Another Leep??

Hi.  I'm just looking for some advice/support whatever anyone has.  I had an abnormal pap in July 2007.  I had a colposcopy and biopsy in September 2007.  The results of that showed high grade dysplasia and HPV.  I had a LEEP done in November 2007.  My first pap after the surgery was in January 2008.  It came back showing ASCUS so my doc performed another colposcopy and biopsy.  It came back showing dysplasia.  She said the treatment would be another LEEP however since I have not yet had kids (I'm 32 and was going to start trying before all this happened!), she wants me to see a gynocological oncologist for a second opinion.  They would tell me if it was severe enough where it needed immediate treatment, or if I could get pregnant and be closely monitored during the pregnancy and treat it afterwards.  I'm so upset by all this.  I'm worried I might have cancer, I'm worried about having another surgery, and I'm worried about never being able to have kids.  I thought i was healthy but I just don't know what to do.  Any advice what-so-ever would be greatly appreciated.  I just can't stop crying right now...

I have a few questions for you.

1. Did your doctor show you the lab results each time and have a detailed discussion with you about the kind of dysplasia you had/have and how extensive it is?

2. Did your doctor tell you whether or not you had clear margins after that LEEP?

3. Did your doctor discuss the risks and benefits of all four methods of partial amputation (cold knife, cryosurgery, laser, and LEEP) before making a recommendation?

If you answer "no" to those questions, get a different doctor. So far, she has said one thing right: You need a second opinion. But I fired my first doctor for not following through with the above questions, so I'm going to give my two cents.

1. It is not ethical for a doctor to refuse to show you the lab results and have a thorough discussion with you.

2. It is not ethical for a doctor to refuse to discuss all of your options and to push one method of partial amputation on you.

3. It is ethical for a doctor to show you the results of your lab report, discuss those results in great detail with you, discuss the risks and benefits of each of your options, and then give her recommendation.

I did not actually see my results but she did say that the margins were clear after the LEEP.  She said this reoccurance could be do to re-infection or that the LEEP did not get everything.  The new spots she saw could have been microscopic and not seen during surgery.  And no, she did not go over other options with me.  She just said that LEEP is how they treat it.  I am waiting to hear this week about my appointment with with oncologist.  I really thought i was done with this.  What if I get another LEEP and it still does not go away??

I think you need to see the lab results so that you know exactly what is involved. Or even have a new biopsy done. Tell the oncologist to show them to you, as well as give you a thorough explanation. It could be recurrent dysplasia, or it could be that the LEEP missed something that was higher up. In any event, the new doctor should go over all of that with you, and if you're not comfortable, get another doctor, especially if the oncologist is one of her friends. You want the best doctor you can find.

And no, LEEP is not your only option, so I'm disgusted with your first doctor for pushing it on you without an explanation. Fire that doctor and get yourself a new one, no matter what. If the dysplasia is more extensive than she told you and you need a cone biopsy, consider cold knife. There is always the possibility of infection, but LEEP has the highest risk. I should know. But you do have several options, considering how extensive and how severe the dysplasia is. However, before you do anything, have a thorough discussion with the oncologist.