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Cancer questions
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07-14-2004, 07:47 AM
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HysterSister
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Posts: 33
Hysterectomy: August 4th, 2004
Surgery Type: TAH
Ovaries: Kept 1 or both
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Cancer questions
I was diagnosed with adenocarcinoma and squamous cell carcinoma of the cervix. This after a colcoscopy and LEEP with a cone biopsy. It appears that the cancer is stage zero, but it goes to the margin. My gynocologist consulted with a gynocology oncologist who is recommending a total hystorectomy because the margins weren't clear from the LEEP/cone biopsy.
Questions:
1. Does anyone have a similar experience?
2. How long does it take to stop having discharge after the LEEP/cone biopsy?
3. What does the margins not being clear mean for the stage one diagnosis?
Trying to stay positive...
SHERLYN
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07-14-2004, 09:07 AM
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HysterSister
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Posts: 4,498
Hysterectomy: February 9th, 2001
Surgery Type: TAH
Ovaries: Kept 1 or both
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Cancer questions
's Sherlyn! Welcome to Cancer Concerns! We're glad you found us!
I'm sorry that your pathology report came back with some issues that still need to be addressed. Stage 0 cancer is also frequently called carcinoma-in-situ or "cancer in place". It's not a true cancer because it has not yet invaded anything, but it's a condition that needs to be attended to so that it doens't decide to become cancer.
The margins refer to the edges of the biopsy sample that were taken. The goal in a LEEP or cone is to get all the way around the abnormal cells and they know they have accomplished this when they achieve clear margins (or healthy tissue at all the edges of the sample). When the margins are positive, that means the abnormal cells went all the way to the edges of the sample, so it is assumed that more abnormal cells are still left behind.
You would not be determined to be a stage one cancer unless the abnormal cells break through the basement membrane. This is different from the margins. The margins refer to the width of the sample (how much surface area is involved). As long as you have CIN (cervical dysplasia) or CIS (stage 0 cancer), the abnormal cells are only in the "skin" of the cervix--just the top few layers of cells. Separating the "skin" from the deeper structures of the cervix is the basement membrane. As long as you haven't broken through that, your cancer is not invasive. Once you have broken through that, you are placed at a stage one which increases as the tumor grows and spreads.
Discharge can vary from 2-4 weeks. Please contact your doctor if it ever becomes bright red or you soak a pad in an hour's time, or if you have any concerns at any time.
Remember that you can always request an additional consult with a different gyn/onc to see if they feel the same way about the necessity of a hysterectomy. Some will go back and do a second cold knife cone biopsy to see if they can achieve clear margins that way. There may be some other options available for you if you are interested in preserving your fertility. You might like to inquire if you are a candidate for a trachelectomy where the cervix is removed but the rest of the uterus remains. If you are finished having children, then perhaps the hysterectomy looks like the best option for you. Discuss this thoroughly with your gyn/onc and see what's best for you!
Good luck! I hope you find a treatment plan that's right for you. Please keep us posted!
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07-14-2004, 11:11 AM
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HysterSister
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Posts: 33
Hysterectomy: August 4th, 2004
Surgery Type: TAH
Ovaries: Kept 1 or both
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Cancer questions
THANK YOU! I really appreciate your explanation. I don't have another appointment with my doctor until the 30th, and I find that I always have additional questions later...
I am going ahead with the hystorectomy because of family history of gynocological cancer and my own issues with endometriosis. This latest diagnosis has just speeded up the process a bit. My concern is mostly that we get all the cells so they can't invade and that I will be healed in time to start school in the fall. I teach and am concerned I won't be healed well enough by 4 weeks post op which is when I'm supposed to start...
Thanks too for the info on the LEEP discharge. My cycle is supposed to start in the next couple of days...do I need to worry about that?
Sherlyn
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07-14-2004, 11:59 AM
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Guest
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Posts: 47
Hysterectomy: August 19th, 2004
Surgery Type: LAVH
Ovaries: Undecided
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Cancer questions
Hi Sherlyn,I too had a cone biopsy and bled for3 weeks ,then got my period then bled some more after that .I was concerned but my doc wasn't. I was going through about 3 panty liners a day,nothing too heavy..My doc does not stitch the cervix because he likes it te heal from the inside out,so that may be why.My cone showed some invasive cancer( that they got) and some CIN III to the margins.My doc acted very casual while I planned my funeral.Hubby almost passed out in the docs office and speaks very little of the surgery coming up.I am more relaxed about everything now.I know now that it's a good thing that they got the invasive stuff and the other stuff will be gone after the 19th of August.I hear recovery time is short for the surgery I'm having,so that is good too.I plan on focusing on the good and just educating myself.In the begginning I was overwhelmed with such a feeling of ignorance.I'm glad to have found this site and glad you did too.Good luck
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07-14-2004, 03:16 PM
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HysterSister
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Posts: 33
Hysterectomy: August 4th, 2004
Surgery Type: TAH
Ovaries: Kept 1 or both
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Cancer questions
Thanks for sharing your info. I am not bleeding heavily, but it stays pretty consistent. I am just going to be glad when this is nothing but a "fond" memory!
