Cone Biopsy

I am glad I read the messages posted on this site regarding cone biopsy. I have had abnormal paps and colposcopies for years. They come and go, and some paps are normal some come back abnormal. I just went through a colposcopy and the results came back at a moderate level. I am scheduled to have a cone biopsy in 2 weeks and I am really nervous. Even  more so, as I am reading up on this procedure. I am scared that 1. it could be cervical cancer, and 2. that the risks involed can lead me to becoming infertile. What are the percentages of these risks and results?

 

 

On 7/21/2008 dianecody31 wrote:

I am glad I read the messages posted on this site regarding cone biopsy. I have had abnormal paps and colposcopies for years. They come and go, and some paps are normal some come back abnormal. I just went through a colposcopy and the results came back at a moderate level. I am scheduled to have a cone biopsy in 2 weeks and I am really nervous. Even  more so, as I am reading up on this procedure. I am scared that 1. it could be cervical cancer, and 2. that the risks involed can lead me to becoming infertile. What are the percentages of these risks and results?

 

 Hi Dianecody31,

I'm sorry you are going through all this - it's a scary time,  If in the coming days you feel overwhelmed, make yourself step back from it, take some deep breaths and get yourself centered, and focus on "what is" rather than "what could be.' (Don't borrow trouble from tomorrow - today has enough of its own.)

I'm not a medical doctor or scientific researcher, so I can't give you percentages, etc.  I am, however, a former RN somewhat knowledgeable about cancer both from professional and personal experience, so maybe I CAN give you some answers  about the results.

As for the cone biopsy itself, it's not a fun procedure, but I suspect you already know that. And I'm sure the information you've been given on cone biopsy runs some thing like this: " After the procedure, there may be some cramping or discomfort for a week or so. Avoid sexual intercourse, douching, and use of tampons for about 4 to 6 weeks. For 2 to 3 weeks after the procedure, you may have heavy, bloody, or a yellow-colored discharge. There is a slight risk of extensive bleeding and infection. Cervical scarring may result from the procedure, occasionally causing painful menstrual periods or making it more difficult to evaluate an abnormal Pap smear. This scarring may also make it difficult for a woman to become pregnant. "

Now yes,  that really is scary.  But as I said, step back, take some deep breaths, and handle this one thing at a time.  If you have cramping and discomfort afterward, do what you need to do to get through it.  Pain meds, lie on your tummy with a heating pad at a VERY LOW setting over the small of your back, use mental re-focusing to take your mind off it.

As for the rest, don't dwell on it- if you have other problems, deal with them as they come, but try not to obsess about them beforehand - that's just crazy-making.

Obviously if the biopsy is positive for cancer, your question about fertility is gonna get a real quick answer - you will most-likely need surgery, and probably chemo, and possibly radiation.  At that point, getting rid of the cancer becomes the primary consideration, and rightfully so. 

But again, you aren't at that bridge yet, and you may never be at that bridge, so focus on what is right now.

Some women with negative biopsies still have to deal with subsequent scarring and infertility.  You want to do whatever you can to avoid becoming a part of this statistic.  Talk to your doctor about what you can do post-biopsy to promote healing of your cervix where they take the sample.  (Ask the nursing staff, also - sometimes they have better suggestions than the doctors!)   And follow his advice.

As with so many other things in western medicine, biopsy procedures have been improved and people are having less complications than when these procedures first gained popularity.  So, your risk of scarring and difficulty conceiving probably aren't as great as they would have been 10 years ago.  There is a procedure other than cone biopsy that you should ask your doctor about:  LEEP (Loop electrosurgical excision procedure. This is a painless electrical method of removing affected tissue to send for biopsy.)  Lots of women are having LEEP done rather than cone biopsies, with some really good results and much less complications, especially those of scarring and inability to conceive.  Ask your dr if you are a candidate for LEEP instead of cone biopsy, and if so, can he do it?  If he says sure you're a candidate and he can do it, ask him why he recommended cone biopsy instead - check it out. If he says you're a candidate but he can't do it, ask if he will refer you to someone who can do it.  Check that out, too.

If you don't like the answers you get, ask for a referral for a 2nd opinion anyway.  As the patient, that is your right.  Unless there really is a seriously good reason you should have a cone biopsy rather than the LEEP, I think it would be well-worth  your while to stop the process and at least get more answers.

Last but not least, remember that if the biopsy comes back negative, but you end up with some problems conceiving, this is the day and age of medical interventions.  Some women who have problems resulting from cone biopsy choose to have in-vitro fertilization, and surgical closure of the cervix with planned cesarian section.  Expensive and extreme, but doable.

Many women who have problems after cone biopsy, or even with cervical cancer, choose not to let it destroy their desire to have children, and they find other ways to make it happen.  Some choose to have their eggs frozen, and try in-vitro with a surrogate.  Others choose adoption.  Others choose to become involved in jobs or volunteer activites with kids. Cancer, or the complications of finding it isn't cancer,  certainly can make life difficult, but neither situation has to be the end of the dreams and aspirations of an imaginative woman.  

Above all, the best advice I can offer is once again, don't let this overwhelm you.  Don't dwell on what might or might not happen, but stay present in the moment, deal with what is in front of you today.

Please take care, and I wish you the very best in the coming weeks.

Sincerely, Tre

It is so awful to be faced with this! I do have some questions for you.

1. Did you look at the lab report?

2. Did you get a full explanation of what you have, where it's located, how extensive it is (How many quadrants it's in), if it's in the endocervical canal, and if there is glandular involvement, especially in the endocervical glands? That would determine what your treatment options are, right there.

