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Unread 03-04-2004, 06:14 PM

I was told I had CIS in early Feb and as I read some of the other postings I am starting to get confused. I had an abnormal pap and then an abnormal colpo(CIS). I was then refered to an OB/GYN and he wanted to re-do the pap and colpo feeling he had more experience. He took 3 biopsies and they all came back normal and the pap came back positive with high-risk HPV. He wants to go ahead with a cone biopsy and a D&C to find out where the abnormal cells are coming from. He is not very concerned about this (of course he's not living with it) and keeps telling me it's very rare for it to turn in to anything. No spotting between periods or bleeding after intercourse and only one previous abnormal pap 2 years ago that turned out OK. And 3 normal paps since then. What I don't understand is if CIS is considered non-invasive "pre-cancer" wouldn't the margins always be clear? And what if their not? Does that automatically mean cancer? I do like my doctor and I do trust him but I work and a hospital and cross paths with him occasionally so I sometimes wonder if he's just not saying anymore until he is sure. For now I have been trying to collect all my medical records so I can actually see the reports.
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Unread 03-04-2004, 07:19 PM

Sounds like you do need copies of the lab reports. CIS is one step from invasive cancer, in fact it is considered stage zero. Is it posible that you have CIN instead? A colpo without a biopsy does not contain enough information to diagnose CIS. However, a doctor can view CIN 1 with vinegar and a colposcopy. Many times CIN 1 will be resolved by the body.

Not sure why the D&C. That is not standared for cervical cancer diagnosis.

Let us know what you find out. I am very interested. Otherwise, keep yourself busy so that it is not so much on your mind.
Unread 03-04-2004, 08:08 PM

I think the clear margin thing goes more to the edges of the lesion not necessarily how deep (invasive) it is. It is possible to still have dysplasia on the edges of the cone but still only have CIS because the dysplasia doesn't extend into the cells below the epithelial layer. Good luck
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Unread 03-05-2004, 06:43 AM

's Miranda! Welcome to Hystersisters and our Cancer Concerns forum.

I'm sorry to hear that you are going through this. You'll find lots of company here, and hopefully some helpful information.

HPV is a pesky virus that can really cause some of us problems. Keep in mind that most women do not have any long-term problems with it. Some of us just seem to have immune systems that can't fight it off. It is estimated that around 80% of women carry one form or another of this virus. Some forms cause no problems, some cause warts, others are related to dysplasia and cervical cancer. What a nuisance!

It sounds as if your doc is following pretty standard procedure here. You have an abnormal PAP, one set of your biopsies was negative, one set showed CIS. It really is in your best interest to see where the cells are at so that they can be removed. The thing about a cone biopsy is that in 80-90% of cases, it not only diagnoses the problem, but it also fixes the problem. Which is good. My doc also did the D&C, and while not all docs do the D&C, many do.

It could be that he's not all that worried about you because he's right. Dysplasia does not always, and does not even usually turn into a cancerous situation. However, lots of women here have had it turn cancerous. But remember, the women who are here stay because of that fact--we required ours to be removed by hysterectomy and some of us needed additional treatments. Most of the women who have had CIN/CIS are not on this board--they had their cone biopsies and went on to a life of normal PAP's. I've read a couple of studies that said that if left untreated, CIS would actually become cancer in only 1 of 7 women. I find that comforting. The only catch is that you don't know if you're the 1 or the 6, which is why medical treatment is so important to get the issue resolved. Many cases of CIN I and CIN II will resolve themselves given enough time. Some cases of CIN III will resolve themselves. And even though on paper CIS is right next to invasive cancer, it's still a big jump to get there. But it's still very important that you get this treated and that you then have your follow-up PAP's (actually, they should do a ThinPrep on you now--you might like to ask about it) every 3 months for the next 2 years.

A cone biopsy is similar to coring an apple. The inside of the cervix is removed. Then they can see where the abnormal cells are. The margins refer to the edges of the samples that are taken. If you have clear margins, that means that the abnormal cells were all contained in the bulk of the sample and that all around the edges of the sample there were only healthy cells. If you have positive margins, that means that the abnormal cells went all the way to the edges of the sample taken and that there's a good chance that more abnormal cells are still in there.

Good luck, (((Miranda)))!

I hope your cone biopsy goes well and that all of the abnormal cells are removed. Please let us know if you have more questions, and please come back and let us know how you are getting along!


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