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Adenocarcinoma in situ confusion! Adenocarcinoma in situ confusion!

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Unread 04-01-2004, 04:26 PM
Adenocarcinoma in situ confusion!

In Oct 2003 I had a pap at my GP's office, it came back with AIS. my doctor "lost the report" luckily it was found by another Dr. In Jan I had a colposcopy. That came back with mild/moderate displyasia. So, I had a cone biopsy (conization) last week. Dr. called me today. He said it only showed atypical cells but wants me to see an Gyn/Onc. How can it be so much better????

Is it true that AIS can "move" around? Is it possible to still have AIS after a "clear" cone biopsy? Orginally I thought I had CIS (I misunderstood my GP I guess.) Now that it is 5-6 months since the original pap smear- could I have healed?

I wasn't too scared until I just found out it is AIS. From what I have read, it sounds worse than CIS - since it is in the glands and harder to detect. Is this true? I am done having children... so should I have a hysterectomy or can conization cure it???

Thanks! Karen
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Unread 04-01-2004, 04:54 PM
Hi Karen:

I had an abnormal pap (and had a history of them on and off for several years). My doctor did a LEEP and that's when I was diagnosed with adenocarcinoma in situ. You're right, Adenocarcinoma is more difficult to detect because it is glandular (not always detected with a pap smear), so I'm glad my doctor took the extra step and performed the LEEP. They could not determine if there were clear margins when they were reading the results of the LEEP because there was a suspicious area that was near the area that had been cauterized during the procedure making interpretation of that area difficult. At that point, my doc decided to perform a cone biopsy which he did about 6 weeks later. The cone biopsy confirmed that the cancer was contained and had not invaded surrounding tissues. My doc did end up doing a TAH anyway, but I was able to keep my ovaries. The final pathelogical diagnosis after the hyst revealed that there was no evidence of residual carcinoma, so I guess I'm cured for now! I'm glad he did the hyst though because they also discovered that I had adenomyosis....which explained the heavy bleeding and clotting that I had been experiencing. So, I got rid of 2 problems at once! Best of luck to you!
Unread 04-01-2004, 09:47 PM
Adenocarcinoma in situ confusion!

If you are done having children the recommendation for AIS is a hysterectomy. A cone can be curative and is recommended for women who want to preserve fertility.

As for the AIS clearing up-I know there are studies that say that folic acid can reverse dysplasia. The body can work in mysterious ways and I would think it is possible that the AIS could have cleared it up.

It is good that your gyn is sending you to a gyn/oncologist. It is always good to get an opinion from an expert.
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Unread 04-02-2004, 07:13 AM
Adenocarcinoma in situ confusion!

Sunnysd - I grew up on a sunnyside drive.
andydenise- I am also in NY.

Thank you for the replies. Since there was confusion about the kind of cervical carcinoma in situ I had/have, I am going to request a copy of my results before my referal. I did a lot of research on the internet and found that if the "atypical cells" are glandular it means more than if not. Also the location and margins, etc. I'm glad that my Gyn called me before my app't. I have so many more questions now.

I read "somewhere"(possibly a post) that this type can move or change location- does anyone know if that is true? I couldn't find that on the internet. It's a little scary.....

Thanks again,
Unread 04-02-2004, 06:49 PM
adenocarcinoma confusion

Hi Karen: I had the same questions. From what I've been told, read, etc., adenocarcinoma of the cervix can spread into other neighboring tissues if not treated. My Gyn told me that that's why they wanted to do a cone before my hysterectomy to make sure that the cancer was contained and had not invaded lymph nodes, etc. If it had, they would have had to take a different approach with they hyst (removal of affected tissues, lymph nodes, etc. vs. a regular hyst.) There are many types of adenocarcinomas that can different parts of the body (i.e. breast cancer is one of them), but I don't think it can jump from one part of the body to another...say from cervix to breast. Does anyone else have info on this?
Unread 04-02-2004, 09:51 PM
Adenocarcinoma in situ confusion!


