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Confused re: ONC/GYN Confused re: ONC/GYN

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Unread 07-17-2007, 02:31 PM
Confused re: ONC/GYN

Hello ladies!

Quick medical history review:
For the past 8 years dealt with abnormal pap's going from low grade dysplasia to sereve dysplasia. I have had 3 biopsies and 2 LEEP's. I have been seeing a OB/GYN. I have high risk HPV and endo. My endo is under control with Aygestin (no periods).

In December 2006, had yet another abnormal pap smear - low grade. The OB/GYN discussed my options.
1. LEEP - did not think an option because most of cervix is gone.
2. Cone - same thing as LEEP
3. Hysterectomy - would not remove the dysplasia and did not recommend
4. Retest in 6 months - to see if it went away on its own

I decided to retest in 6 months. In June 2007, had another abnormal pap smear - low grade. The OB/GYN decided it was time to see an ONC/GYN because she can perform a certain laser surgery and get deep in places.

Met with ONC/GYN yesterday (July 16th). After she reviewed my medical records from OB/GYN, thought it would be best to have hysterectomy. I commented that hysterectomy would not get rid of dyplasia. Her response was "It would get rid of the chance for cancer to end up in your uterus". Okay, logical answer. Then she decided to do an exam. While doing the exam she keep asking me when I had my last period. I kept telling her its been years since I have had a period. Then she decided to get a scrapping of the vaginal area. OH MY GOSH, talk about pain. My legs were jumping it hurt so bad. I kept telling myself hopefully she is getting a good deep sample of this area since its the area that the bad cells likes to hang out at. The scrapping was so intense the nurse had to give me a pad because I was bleeding. The ONC/GYN while walking out of the room stated the results would be in by Friday and to call the nurse on Monday. That she did not think I was ready for the laser surgery, that maybe a cone or hysterectomy would be better.

Needless to say I was floored at the treatment I received at a cancer center. No aftercare call if you have nothing.

Now I am confussed because of the conflicting information from my OB/GYN and the ONC/GYN. I know that ONC/GYN are better skilled to handle this stuff but my OB/GYN has been my doctor for 10 years and knows my history and the pattern.

Who should I listen to?

Sorry for the long post!
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Unread 07-17-2007, 03:17 PM
Confused re: ONC/GYN

I can't believe they were so mean to you!!!!! That's horrible.

I also got conflicting information from the gyn/onc, in fact, he was a real jerk. I ended up
trusting my ob/gyn doc but in your case it really sounds like you would benefit greatly from getting another opinion. I know it's a hassle but at least you might get some better answers.
Unread 07-17-2007, 04:40 PM
Confused re: ONC/GYN

I'm sorry you were treated that way, Jessica.

What I would do is wait until the results from your scraping come in, get a hard copy, then make an appointment with another gyn/onc.
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Unread 07-17-2007, 05:52 PM
Confused re: ONC/GYN


I'm sorry you had a difficult exam. I have found that those vaginal scrapings can be painful at times. Perhaps your pathology report will give some indication as to why it was so painful for you.

On the bright side, it's a low-grade dysplasia you're looking at, just like it was 6 months ago. It's always possible that your body is trying to deal with this on its own.

On the not-so-bright side, you've been dealing with it for several years. It's really frustrating to deal with this for extended periods of time.

I'm not sure why you're saying that the hysterectomy won't remove the dysplasia. That's exactly what it does. Your cervix is removed during the hysterectomy, and the cervical dysplasia is thus removed. Most women never have any problems with their dysplasia once they've had their hysterectomy. A very, very small percentage have a vaginal recurrence.

What I think is probably less clear is that when a woman gets vaginal dysplasia, is it because some of the cervical dysplasia cells were left behind? As the cells continue to proliferate and take up more surface space, they can spread onto the vaginal wall. If the surgeon does not remove a wide enough circle of tissue at the top of the uterus around the cervix, then some abnormal cells can be left behind which can then just continue to grow and proliferate.

The other possibility is that the HPV (which is not removed during the hysterectomy, though the HPV-infected cervical cells are removed) simply causes a new area of difficulty. It appears, though, that the cervical cells are much more vulnerable to HPV than vaginal or vulvar cells are. So, by removing the cervix, you've removed the tissue that is most susceptible to the HPV. And, if that's removed, then the dysplasia can't continue to proliferate onto the vaginal walls (unless it's already there).

Once you have your pathology report, then hopefully you'll have the information you need to make a good decision. Your decision could be to get a third opinion. I absolutely love my gyn. I've been with him 21 years. But I don't hesitate to listen to my gyn/onc. Gyn/onc's are extensively trained (3-4 additional years) in gynecologic cancers and precancers. They are the experts. But that doesn't mean you can't go ask another gyn/onc for their opinion.

I wish you good luck with this. It seems like forever ago (although it's been only 6 years) that I was going through this. It can be difficult to sort through all the information and make a decision that you're comfortable with. Please keep us posted on how things are going.

Unread 07-17-2007, 07:27 PM
Confused re: ONC/GYN

Hi there....I just wanted to let you know that at one point I had severe dysplasia. I then went through the CONE procedure and it was removed. However as time went on I was having other issues and ended up having a hyst with the cervix removed. I now have no issues with dysplasia. Hope that helps.....Lisa
Unread 07-18-2007, 01:23 AM
Confused re: ONC/GYN

The treatment for cervical dysplasia is a hysterectomy, assuming that the area is too extensive for a cone or Leetz. I cannot imagine why your ob/gyn said a hysterectomy would not treat dysplasia. A hysterectomy removes the cervix, and the dysplasia along with it.

I would NOT go to an ob/gyn at this point. You need to see a gyn/oncologist, either this one, or another one. There is no ob/gyn who has the necessary experience to deal with this.

Best wishes to you. And big hugs of comfort.
Unread 07-18-2007, 09:36 AM
Confused re: ONC/GYN

I should have mentioned that because of the biopies and LEEP's my cervix is flush with my vaginal area.....pretty much all my cervix is gone but yet the dyplasia is still there. So by having the hysterectomy, we would remove what little is left of my cervix and my uterus. Seems like the dysplasis is still in the vaginal area so what prevents it from becoming vaginal dysplasia. Seems because of my history, my body cannot rid itself of these horrible little cells.

I hope that when I get my results on Monday, things will be clearer as to what is going on and then I can make a decision.

I just want this to end for good!!! I want to be sure to make the right decision so that I never have to deal with this again.

ONC/GYN did mention she was going to speak with OB/GYN so maybe between the both of them we can have a GREAT game plan!

Thanks for all your replies and I will update on Monday!

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