3. Last but not least, did you get a full explanation of the risks and benefits of all your treatment options - cryosurgery, laser, LEEP, and cold knife - before a recommendation? All treatment options have the same successful rate. It just depends what you have. A cone biopsy seems a little extreme. At CIN II, laser or LEEP would have equal success.

However, if you answer "no" to any of these questions, please get a different doctor, immediately. That you are asking these questions on a forum board makes me wary of how much information you are really getting from you doctor. You want a doctor who cares enough and is ethical enough to want you to be educated enough to make an informed decision. Looking at the lab report is the first step. You'll know exactly what you have. It also removes the mystery and gets you actively involved in deciding what is best for your body. That, right there, takes away a lot of the fear factor. But never let a doctor take advantage of your fear and coherce you into something you haven't researched.

If you are at CIN II, although you do need to act quickly, you can still get at least another opinion and you can still research your options. Speak to your primary care physician for a referral, today, and if you tell the new office it's urgent, the doctor will make room for you. That's what my new doctor did, after I fired my first doctor. Cervical cancer takes about five to ten years to get to that level, depending which HPV strain you have. (It can move faster witha more aggressive strain/)

In addition, take into consideration your body's tolerance for pain, as well as your fear factor, before going through surgery. A lot of women have either had these procedures under general anesthesia or an IV sedative in the office. There is always a risk, but a frightened patient is also going to create risks.

As an fyi, Roche has a new HPV DNA test called AMPLICOR. It's much more accurate, can you can find out which strain you have. I did that, and it definitely has helped me create a plan to protect my health for the future. The only problem is that insurance companies don't like to pay for it, so your doctor may not have it available. Or, he or she may have it available but can't offer it unless you know about it. (This was the case with my doctor.) Or you can go to a teaching hospital and get that done.

I'm going to give you some websites. Not only are they informative about treatment options, but if you follow the website links, you'll also get information about dysplasia itself.

http://www.gynalternatives.com/cervical_dysplasia_treatment.

This is older, but it's still one of my favorites because it's very concise.

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

And here are some others.

http://www.imaginis.com/cervical-cancer/treatment.asp

http://adam.about.com/reports/000046_7.htm

http://www.jotrust.co.uk/about_cervical_cancer/cin__pre_canc

I hope this helps you!

Hi there,

I don't know if you are still watching this topic but I thought I'll give you an idea of what cone biopsy is like as I went through it myself in Sep 07. I was like you, searching various forums and getting more and more worked up about it - THERE IS NO NEED! It really was not that bad. You will be given general anasthetic and after about 30-40 mins you will wake up. They will give you painkillers so the pain really isn't that bad - it is a bit like strong menstrual cramps but nothing to get worked up about. After the procedure they nurse will be checking you quite often, they will check your blood pressure and blood loss and you will probably need to change the sanitary towels quite often thoughout the first day. I was discharged after being in the hospital for about 8 hours. The next 2 days I just rested - the anesthetic will make you feel quite tired and after that I went back to work. You will bleed for about 6 weeks so no sex allowed! After that, all will be back to normal. When I first had sexual intercourse after the procedure I was a bit scared it will hurt but it just felt normal. I had 3 pap tests since and all are looking good. I got pregnant and I am now in my 12th week due to have my scan on 14Aug. On 22Aug I have to have cervical cercalage in the cervix as it has been weakened by the cone biopsy - this involves putting a small stitch in the cervix to keep it closed and the OB will take it out at 37th week of pregnancy. There really is nothing to worry about when it comes to cone biopsy and remember that all those post operations complications you read are really quite rare.  Good luck with the operation!

Hi there again, it's Bambulka again.

There was one more thing I forgot to mention to you. When I had the abnormal cells I initially just had CIN 1 which quickly progressed to CIN 3. These are the sqamou cells. However, I also had the glandular cells, which are quite rare, a bit more vicious that the squamous type and only about 10% of women get them. After I had the procedure I browsed the internet to see if there is anything I can do to prevent this from developing again. And I come across DIM - Diindolylmethane. These are just supplements from cruciferous vegetables (cabbage, broccoli, brussel sprouts). In studies they have shown they are excellent for healthy breast, endometrial and cervical tissues. Cancer research UK is trialling them now and the results are due to be out sometimes this summer. I have been taking the supplements since after my operation and the cells haven't returned. I don't know if this is anything to do with the supplements, however, I will continue taking them. Unfortunately, you should not take them in pregnancy as they haven't done any studies with pregnant women but I will be taking them again after I give birth. I don't know if you will be interested in taking them but I have heard of people that had abnormal smears for years, started taking these supplements and are now completely healthy without any procedures. The brand I use is Source Naturals - you can only buy them in States. I am in the UK so I order them online and even with the postahe it still works out cheaper than buying them in the UK! And you cannot get this brand in the UK anyway. OK, well, that's all I can think of, hopefully this info will help and as I said, good luck with everything.

Have you tried bioresponse to order DIM? I don't know about whether or not you can get them delivered to UK, but it's worth looking into. That's where I got mine. Bioresponse's DIM is also in clinical trials, right now, for more extensive research. I swear by DIM! I also drink the Green Drink, which was posted by Tumor in the homeopathy thread. It has five gold stars, so if you keep scrolling down, to the different pages, you'll find it. I have been making it, and I find it delicious! Then again, I have always loved my leafy greens.