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Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index

I was just diagnosed with this on Wednesday after having a cold knife cone biopsy done on Nov 30. Originally I had a very abnormal pap, then had colposcopy with several biopsies. Those biopsies still couldnt determine if I had invasive cancer. But I had glandular involvement and problems higher in the cervix, so I had the cold knife cone done. My doctor said the good news is that it was a small area of in-situ and after the cone, all margins are clear and she feels positive that everything was removed. I just have to get check ups every few months. Adenocarcinoma affects the glandular cells higher up in the cervix, is more rare, but gets treated similarly to squamous. I was glad to hear the cold knife removed everything & I wouldnt need a hysterectomy. I was just out of work for 2 1/2 months due to spine surgery so I was panicked thinking what if I need to get more surgery right away?..I might lose my job. But thankfully, all is well for now.
Hi Ladies.
I Have Read All Your Posting. You Are All Beautiful And Strong Women And I Will Pray For You All. Can Anyone Tell Me If When They Received An Abnormal Pap, It Showed "a Typical Glandular Cells". I Am So New To This And So Nervous. I Keep Thinking I Am Going To Die And I Am So Afraid. It Is So Good To Read All Your Stories And Know We Are All In This Together And Can Help One Another. I Am Trying To Find Good Info, But Have Read All There Is To Read On The Internet. Waiting For My Results Of D&c And Cone. Are Findings Of Glandular Cells Really Are Rare As I Am Reading? Thanks And God Bless...
The adenocarcinoma does mean that glandular cells are the problem - they can be glandular cells in the cervix or from higher up in the uterus. This is why they generally also do an endocervical curretage (ECC) if you have any glandular abnormalities. Your Dr. should have done this. I think you are correct to question your Dr. - was it a PCP or an OBGyn? Research on adeno in situ suggests that LEEP is not sufficient to ensure that there is nothing to worry about no matter what your age. I think that many other Drs would suggest that you have a cone biopsy (and they usually do a D&C at the same time to rule out the possibility of abnormal cells in the uterus). My guess is that your Dr. is concerned about the long term possible effects of doing a cone (some people have an incompetent cervix during pregnancy and some have trouble getting pregnant because scar tissue can form on the cervix and sperm have some trouble getting through). In my opinion, these are more acceptable risks than a missed cancer diagnosis. Also keep in mind that many Drs, even OB/Gyns, have never seen this and are not up to date on the research. You should definitely talk about this with your Dr and/or ask for a second opinion. You should at the very minimum speak with an OBGyn, preferably one affiliated with a medical school or, even better, with a GynOnc.

If you go to [url][/url] and do a search on adenocarcinoma in situ cervix, you will get a list of abstracts from scientific research articles on the subject. These are from peer reviewed journals and are considered reliable sources (as opposed to ******, ****pedia, etc). Some of the full text articles are available free of charge but for most you will only be able to get the abstracts, which summarize the findings. Take these with you to your Dr. It is very difficult to be assertive with Drs. because we are conditioned to think that they know what's best but it is impossible for them to keep up to date on everything.

Another possibility to consider is to request that your slides be sent to a different pathologist and reread to make sure that it is in fact adeno in situ. Because it is rare, pathologists often get it wrong and you'd hate to do a cone biopsy if you never had AIS in the first place.

Unfortunately, in order to make sure that you are being properly treated, you have to be very proactive and assertive but you have to do it in a way that doesn't tick the Dr off. I have found that they often respond much better if you take the humble approach " I was curious to learn more and found these articles which confused me - could you explain again why LEEP is sufficient in my case because these articles make it sound like it isn't?" If that doesn't work and the Dr treats you like a child, I would find a new Dr. If you have insurance issues, keep calling the insurance people until they agree to pay for a second opinion. If you stress how much money it can save them in the long run, they usually cave in but it can take a lot of time and frustrating conversations. You deserve quality care so don't give up if you think you aren't getting it!

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