cone pre-op today

I saw my OB/GYN for the cone biopsy pre-op today. He explained the procedure to me and continued with his usual positive outlook, saying the biopsy "won't come back positive". He's been Mr. Positive the whole time, and while many of his patients may appreciate that, I am not a cartoon with butterlies and bluebirds flying about my perfectly groomed head. I made him discuss the what-ifs and expressed that I am feeling stress, and he replied with "Well, yeah. When you talk about this stuff, it is stressful." *sigh*

So the scoop is this. If the cone comes back with a clear margin of healthy cells, they'll consider me cured. He added that he will take another endocervical curettage beneath the biopsy site for good measure. Then I made him tell me what he'd do if that still showed dysplasia (even mild). He said at that point he'd consider a partial hyster or trying to go deeper with the cone (but admitted that would be difficult). I asked what would happen if the pathology on the cone came back abnormal, and he said he'd refer me to a gyn oncologist for a radical hyst.

When I asked him if he would consider a partial hyst if the pathology came back normal and I desired to prevent recurrence, he said that would be overkill and medical malpractice. Then he added that he could be in big trouble with the gyn oncologist if he did a partial and the path on the hyster came back abnormal because he just limited the options for the gyn oncologist. :confuse:

Now I am thinking I want a second opinion. This time from a gyn oncologist. Anyone have thoughts, suggestions or comments?

I had a laser cone on December 19th. I had CIS. None of my margins were clear, so I had a hysterectomy on January 23rd of this year.
If you are not comfortable with the way your doctor is handling this, I urge you to get a second opinion. I was comfortable with my doctor's opinion, and the way he explained it. I had a few moments now and again of panic...... but that was due to the situation, not my doctor.

Please seek a second opinion if for nothing more than to set your own mind at ease. You need to not only know that this will be taken care of, but also that you will feel cofident in the care you receive from your doctor.

Go for the second opinion. I was told after my cone that I was "cured". I was aggressive and had a TAH/BSO anyway. I am so glad I did because the pathology report came back with more CIS that was missed by the cone and adenocarcinoma that was not detected by the colposcopy or cone. So apparently, I was not "cured". Now that everything is out and a gyn/onco was consulted, I am CURED.
Ease your mind and take all steps necessary to make you as comfortable and confident with your decision as possible.
Best Wishes
Kathy

Good for you for making sure you got all you questions answered! I think getting a second opinion from a Gyn/Onc is always a good idea.....and you don't sound too confident about the dr you saw today.

My Gyn/Onc did my Cone Biopsies. The first one was done back in '89 and I had clear margins. I had 10 yrs of normal paps before the dysplasia showed up again. From what I understand a good percentage of pre-cancers are taken care of by the Cone and never show up again. You might want to do some research on the cure rates with a Cone Biopsy so you have as much information as possible when making your decision.

Good Luck!

EM, the truth is, I don't know whether to trust my gyn or not. He's always been pretty laid back about things. He came into my life after we moved to a new town, and I was pregnant with my third (after two miscarriages from PCOS). I was planning a home birth and that went sour, so my midwife suggested him. He's a great doc, very gentle and all, but like I said... he's laid back.

My dilemma right now is trying to strike a balance between overkill and buying the farm when all I need is a carton of milk. I have no doubt in my mind that he'll do the right thing if the path comes back abnormal, but if it's normal, he's made it clear that he's not pro-hyst.

I'm trying to navigate through my thoughts and feelings on this. When I miscarried twice, my gyn at that time (not Dr. Positive Pants) refused to do any testing until I'd lost three. I found that unacceptable and found a specialist who discovered the PCOS, LPD and Hashimotos. He treated me and I had my miracle baby. I came to the realization that OB/GYN's typically see healthy patients. Maybe they're just not as vested in the anomalies. However, I do not know this for certain, so I am asking myself two questions. 1) Am I trying to control things that cannot be controlled? or 2) Am I being my own best advocate?

*shrugs*

[edited to add a thank you to lepfan and Kathy for their thoughts as well. It's probably not a bad idea just to go ahead with the second opinion]