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Opinions on second cone vs hyster Opinions on second cone vs hyster

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Unread 01-07-2013, 04:25 PM
Opinions on second cone vs hyster

Hi Ladies!

I'm looking to get some opinions on having a second cone biopsy done. I am 34, not married and don't have any kids and I know that's the big concern with my case. I have always felt very strongly about adoption and have always wanted to adopt so if I need to lose the baby maker I am good with that. I realize that not every woman feels this way but I am truly okay with adopting when I get to that place in my life. That being said, I don't want to start taking out body parts without some serious considerations to factors beyond having a child.

I've had abnormal paps for 8 years now but they have always been low risk and CIN I so I have been in the "watch it" camp even though I have HPV. This year, my yearly came back with high risk and CIN III. I had the colposcope and biopsy, all confirming CIN III. I had a LEEP done in July with positive margins and then a cone done in September with negative margins. Pathology on both of those was CIN III but since I had clean margins after the cone I thought I was in good shape.

My follow up in pap in December showed CIN III again. I was pretty bummed because in three months I went from clean to CIN III. My gyno referred me to a gyno onc and I had a really bad experience with him. He told that "this really isn't a big deal and you just need to get over it and accept that your paps will be abnormal for the rest of your life". I'm sorry but this is a big deal! The gyno onc said there wasn't anything that he could do so I would just need to have a pap every 3 months and if I get cancer then he will deal with me then.

So, I have an appointment with my regular gyno on Thursday to discuss options. Any thoughts on doing a second cone? Would it even matter? At this point if the end game is going to be a hyster then I would prefer to get it over with now but again, I don't want to go down that route without being completely informed. Has anyone had repeat cones and had CIN clear up? What are the chances that CIN III will clear up on it's own?
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Unread 01-07-2013, 08:19 PM
Re: Opinions on second cone vs hyster

I kind of had a similar experience. PAP abnormal in August 2012, colposcopy done November 2012 showing high risk CIN II/III, had LEEP done December 2012 where they removed adeneocarcinoma in situ with positive margins for squamous cell cancer. Gynecologist said I could do vaginal hyster, or 2 year monitoring with biopsies every 6 month. Gynecologist/oncologist said the same, but would do hyster laparoscopically. They didn't seem to "concerned." I think because I am only 32 with no kids. I am married, but don't want kids. I just feel at the point I just want to get it over with. Seems like high risk HPV is going to cause more problems. Thought?
Unread 01-07-2013, 09:02 PM
Re: Opinions on second cone vs hyster

I think you have some excellent questions to discuss with your gyn at your upcoming appointment. Would it be possible to get another opinion from a different gyn/onc? That might help your decision-making process and provide additional peace of mind.

In addition to the wonderful sisters who'll come along to post, you can try some searches here on Cancer Concerns to find previous discussions and information which might be helpful.

It is a big decision, to be sure. My adenocarcinoma was diagnosed at colpo/biopsy, so the choice was pretty much made for me. Get as many opinions as you need, do your research, then go with that little voice inside. She's pretty smart, you know.

We're glad you found us!

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Unread 01-07-2013, 09:12 PM
Re: Opinions on second cone vs hyster

Yes, you're right, this is a big deal. I'm amazed that a GYN oncologist would act like it wasn't! First things first, you need to find a new GYN oncologist. They are the experts in cancer and pre-cancer, and it is recommended to consult one if cancer is suspected or diagnosed. I'm sorry you had a bad experience with the first one. Seek out a second or even third opinion.

A hysterectomy is generally the standard treatment for CIN III, as it can be a sneaky cancer and play hide-and-seek. At this point, you would probably be better off (IMO) getting the hyster done and not worrying about a second cone biopsy. If in fact you do need a hyster and had a second cone, you would most likely have to several weeks to heal prior to the hyster. This would further delay your treatment.

Good luck. Sending hugs and prayers your way. Keep us posted!

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