New- Have ?S Abt Diagnosis

Hello!

I am new to all of this.  Two weeks ago I had an abnormal pap (my last pap was 16 months ago), went in for a colposcopy, and had biopsies.  My gyno got the results back today and said that I am confirmed between CIN II and CIN III.  She did a biopsy from inside the cervix, which she said tested negative.  The precancer (?) is in squamous cells- don't know if that helps. I am a little concerned that my last pap was negative only 16 months ago and it has progressed to the level it has so quickly.

My Dr. said the area she would have to remove would be small and that she would like to schedule a LEEP.  LEEP seems to be nasty word around the message board so I am a little apprehensive.  My dr. said that she has not had anyone who has had an infection and has only had one patient who had to have a second LEEP performed.  No one I know has had any experience with this so I am quite in the dark.  So do I technically have cancer, or just pre-cancer?  What other questions do I need to ask the dr. about what stages I am in, etc.?  She is suggesting a follow-up pap smear (after the LEEP) every 4 months for 2 years.  Has anyone here had any positive results following a LEEP?  How would I find a local support group- any suggestions?  What is the chance of recurrence after the LEEP (my dr said that usually after the LEEP it doesn't come back)?

Thanks for your help!

Elizabeth

I'm glad there is no dysplasia inside the endovercial canal. You won't have to get a cone biopsy. I am curious, though. Did your doctor discuss all four methods of partial amputation with you before making a recommendation? LEEP is a dirty word to me because I had only complications from that electric knife. I'm not saying don't get LEEP because for many women, it is the best method. I am saying, however, it is unethical for a doctor to tell you there is only one choice. Your doctor should have discussed all four methods and then recommended the one she believed is best and then honored your decision. As an fyi, I'm glad she hasn't had trouble with patients who had infections from LEEP, but LEEP does have the highest risk of infection.

There are a lot of clinics out there that would be happy to send your information. You can also check the internet. Here are some of the links that could explain dysplasia to you.

http://www.nlm.nih.gov/medlineplus/ency/article/001491.htm

http://www.cervicaldysplasia.com/

http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=Z

http://www.mjbovo.com/Women/Dysplasia.htm

http://cancer.about.com/od/cervicalcancerbasics/a/dysplasia.

 

On 3/19/2008 herenow wrote:

I'm glad there is no dysplasia inside the endovercial canal. You won't have to get a cone biopsy. I am curious, though. Did your doctor discuss all four methods of partial amputation with you before making a recommendation? LEEP is a dirty word to me because I had only complications from that electric knife. I'm not saying don't get LEEP because for many women, it is the best method. I am saying, however, it is unethical for a doctor to tell you there is only one choice. Your doctor should have discussed all four methods and then recommended the one she believed is best and then honored your decision. As an fyi, I'm glad she hasn't had trouble with patients who had infections from LEEP, but LEEP does have the highest risk of infection.

There are a lot of clinics out there that would be happy to send your information. You can also check the internet. Here are some of the links that could explain dysplasia to you.

http://www.nlm.nih.gov/medlineplus/ency/article/001491.htm

http://www.cervicaldysplasia.com/

http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=Z

http://www.mjbovo.com/Women/Dysplasia.htm

http://cancer.about.com/od/cervicalcancerbasics/a/dysplasia.

Thank you for the information.  No, my doctor did not give me all 4 options.  I brought up the laser procedure to her and expressed my concerns and she just had "come backs" as to why LEEP was better than laser.  Don't get me wrong, she is a very good doctor- she delivered my daughter- but is she the most experienced person for me to be talking to, probably not.  I requested a referral to a gyn oncologist.  Unfortunately, the gyn oncologist is booked out until May.  But I think he will be a better person to work with on this matter b/c he deals with it day in day out.  My gyn has too much on her plate to extend herself the way I would expect.  Thank you for the links and I will read up on them.  Do you know anyone who has had laser performed- is there any greater risk that you don't get all the cancer in the margins with laser vs. LEEP.  My dr said the area to be removed would be small- do you have to do a larger area with laser to get a sample that can be biopsied and to make sure you get all the cells?

 Thanks!

Elizabeth

I think you need to fire your doctor, immediately. Call the new doctor you want and tell the person who schedules appointments that your situation is urgent. If that doctor can't take you, get a referrel to another one who can. I don't like the way your current doctor is handling your case. It is within her right to make a recommendation. But not discussing the benefits and risks of all four methods of partial amputation before making that recommendation is unethical. LEEP is not the worst method, but neither is it the best method. It's just another method with benefits and risks, which all methods have. You also need a doctor who will show you the lab report and discuss anything you have questions about in great length.

The success rate of all four methods is exactly the same. The method most appropriate for you depends upon the kind of dysplasia you have and how extensive it is. The one big benefit of LEEP is that it produces a live specimen for pathology. (Then again, so does cold knife.) The one big risk of LEEP is infection. I keep hearing doctors say it only has a slightly higher risk of infection. But to be blunt, most women I have spoken to who had LEEP had infections, even if it was only slight. Something else to take into consideration is that insurance companies love LEEP because it's so cheap and can be done in the doctor's office. When I received the itemized bill, that electric knife was only $73.

Here are some links to explain the four methods. The first one is older, but the information is still good.

http://www.mjbovo.com/Women/DysplasiaRx.htm

http://www.gynalternatives.com/treatment.htm

http://www.womenshealthchannel.com/cervicaldysplasia/treatme

http://www.healthology.com/gynecologic-health/gynecologic-he

http://www.thehpvtest.com/over-30/HPV-facts-cervical-dysplas

These links discuss LEEP itself. I'm not saying you shouldn't choose LEEP. I am saying, again, make sure you are informed about all of your choices, as well as the kind of dysplasia you have, before you make your decision. Your doctor also needs to respect your choice. But it needs to be an informed decision, and I am suspicious of a doctor who doesn't have a detailed discussion with you.

http://www.leep-procedure.com/leep-procedure-risks.htm

http://en.wikipedia.org/wiki/Loop_electrical_excision_proced

http://www.acog.org/from_home/publications/press_releases/nr

 

I agree with your respondent. Fire your OBGYN and find a Gyn -oncologist who will see you as soon as possible. Do not accept the wait and see attitude. Cervical cancer is only prevented if early indicators are dealt with promptly.  Many types of Cerv cancer are extremely aggressive.

 Get copies of all your records and demand written copies of your test results. Always followup on your pap results and never assume that if you do not hear anything that everything is OK. 

 Get competent treatment right away and you should be fine.  If you wait, you may be gambling with your life. God bless you 

 

On 3/28/2008 Harry5177 wrote:

I agree with your respondent. Fire your OBGYN and find a Gyn -oncologist who will see you as soon as possible. Do not accept the wait and see attitude. Cervical cancer is only prevented if early indicators are dealt with promptly.  Many types of Cerv cancer are extremely aggressive.

 Get copies of all your records and demand written copies of your test results. Always followup on your pap results and never assume that if you do not hear anything that everything is OK. 

 Get competent treatment right away and you should be fine.  If you wait, you may be gambling with your life. God bless you 

How do you obtain copies of your test results??  Is that something they can fax to you if you give the proper information?  I am concerned because my doctor did not say ANYTHING about any other treatment options other than the LEEP.  She briefly mentioned something about freezing but that is it.  The nurse said that both of my biopsies were "moderate to severe dysplasia" but my husband wants to see the reports.  Just curious if it is just as simple as requesting the lab results?