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Cancer: Cervical & Ovarian Message Board


Cancer: Cervical & Ovarian Board Index


I am new to this board, after reading back through several pages i called my doctor to get a printout of my pathology report. i have my annual pap in jan, to come back abnormal. i had a Copo in Feb, which came back mild/severe dyaplasia, i had a LEEP march 8th, which came back stage 1a cancer, i see the GYN/ONC april 5th. ok this is my history....i was reading about peoples margins being positive or clear, and wanted to know more about mine, i was in such a shock last week when i went in to talk about my results (i should have known somehting was bad then) it says

-transformation zone cervical mucosa with micriinvasive squamous cell carcinoma
-extensive carcinoma in situ with extensive endocervical glandular involvement
-seperate focus of cervical glandular intraepothelial neoplasia high grade (adenocarcinoma in situ)
-carnicinoma in situ at endocervical margin multipocally (see comment
and comment was
A- the focus of microinvasion is approx. 1 MM deep and 3 mm wide. this leasion is stages at figo stage 1A1.
margin elvuation for involvement difficult in this speciman due to orientation.

anyone know what any of this means? i have been looking for hours on the internet with not much luck. i will check back for responses! thanks a bunch!
[QUOTE=dagiffen]I am new to this board, after reading back through several pages i called my doctor to get a printout of my pathology report. i have my annual pap in jan, to come back abnormal. i had a Copo in Feb, which came back mild/severe dyaplasia, i had a LEEP march 8th, which came back stage 1a cancer, i see the GYN/ONC april 5th. ok this is my history....i was reading about peoples margins being positive or clear, and wanted to know more about mine, i was in such a shock last week when i went in to talk about my results (i should have known somehting was bad then) it says

-transformation zone cervical mucosa with micriinvasive squamous cell carcinoma
-extensive carcinoma in situ with extensive endocervical glandular involvement
-seperate focus of cervical glandular intraepothelial neoplasia high grade (adenocarcinoma in situ)
-carnicinoma in situ at endocervical margin multipocally (see comment
and comment was
A- the focus of microinvasion is approx. 1 MM deep and 3 mm wide. this leasion is stages at figo stage 1A1.
margin elvuation for involvement difficult in this speciman due to orientation.

anyone know what any of this means? i have been looking for hours on the internet with not much luck. i will check back for responses! thanks a bunch![/QUOTE] I'm sorry you must deal with this stressful and scary situation. Basically, this pathology report says that you have cervical cancer which is so far contained in the cervix, however "extensive endocervical involvement" means it may be headed up the os towards the uterus. In addition, it's not possible to say at this time whether the margins are clear (margin evaluation for involvement difficult [to assess]) due to orientation of the specimen.
While this sounds truly frightening, the cancer is in early stages and can be treated straightforwardly.

Your treatment options include:[quote][B]STAGE IA CERVICAL CANCER
Equivalent treatment options: [/B]
[U][B]1. Total hysterectomy:[1][/B][/U]
If the depth of invasion is less than 3 millimeters proven by cone biopsy with clear margins [2] and no vascular or lymphatic channel invasion is noted, the frequency of lymph node involvement is sufficiently low that lymph node dissection is not required. Oophorectomy is optional and should be deferred for younger women.
[U][B]2. Conization:[/B][/U]
If the depth of invasion is less than 3 millimeters, no vascular or lymphatic channel invasion is noted, and the margins of the cone are negative, conization alone may be appropriate in patients wishing to preserve fertility.[1]
[U][B]3. Radical hysterectomy:[/B][/U]
For patients with tumor invasion between 3 and 5 millimeters, radical hysterectomy with pelvic node dissection has been recommended because of a reported risk of lymph node metastasis of up to 10%.[2] However, a study suggests that the rate of lymph node involvement in this group of patients may be much lower and questions whether conservative therapy might be adequate for patients believed to have no residual disease following conization.[3] Radical hysterectomy with node dissection may also be considered for patients where the depth of tumor invasion was uncertain due to invasive tumor at the cone margins.
[U][B]4. Intracavitary radiation alone: [/B] [/U]
If the depth of invasion is less than 3 millimeters and no capillary lymphatic space invasion is noted, the frequency of lymph node involvement is sufficiently low that external beam radiation is not required. One or 2 insertions with tandem and ovoids for 6,500-8,000 milligram hours (10,000-12,500 cGy vaginal surface dose) are recommended.[4] Radiation should be reserved for women who are not surgical candidates.
[U][I]References:[/I][/U]
Sevin BU, Nadji M, Averette HE, et al.: Microinvasive carcinoma of the cervix. Cancer 70(8): 2121-2128, 1992.
Jones WB, Mercer GO, Lewis JL, et al.: Early invasive carcinoma of the cervix. Gynecologic Oncology 51(1): 26-32, 1993.
Creasman WT, Zaino RJ, Major FJ, et al.: Early invasive carcinoma of the cervix (3 to 5 mm invasion): risk factors and prognosis. American Journal of Obstetrics and Gynecology 178(1, Part 1): 62-65, 1998.
Grigsby PW, Perez CA: Radiotherapy alone for medically inoperable carcinoma of the cervix: stage IA and carcinoma in situ. International Journal of Radiation Oncology, Biology, Physics 21(2): 375-378, 1991. [/quote] Please review the NIH's info on cervical cancer: [url]http://www.cancer.gov/cancerinfo/wyntk/cervix[/url] and by searching on 'cervical cancer' or 'cervical adenocarcinoma'

Cervical cancer is not life threatening unless left untreated. Please write out the questions that concern you most for your April gyn appointment. Your doctor may also be able to recommend a cancer support group if you feel you need one (there are many available online, as well).

I wish you all the best,

charli





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