2Nd Leep - Involved Margins - Future Fears

I've just had my second LEEP in 2 months.

After my first LEEP I was told that I had CIN3 and involved margins so was booked in for a second treatment ,where my doctor told me that there had been cell changes.

I now just have to wait for the test results before knowing what the next course of action will be.

Can anyone explain involved margins as I didn't really get an explanation.

Also does anyone have any advice on LEEP and pregnanacy , I am starting to think that after 2 LEEP treatments more may not be a good idea.

If my results come back and I still have CIN3 and involved margins will I be offered another LEEP or will another course of action be offered? My doctor would no go into this with me ,just saying that we will deal with the next course of action when my results come in.

Anyone had the same?

Tired of worrying about it all and living day today while waiting for the test results. Any advice , help and info would really help.

No one else I know has gone through this so to hear from others who have gone through or are going through it is a great help.

Thank god for a site like this where you don't have to feel alone.

Vicci, out of curiosity, did you see the lab report? If you were told you had CIN III, what grade of dysplasia was in the margins? Is it in the endocervical canal? CIN III with involved margins could mean a lot of things, which is why it is so critical to see the lab report. Insofar as other options are concerned, if you still have involved margins and need further treatment, you still have choices of what you can do. It just depends where the dysplasia is located and how extensive it is. In the thread "Cold Knife Cone Procedure And Update", SacMomof2 got a second opinion from the GYN/oncologist at UC Davis,who adviced her to get traditional cold knife. (Her previous doctor told her to get a LEEP/cone done.) 

In more extreme cases, there is trachelectomy, which removes the cervix but leaves the uterus for fertility. But it really depends on the what the lab report says. Since your doctor hasn't been very explanatory with you, I think she should be fired. A caring, ethical doctor wants you to be as educated as possible about your condition and your options so that you can make informed decisions. Knowing what is involved also removes so much of the fear and gets you actively involved. I speak from personal experience.

I'll definitely keep you in my thoughts, while you wait for the lab report so that you don't need anything else done. Worst case scenario for pregnancy is that you would need help from a doctor to get pregnant and carry the child to term. The more of a cervicx gets removed, the higher the risk for pregnancy, but please talk to your doctor about all of this. The new doctor, that is. If you want me to give you some links for cold knife cone biopsy or trachelectomy, I can do so.

Thanks for your response.

I haven't seen the lab report and the only treatment on offer is LEEP. I'm UK based and this is the only method on offer at my hospital. If I went private it maybe a different case , but expensive and thats money that I don't have.

All I have been told is`that there are involved margins and CIN3 , no discussion on the exact whereabouts etc.

I'm trying to get all the info I need but am finding it so hard. To be honest I feel likeI am not being told the whole story. Also suffering slighly after my last LEEP (a week ago), bleeding very heavily and it feels like a life time waiting for`my results to come through.

Being 32 yrs I am also worrying about having children now, I have obviously been told not to get pregnant until I have a clear result but my head is consumed with it. It doesn't help that I have friends and colleagues expecting soon and being around pregnant ladies all day every day is only making it worse.

Oh well ,oneday at a time I suppose. Thanks again.

Hello again,

I've just recieved a copy of the letter sent from the hospital to my local doctor. It states that results from my last biopsy showed CIN3 involving both the endocervical (CIN3) and the ectocervical margins (CIN2).Can you shed any light?.

Can't get to see my doctor for another week.

P.S Hope your doing ok.

Vicci, out of curiosity, did you have LEEP or LEEP/cone biopsy done? Before the first LEEP was done, did you also have an ECC done at the same time as the biopsy taken from your cervix during the colposcopy? I'm so worried about you, and I'm so sorry you have had such a tough time! If the dysplasia is in the endocervical canal, you would definitely need a cone biopsy. I'm dismayed your doctor hasn't given you much of an explanation. Please, please fire that doctor! I'm glad you got a copy of the report, though. That's the first big step in actively protecting your health.

Let me give you some links about CIN grades, treatment, etc.

http://www.oncolink.com/types/article.cfm?c=6&s=17&s

http://www.ashastd.org/learn/learn_hpv_dysplasia.cfm

http://www.hystersisters.com/vb2/showthread.php?t=198261

http://www.tripdatabase.com/SearchLander.html?s=1&gk=treatment+for+endocervical+dysplasia&itemId=644902

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

This is still one of my favorite sites, even if it's a little old. But it's very concise.

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

This link also shows some studies being done for treatment, management, etc.

http://lib.bioinfo.pl/pmid :17977166

If the results from the second treatment show more dysplasia, hopefully, you will have a new doctor, by then, who cares enough and is ethical enough to want you to be educated about all your condition and treatment options. I am definitely keeping you in my thoughts so that you hear good news from the second lab report. But if you did require more extensive surgery, there is the trachelectomy. It would remove the entire cervix but leave the uterus so that you could still have children. I'll give you some links.

http://www.medterms.com/script/main/art.asp?articlekey=12131

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

http://www.medscape.com/viewarticle/558569

Hi, Hope your doing.

Thanks for the links that you suggested, a couple I had seen before but still very helpful.

In response to your last questions, the two treatments I’ve had have been LEEP and have had biopsy on both of those occasions.

ECC?????? What is an ECC ?, this is something that has never been mentioned to me before.

I haven’t been given a copy of the report I have only been told about the Endocervical and ectocervical CIN3 – no other detailed info has been given to me.

Do feel alittle left in the dark!

In regards to  me sacking my doctor, as treatment in the UKis free I don’t have the same ability to ‘sack’ them as such. The doctor that I saw last time I did complain about and was given this new doctor who as least had some understanding towards my emotions and has given more explanation to me that my previous doctor of my diagnosis.

Still waiting for the results which in the UK usually take 4 weeks but have been told that I should have them shortly as my doctor wanted to push them through quickly ,last time it was only a week and a half. In the back of my mind I am alittle worried that they are not giving me all the info until they are clear if everything is ok. My biggest worry , which may not be justified is that they have gone deeper to remove the CINS 3 cells but that they find a higher grade –invasive cancer . During ,my last LEEP the doctor did say that he could see that there had been cell changes –probably me worrying too much, but its hard not to isn’t it.

 Thanks you for you info and support, it’s made the world of difference.