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Unread 11-04-2005, 08:47 PM
Cone biopsy

I have a friend that has had a couple of abnormal pap smears. She has undergone several freezes and when she went for the checkup the other day the DR told her everything looked very good and gave her the clear to try and get pregnant. Since that day, she and her DH have been actively trying, as this was her fertile week. She may be pregnant, it's really too early to tell. Today her DR's nurse calls to tell her that she is set up for the 18th for a cone biopsy because they got back results that were not good. This thoroughly confused her because she feels she is getting two different answers from her DR.

My friend became frantic because of the chance that she may now be pregnant. The nurse told her it was a relatively simple procedure and not to worry because it would not hurt her pregancy (if she turns out to be pregnant). She didn't accept that answer and turned to the web, where she found some disturbing answers. According to the website she found, if she is pregnant, she could miscarry.

She is very confused, frantic, and quite upset. I told her that I would put it out on the hystersisters support group and see if I could get some answers from women who had actually had the cone biopsy.

Has anyone had this procedure? If so, what did your DR tell you?

I suggested if she was uncomfortable with the answers she got from her DR that it would be a good idea to get a second opinion before she actually had the procedure.

Please help me help my friend!
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Unread 11-04-2005, 10:21 PM

I had a cone done 13 yrs. ago. They cut a cone shape out of your cervix(only the abnormal cells). It is not a painful procedure and is done on an outpatient basis. When you get a pap, sometimes the naked eye will not see anything wrong and when the nurse called her several days later is probably when the results came back abnormal. This is something she should not advoid as dysplasia(sp?) on the cervix can lead to cancer if not treated. I did not need to do anything after my cone except get paps every 6 months for 2 yrs. and then once a yr. as usual. Everything has been fine after that. They will tell you sometimes you will not be able to carry a baby after a cone. I think that depends on how much is taken out with the cone. I guess it weakens the cervix. I had a baby two yrs. after my procedure and that was 13 yrs. ago. Tell your friend not to worry and just follow the doctors advice. Things you read can be very negative and intimidating. Best of luck....If she is pregnant, it might not hurt the fetus being it is really early.....BUT, tell her not to delay the cone......
Unread 11-05-2005, 12:02 AM
Cone biopsy

I had one and they put me to sleep for it. I have done A LOT of reading up on it and there are women that have a Cone and are pregnant. The Cone Biopsy does nothing to the uterus so she should be fine. They would only take a small one from her in the event that she may be pregnant.
Some spotting afterwards but she should do just fine.
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Unread 11-05-2005, 08:56 AM
Cone biopsy

My understanding is they would try to avoid doing a cone if at all possible if the woman is pregnant. I think the best thing your friend can do is phone the doc's office, find out exactly why she is having a cone biopsy scheduled (has she had a colposcopy with biopsies?) and what grade of dysplasia she is dealing with. For the doc to give her the all clear to start making babies then to turn around and get a phone call saying, go for cone biopsy....there's something missing here. I know it's the weekend, but I hope she will call her doc first thing Monday morning and get more information.

I just looked at my provincial management guidelines, and it says if the woman is pregnant, to do the colpos to ensure there is no invasion, then let the pregnancy carry out and treat after. Also, I am in communication with another lady who has gone through her entire pregnancy with CIN 3 (severe dysplasia), because they would not treat it while she was pregnant. Please help your friend to call her doc and get more information.

Unread 11-05-2005, 09:11 AM
Cone biopsy

I agree, cones can be done during pregnancy, but I would try to avoid it unless there is a high chance of invasive cancer. Colposcopys and leep can be done if necessary. I would try to wait for a month and see if she is pregnant. I had a cone about two months before becoming pregnant. My cone had clear margins (but very close in multiple spots)and showed adenocarcinoma in situ and CIS. A hysterectomy was the offered opinion...

After weighing the risk and benefits, we decided to try for a baby. But it took a lot of thought- my husband wanted to keep me more than have a baby...

many docs don't treat cervical issues while pregnant unless necessary. I would see if they could do a less invasive test without sedation (like the leep) if it had to be done and she were pregnant (unless it was likely that it was invasive cancer). If it is likely invasive cancer then your friend and her husband have to decide the risks vs. the benefits... I hope all goes well in the next couple of weeks. I agree that your friend should call the doc to get more info at this time...
Unread 11-07-2005, 08:45 PM
Cone biopsy

I agree with Karen's (oneconfusedlady's) advice. There are variations as far as the size of the cone taken during the procedure, but I would imagine that even with a small one there would be some possibility, however slight, that a miscarriage could happen. I would suggest, if she hasn't had it done already, a colposcopy with or without biopsies taken.

During my first prenatal appointment, I had a pap done because I'd had a history of abnormal paps (low grade) --- this one came back with high-grade changes. I went in for a colposcopy and my doctor told me that I had severe dysplasia but we'd monitor it and treat it after my pregnancy was over. She didn't take any biopsies, not even a scraping --- it could be that it was a matter of *her* opinion to not disturb the cervix during pregnancy. Some doctors may think differently about this, so if she isn't comfortable with the advice that her doctor is giving her, she may want to look into second opinion.

Not to scare you (or your friend) in any way, I was diagnosed with cervical cancer after I gave birth to my daughter this past April. But --- I had an otherwise healthy pregnancy, with no complications. And after having surgery in August, I am cancer-free.

I hope that all is well with your friend, my thoughts are with her. Just be sure that she is aware that she is ultimately in charge of her own body, and her own care --- if she's uncomfortable with what her doctor is suggesting, she has the right to disagree with it and/or find another doctor who errs more on the side of caution.
Unread 11-09-2005, 08:28 PM
Cone biopsy

Hi, I am 28, I have had 2 babies, one is 3 now and the other just turned 2.....had a normal pap early last year at my post delivery for my second child and 11 months abnormal pap, they did a cone biopsy, path report showed invasive cervical cancer, had another pap 12 weeks later, showed the cancer was comming back already...had a hysterectomy two weeks ago tommorow. I think that your friend should see her Dr. and should follow the recomendations that he/she has in regards to the abnormal pap and what it might mean, it could be a mild, moderate problem, that is what I thought, but it wasn't,,,, you just never know. If there a serious problem, she needs to know about it and needs to be able to take care of the problem asap. If she is uneasy with her Dr. as she was told to go ahead and try to get pregnant, that it was okay to go ahead and do that, even before receiving her pap results....maybe she should get a second opinion, that is pretty serious for a Dr. to be so careless.

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