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I am a bit confused about CIN III monitoring I am a bit confused about CIN III monitoring

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Unread 01-13-2004, 04:36 PM
I am a bit confused about CIN III monitoring

I had been under the impression that although CIN III is severe dysplasia, it does not necessarily mean cancer. I have now been on the web and it seems as it is in fact considered to be carcinoma in situ. Is that why the feedback i have been getting is that I need to see an gyn/oncologist? My ob/gyn is not pushing for it at this time. The sequence of events pap, colposcopy with biopsies, leep and follow up pap 2 weeks ago showed now clear margins, the fact remains of the 6 biopsies taken; 4 were HGSIL CIN III and 1 was CIN II and one was CIN I. I guess I should not wait until my next pap to consult an oncologist? Help? I am confused.
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Unread 01-13-2004, 06:42 PM
I am a bit confused about CIN III monitoring

There is a very fine line between CINIII and CIS. Some doctors/pathologists do not differentiate between the two. Essentially, the way I understand it, is that CINIII means at least 75% of the cells in the "skin" (top layer) of the cervix are abnormal, but that there are still some normal cells remaining. CIS means that essentially all cells in the "skin" of the cervix are abnormal in nature. Once the cells break through the barrier (or basement membrane) separating the "skin" of the cervix from the body of cervix, well, you have invasive carcinoma. In some women it may take a long time to progress from CIS to invasive cancer, or it may never progress. In some women, it seems to be a relatively quick process. CINIII is a precancerous condition. CIS is generally considered to be precancerous, but some docs consider CIS to be stage 0 (noninvasive) cervical cancer.

As far as seeing a gyn/onc, well, a lot of gyn's do not refer to a gyn/onc until cancer is suspected. Some will refer once there is a recurrence of dysplasia. I had several episodes of dysplasia (my first episode being CIS) before we consulted with a gyn/onc. I was just very comfortable with my gyn and he is widely known for doing things by the book and as conservatively as possible. The fact that you had clear margins after your LEEP is very encouraging. I can't tell you whether or not you should see a gyn/onc right now. At the very least, I would suggest that if you have another abnormal PAP or before you decide to have any other treatments (should an abnormal PAP arise), that would certainly be a good time to seek an opinion from a gyn/onc. If you would feel more comfortable talking to a gyn/onc now, then absolutely request a referral to see one.

Good luck, Neesey! Let us know what you decide to do!


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