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Is cancer diagnosed after the cone? Is cancer diagnosed after the cone?

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Unread 03-03-2004, 01:40 PM
Is cancer diagnosed after the cone?

I was diagnosed CINIII/HGSIL a month ago during a ablation and D&C. I am scheduling my cone biopsy Monday. If it was cancer wouldn't it have already shown up during the ablation and D&C? Is the cone just to remove the cells? Has anyone been diagnosed with cancer after the cone biopsy?

Does my question make sense?

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Unread 03-03-2004, 01:49 PM
Is cancer diagnosed after the cone?

I would think that the biopsies you already had would have detected the cancer but some think that a CINIII is cancer-in-situ. When I had cancer, my pap showed a CINIII. BUT that is not common. A cone biopsy certainly can be curative. And I suppose that it could also show that the CINIII was, or is now, cancer.

Make a list of all your questions and take it to the gyn/onc when you go in for your cone biopsy. Despite my pap smear, the gyn/onc was able to accurately diagnosis my cancer immediately, just by looking at. All the other doctors had been unable to do that but the gyn/onc had so much experience he didn't even have to wait for the biopsy. The biopsy results confirmed his diagnosis.

Chances are that the cone biopsy is all you will need to fix the problem, with close follow-ups after that. That's the case for the majority of women.

I know it's easier said than done, but try not to worry yourself sick between now and Monday.

Unread 03-03-2004, 05:51 PM
Is cancer diagnosed after the cone?


I had a cone biopsy done done Nov 03 after an abnormal pap and colposcolpy. I was not showing cancerous cells on the cervix, but i was CINIII/HGS. My doc felt that i hadnt crossed into cancer yet, but still wanted to make sure. Thank God he did.
The pathology reports came back as 1A1 microinvasive
carcinanoma, with negative borders.
I had a TVH on 12/23.
The waiting is the hardest part. I remember being so numb during those months and i find myself still scratching my head.

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Unread 03-03-2004, 08:04 PM
Cancer Diagnosis after Cone

I was diagnosed with CIS in Feb and had a LEEP cone two weeks ago. As seeing carcinoma written on a path report scared me to death, I did all the research I could. I'm a scientist so I had a pretty good grasp of the literature I was reading. If nothing to this point has indicated you might have invasive cancer (i.e. the biopsy or pap), you have less than a 5% chance they will find invasive cancer in the cone. This is true even if you have CIS. Usually invasive cancer shows up before the cone. You have an even smaller chancer of having invasive cancer if you have been getting regular paps. I'm not saying it can't happen (I'm sad to see it has happened to people on this board) only that it is very unlikely.

I wish you luck with the cone. May they get all of whatever it is (most likely CIS ONLY) so you can be done with only the cone procedure.
Unread 03-03-2004, 11:54 PM
Is cancer diagnosed after the cone?

I would ask about DNA testing for HPV; there are a number of strains, and only some of them are associated with truly invasive cancer.

I'm one who had a supracervical hyst after years of normal, negative HPV Paps. This last summer, a Pap came back showing squamous hyperplasia, HPV negative. Follow-up a few months later came back CIS, HPV-positive. I've had culposcopy and cryo-ablation, and now I'm waiting for that follow-up Pap next month. We plan to do the DNA testing if it comes back still positive, and if it's one of these high-risk strains, we're beginning to talk about surgery.

In the meanwhile, there is evidence that folic acid intake and other dietary maneuvers may improve the outcomes. It stands to reason that anything you can do to improve your immune system (including exercise, diet, quitting smoking, trying to improve stress levels) can only help your body fight off the virus. It's worth a try!

I hope the cone is "curative" for you. Did the endometrial biopsy show anything from the D&C? If you've been having abnormal bleeding too, I can see where you would be worried even more. In your situation, if the biopsy comes back with unclear margins, or progression, you need to see a gyn-oncologist (if you're not already). They are really the experts, and if there is any endometrial abnormality as well, they'd be the best surgeons to take care of it if anything surgical should be required. They are the experts in women's cancers, and would be best-equipped to advise you.

Here's hoping for clean margins, and a healthy future!

Unread 03-04-2004, 08:33 AM
Is cancer diagnosed after the cone?

Hi CJ,

This is the toughest part, waiting around for the surgery--hang in there! I'm one of those rare birds who had an abnormal pap showing CINIII, had a cone to treat it, and was diagnosed with very early stage microinvasive adenocarcinoma from the cone results. This happened in 2002.

I ended up having a trachelectomy, in which the cervix is removed but not the uterus, leaving the possiblity of fertility in the future. I have been clear of the cancer since. However, the vast majority of the time a cone biopsy is all that is needed treatment-wise. Best of luck to you and let us know what happens.

Unread 03-04-2004, 08:59 AM
Is cancer diagnosed after the cone?

's CJ!

Abnormal PAP's are such a worrisome thing. I'm not sure I understand your entire situation, but if you went in for a D&C and ablation, well, those things involve your uterus. Somehow either some cervical cells came through with that procedure, or they did a PAP at the time of those procedures which then came back abnormal. So abnormal cervical cells would not necessarily be thoroughly detected at that time. That's why you are having the cone. The cone will specifically biopsy the cervical cells to determine the extent of involvement. As the other ladies have said, a cone is frequently all the treatment that is needed for CINIII and even for CIS.

I will be keeping you in my thoughts and 'ers. Good luck!
Unread 03-04-2004, 12:33 PM
Is cancer diagnosed after the cone?

Thanks for all the words of wisdom!

Jeanine ~ Actually my paps have always been normal but for two years I had been experiencing debilitating menstral cycles. Heavy bleeding/large clotting/severe cramps. Therefore, I had the D&C and endometrial ablation. It was during this procedure that the abnormal cervical cells were detected. It was a complete surprise. Apparently they are located high in the cervical canal. I guess what I'm really worried about is #1 if they are that high in the cervix will they all be removed by cone and #2 if they are all removed how will I know in the future if they come back that high since you can't detect them that high by pap?

I am becoming a lot less convinced that it's cancer as time goes by. I've had a month to "digest" as much info as possible and this site is great because I can actually "talk" to women who have been there / done that.


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