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adenocarcinoma in situ adenocarcinoma in situ

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Unread 09-15-2010, 05:29 PM
adenocarcinoma in situ

Last years pap showed high risk HPV and no lesion. This year was high risk HPV and high grade lesion-adenocarcenoma in situ. Since I am 53 four drs. said hyterectomy. Can't it be followed by cloposcopy or EEc's? Anyone else have this? Also last two paps showed yeast infection-can that make the cells look worse and the diagnosis be wrong? HELP
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Unread 09-16-2010, 03:11 AM
Re: adenocarcenoma in situ

I was diagnosed with adenocarcinoma in situ back in may after a colposcopy. They only wanted to do a cone biopsy for me, but the pathology after the cone showed that it was invasive cancer. The cancer reached the margins of the biopsy so they needed to do a hysterectomy. I am 35 and hadn't had children yet. I'm not sure if they did the cone to preserve my fertility or if it was standard practice. I know with the cone you have to worry about the cancer coming back and maybe if you are done having children it is the safer choice. You should ask them why they didn't recommend the cone for you.
Unread 09-16-2010, 06:29 AM
Re: adenocarcenoma in situ

While I never officially had the in situ diagnosis, I was told that if it was only in situ a cone might stave off the inevitable hysterectomy, but that the hyst was in fact inevitable as eventually all pre-cancer cells develop into full blown cancer. I'm 42 and hyst was recommended for me before my cone biopsy was done. I think it's because they saw cancer in the first biopsy, but didn't know how advanced and still thought that a hyst was the best overall cure. When the cone showed the level of invasion hyst became my only cure and I'm cancer free now.

If you're 2nd guessing the diagnosis, do the cone and see what that brings. Ask if a 2nd pathologist with a gyn cancer specialty is available to review the tissue. I had 2 opinions on mine and they agreed.
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Unread 09-16-2010, 02:39 PM
Re: adenocarcenoma in situ

An adenocarcinoma in situ diagnoses will almost always result in hysterectomy recommendation if you are past child bearing years. Anden. is dangerous because it frequently is associated with 'skip lesions' therefore harder to detect the extent of the lesion if it does infact extend into the endocervical canal. In some cases a Cone Biopsy can be preformed on individuals wishing to preserve fertility, but even with clear margins, a CONE cannot be 100% accurate when determining if the AIS has truly been removed.

Ecc and colposcopy are only a diagnostic procedure to determine the significance of an abnormal pap smear, but are not a treatment procedures for such diagnoses as CIN 1,2 &3 , CIS or AIS. All of which require some sort of followup surgery; cryosurgery, LEEP, CONE or even a trachelectomy. I'm sure that all Dr. would want to treat a pre-cancerous condition rather than to wait until it becomes cancerous.

Are you seeing a gynecological oncologist? They would be specialists in dysplasia, pre-cancers, and cancers. It sounds as though you've certainly gone in for multiple opinions. I know that a hysterectomy is a difficult decision to have to come to, but hopefully your Dr. have given you plenty of information on AIS and the recommended treatment of.

**of course this info is just from my personal experience. I've had a Cone Biopsy surgery done in June, with positive margins, so hysterectomy was the next recommended curative treatment. I just turned 29 and I went to 3 opinions before deciding that a hysterectomy was really the best/safest option, it wasn't an easy choice but I want to stay one step ahead of HPV. **

Good luck with your choice!!
Unread 09-16-2010, 04:08 PM
Re: adenocarcenoma in situ

Thanks! It is a difficult decision and that helps! Amila
Unread 09-16-2010, 06:15 PM
Re: adenocarcinoma in situ


Yes, adenocarcinoma can be easily missed as the other sisters have explained. So, the cancer could get a good head-start even if you're diligent with follow-ups, etc.

Have you consulted a gyn/onc (gynecological oncologist)? They are the experts for gyn cancer/pre-cancers, and we strongly recommend them. It's always a good idea to get a second opinion (or third!), anyway. After all, you want the very best for your health.

Hang in there, sweetie!
Unread 09-16-2010, 06:26 PM
Re: adenocarcinoma in situ

Thanks. That is exactly what the dr. who I chose for the hyst said. That is why I chose him. I just need to be sure I relly need this in order to put myslef through it. Thanks for the support. Amila

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