This site has been quite helpful! Best of luck on your surgery...mine is Aug. 4
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07-14-2004, 06:49 PM
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Guest
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Posts: 312
Hysterectomy:
Surgery Type: LAVH
Ovaries: Kept 1 or both
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Cancer questions
Sherlyn,
Thanks for asking those questions and for Jeanine answering. MY mom was diagnosed with stage 1 cervical cancer last week and I have lots of questions myself. She goes next week for results of biopsy and decide what route to take. I myself had a hysterectomy in Feb for endo and was really surprised with my moms diagnose. She has been going thru menopause for 5 years and only began to have problems this year. She spots all the time. Of course, the abnormal pap for 2 years now. She didn't tell me about last years until now. It really scares me. My surgery was done for constant pain not cancer. Thanks again and best of luck to you. You are in my thoughts as well.
Tammie
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07-14-2004, 09:25 PM
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HysterSister
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Posts: 62
Hysterectomy: July 17th, 2003
Surgery Type: TAH/SAH
Ovaries: Removed both
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Cancer questions
Sherlyn,
I had endometrial cancer and had a TAH/BSO on 7-17-03.
I am a teacher's assistant with 10th grade special needs students.-- I went back to work after 6 weeks on a part-time basis for 2 weeks---working only afternoons. Then back to work full-time after 8 weeks post-op. Someone gave me this suggestion and it was worth it's weight in gold.
I don't know if you have this as an option, but it worked for me.
I did a lot of walking around a huge school, but maybe you work in the same class all day. I was exhausted after every day and it seemed like it was almost Christmas before I finally felt a lot better--- after 2 weeks of Christmas vacation, I felt a whole lot better.
No one ever told me but I found panty girdles to be a lifesaver and they seem to help hold me in ---they may work for you too.
Ro ro the sub
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07-15-2004, 12:40 PM
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Guest
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Posts: 37
Hysterectomy: October 11th, 2004
Surgery Type: TVH
Ovaries: Kept 1 or both
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Cancer questions
Sherlyn,
I too had the LEEP procedure done 2 years ago in June for Carcinoma-In-Situ. Mine also went to the margin, but the area where the carcinoma was found was right at the edge of the opening of the cervix. Therefore it has been very hard to get tissue biopsies from the area pass where the coning was done. My doctor gave me the option of a TVH but at that time I was getting ready to move to Texas from Alabama in August. Believe me I wanted to take my doctor with me. At this point he was very admit about me doing my follow up in 6 months. When I got to Texas I found a doctor but she did not seem to take it serious enough for me. It took me about a year to find a doctor I really loved & trusted. Two weeks ago I went in for another scope & biopsy. I got the results yesterday and they were good but my doctor is leery because he can not get far enough in to the cervical opening to retrieve tissue to see past the margin of the conization that was done. He has given me 3 options & I am now in the decision process of what to do. He told me that I can wait another 6 months a do a re-thin pap, I could go in and have another LEEP done still no guaranty, or go ahead and know 100% that it is taken care of with a TVH leaving my ovaries. This is a really hard decision for me.
I'm sorry to have rambled on but it is so comforting to know that there is someone else out there that is going through the same thing I am going through. I know you had said that there were some other things that have helped you to make the decision such as your family history & your endometriosis, for me I am healthy except for this so you can see why this is so hard for me. I know that ultimately I have to make the decision fro myself but this web site has helped.
Hang in there, I speak to my self also when I say this, "You can so all things through Christ who strengthens you." You are in my thoughts and prayers. God Bless!!!!
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07-15-2004, 01:27 PM
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HysterSister
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Posts: 33
Hysterectomy: August 4th, 2004
Surgery Type: TAH
Ovaries: Kept 1 or both
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tough decisions
Dear Yellowrosetx,
I am also comforted by this website and people like you willing to share and communicate. I have a close relationship with the Lord and feel at peace with my decision. I have other issues, as you saw, but I also let my husband and family weigh in their opinions as well. My husband can't bear the thought of leaving the possibility of more cancer or invasive cancer later. That is my biggest fear as well.
Right now the plan is to do a TVH on August 4. However, because of how my cervix is placed and it's lack of "give" I may end of with a TAH instead once they start. My doctor and I are going to further discuss that on my pre-op appointment.
I am glad you were persistent in finding a doctor you can work with...that is so important. Continue to ask lots of questions, pray without ceasing and the right answer for you will come! I am praying for you...keep in touch!
Sherlyn
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07-16-2004, 08:05 AM
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Guest
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Posts: 37
Hysterectomy: October 11th, 2004
Surgery Type: TVH
Ovaries: Kept 1 or both
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Cancer questions
Good Morning Sherlyn,
It was so good to hear from you. It is so funny that you had mentioned that your family has been a part of the decision that you had to make. Last night after my husband & I talk for a long while, we brought our children in to let them know what we were looking at fro me. I have a son that is 14 & a daughter that is 12. They had a few questions for us, but all in all I felt a peace from them. They didn't seem worried or scared for me. My husband also doesn’t like the idea of not knowing 100% that things are ok so we have come to the decision together & under God that having the TVH would be what is best. There is a peace in our hearts & that is what we have to go with. Of course the enemy has tried like crazy to mess with my head but "Greater is He that is in me than he that is in the world!"
I will be talking to my doctor today to let him know what we have decided. Also, I will let him know, since it is not something that has to be done right away, when it looks that the best time, financially, I can be out of work. I will be asking a lot more question of course. I will keep everyone informed as to when the TVH will be scheduled.
Thanks so much again for letting me bend your ear. I am also here for you to bend mine. Good luck with your surgery on Aug 4th...I am believing with you that the TVH will be sufficient & no Abdominal cutting will have to take place. God Bless!!!
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