal hysterectomy as the option). He went on to further say that if he saw cancer that had spread, he would wake me up to talk to me about my options for a radical hysterectomy.

I still don't know if I have something going on with me or not, but I finally feel at peace that I am going to find out once and for all. At first I really felt ridiculous, referring myself, like I was making a mountain out of a molehill, but I could not ignore my gut instincts that my regular gynecologist was out of her league. (I don't fault her, though, it is a very rare occurrence, and she followed protocol to a T...) After gyn/onc laid all of that on the line, I am kicking myself for not going there right away instead of having the ECC and endometrial biopsy in my regular gynecologists office. It was a waste of time. I suspected that my ECC had not even hit the right spot (pathology report talked about fragments of endocervix). I asked gyn/onc this, and he said you are correct.

On the right path to diagnosis now!

Very glad to hear that you are feeling more at peace with things. That's no small thing in and of itself. I think having some sense of "control" kind of helps as well. It's always a good idea to pay attention to your body and to listen to that little voice we all have. Sending prayers and positive thoughts that you'll need the least invasive procedure possible and for path results that are a total snooze. (((HUGS)))