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What's the likelihood? What's the likelihood?

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  #1  
Unread 05-12-2003, 08:36 PM
What's the likelihood?

Hi, Sisters...
I am a bit concerned here, only really given what has happened thus far. Here is the quick version:

- Had a pap, abnormal, showed CIN I, scheduled colp & biop
- Biop showed CIN II, scheduled a LEEP
- LEEP path showed CIN III and adenocarcinoma in situ

Each one has gotten worse, here. My dr really feels most comfortable doing the hyst, which is ok with me. Will they test the cervix completely at that time too? What if it is worse? Could that be the case?

Thanks, girls.
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  #2  
Unread 05-13-2003, 05:54 AM
What's the likelihood?

(((Beth)))

Many 's coming your way. I have to say, though, that at this point, I would suggest you ask to see a gyncecologic oncologist. They are the experts when it comes to female cancers and precancers. You are a very young woman, and you should explore all of your possible treatment options before you commit to a hysterectomy.

It's not necessarily bad that your tests kept coming back looking worse. It sounds as if you have glandular cell involvement (adenocarcinoma-in-situ). The cervix has 2 cell types--squamous and glandular. The squamous cells cover the outside of the cervix and the lower part of the inside of the cervix. The glandular cells are located high up inside the cervix. The PAP and the biopsy typically are only able to examine cells on the outside of the cervix and those just inside the opening of the cervix. So if your problem is higher up inside, it really takes the LEEP to locate it. So it doesn't mean your condition has worsened, it just means that they found the source of your abnormal cells.

It is possible that they could go in and find that things are worse than they thought, but they usually have a pretty good idea before they go in. They will biopsy the entire cervix after surgery. If they happen to find early stage cancer (like 1a which means the tumor is very, very small) you would not need any additional treatment. We'll keep our fingers crossed that it is still in the precancerous stages (and chances are that it probably is, given your test results).

Did the pathology report happen to comment on if there were clear margins? That might lead them to believe that they got all of the cells and then you might not need the hysterectomy. Or you might wait for 3-6 months, have the LEEP again, and see what it says. A gynecologic oncologist is going to be the best person to help you make those decisions. There are other options out there besides a hysterectomy that will leave open the option for future fertility (such as a trachelectomy which removes the cervix but leaves the uterus). You might like to see if you are a candidate for any of these other procedures.

And remember that you can keep your ovaries. I kept mine. They work great and I feel like I always did.

Please let us know what you decide to do!
  #3  
Unread 05-13-2003, 03:47 PM
What's the likelihood?

I had the exact same scenario. It even got worse. When I had the hysterectomy they found Stage 1A adenocacinoma. This was over 99% curable with the total hysterectomy.

I would look into having a cone biopsy instead of a hysterectomy as well. You are so young. I was 35 and had 2 children already. Please see a gyn oncologist and ask about this. AIS and even stage 1A cancer can often be successfully treated with the cone biopsy. Good luck.
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  #4  
Unread 05-13-2003, 05:51 PM
What's the likelihood?

Thank you for the replies, ladies. I do have two children already, which is why I am really considering the hysterectomy. I am wanting to make sure that the possibility of anything else/worse occuring is just not existent. I would be keeping my ovaries, so I am not concerned about hormones... there are a lot of things to consider, and I am thinking that not taking any chances for the children that I have is much more important than the potential "what if's" or "it could happens".
Thanks again!
  #5  
Unread 05-13-2003, 08:49 PM
What's the likelihood?

If you have children, then it is very different. I made my decision based on the fact that my children came first. I did not want to take any chances. I made the same decision that you have made. It was hard but it gave me peace of mind. Good luck. They do the pathology on the entire uterine/cervix. It most likely is just AIS or might have progressed slightly as mine had. Either way your prognosis is excellent. Good luck!
  #6  
Unread 05-13-2003, 08:53 PM
What's the likelihood?

Thank you, Denise! I am relatively optimistic. (The decision and outcome I am confident of, the actual procedure -- yikes!).
Actually, I noticed you had a TVH also, as I will. How was your recovery? (I know all women are different, but I enjoy hearing individual cases.)
  #7  
Unread 05-13-2003, 09:17 PM
What's the likelihood?

Beth,
Just wanted to let you know that I am going through exactly the same thing as you. My hysterectomy is scheduled for May 29. I am 32 and have only one child, but I have decided that I'd like to be there for him and not always worried and stressed out about my health. I am glad that you posted, because I have been looking for someone who knows exactly what I am facing and has made the same decision. Take care.
  #8  
Unread 05-14-2003, 05:59 PM
What's the likelihood?

The TVH was a piece of cake. I was walking the next day. The worst part was the constipation.
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