Thank you for the reply. I guess what I wrote was confusing. I am wondering if this type can heal and then come back(elsewhere in the cervix). Since my pap was more severe than the colposcopy and my cone was even less severe. I want to be sure they aren't missing something. I was told by my Gyn that "abnormal cells don't get 'that much' better".

pap- oct 2003 adeno carcinoma in situ
colposcopy jan 2004- mild/moderate dysplaysia
cone biopsy march 2004- atypical cells of unknown significance

I am not sure of the 'type' of cells in the colposcopy and the cone biospy. I am also unsure of margins. I have my appointment on Tuesday with my Gyn to get the actual results- I have lots of questions. If they are glandular, it concerns me more.

Until yesterday, I was unaware that there where different types of cervical in situ. My GP may have read me the whole report but I must have pulled out "carcinoma in situ" and missed the "adeno" part. When Gyn called he read the reports to me and I caught the word "adeno" at that point. So, then I did research on my own.

I can't imagine why the big differences in these cells. It makes no sense to me. I am just so confused!!!!
Unread 04-02-2004, 10:29 PM
Hi Karen..yes, lots of confusion...

I don't think that adenocarcinoma goes away by itself. I have heard that dysplasia can come and go depending on a woman's situation, but adeno is different. I know that it is more difficult to detect. In fact, the last pap that I had wasn't that abnormal, but because my doctor was vigilant, he ordered a LEEP prodedure and that's how they detected that I had AIS. I've heard that sometimes, AIS won't even show up in a routine PAP.
Unread 04-03-2004, 08:59 AM
could this be why my cells appeared "better"

I may have missed something of sigificance. My first Gyn that didn't explain things well, did the colposcpy. When he was done, I remember his nurse asking if he wanted the liquid nitrogen and he said yes. So, if he treated the area with nitrogen, for what ever reason, I am thinking it could make my cone biopsy appear to have less bad cells. It was 2 months after the colposcopy that I had the conization- from what I have read about freezing the cells- it would have healed with little or no scarring.

Does anyone know about the affects of freezing?? could that make conization appear better? Also is this common practice to freeze the cells before the cone biopsy?

Thanks for all the input,

Unread 04-04-2004, 08:12 AM
Adenocarcinoma in situ confusion!

I had invasive adeno carcinoma and it probably was there is some form 7 years ago when I had an abnormal pap.

However after the colpo and a biopsy all came back fine. Then I had all normal paps for 7 years. Endo cervical adeno carcinoma appeared last April and it turned out to be invasive cancer.

I am almost one year out and doing ok - I do still have mild dysplasia from HPV but it is getting better.

I do recommend seeing an board certified oncologist and here is why - you doctor maybe familiar with squamos cell carcinoma however adeno is tricky and can hide in the endocervical canal.

Inflamation and a water discharge are very common indicators of
AIS and CIS. However oncologists are very familiar with AIS and
you should visit a good one (preferably one the does not know your current doctor)

I am sure you will be fine because you are being proactive!!!
It is also good you are educating yourself.
Unread 04-04-2004, 04:39 PM
Adenocarcinoma in situ confusion!


Your reply made me think way back..... I had a 2 paps, 8-10 years ago years ago, come back with something- One said inflammation and one I can't remember but, it was a re-test in six months both times. I know one pap showed endometrial cells on my cervix- I don't know if that would have been a reason for a retest. Both times the re-tests were normal. It was so long ago, it's hard to remember exactly what they said. I have changed Gyns several times because of moving, insurance, etc..

I haven't had a problem with a watery discharge. I do have a problem with an itchy discharge after...... well you know...... 'being with my husband'. I've also had a problem with dryness and that started about 8 years ago- I am only 33. Not sure if it is related......

I am seeing the Onc on Thursday. We only have 2 Gyn/Onc within an hour drive so, my Dr. knows both of them. I am going to see the one at the University Hosp. Why did you recommend seeing one that does not know my Gyn? Just curious.....

Thanks again,

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