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Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index

My name is Katie. Approximately 8 months ago I had my annual pap and results came back abnormal, which did not make me take notice as I have always had abnomal paps since the first. I was informed that I was HPV positive and with the abnormal pap I needed a colposcopy and biopsy. The results of which came back normal and was told I should now have paps semi-annually.
About 2 months ago I had my second pap, although the results have, what I call escalated, to LGSIL. This meant another colposcopy and biopsy. During the procedure I was able to look at the screen and view my cervix with the rest of the staff on hand. The physician informed me she saw nothing to worry about, but we went ahead with the biopsy just to make sure. Unfortunately for me the results came back HGSIL. I now have to go for a LEEP in the end of June, because it was the earliest I could be scheduled. I am reading up and doing as much research on the subject so I know what is happening and where I should have concerns. But there isn't really one site that puts the acronyms in definitions and places them in any sort of severity level. I can understand that LGSIL is lesser than HGSIL, but what is CIN, VIN, or CIS I keep reading about?
I recently just read that there can be a correlation between long term birth control use and cervical dysplasia as well. This will be my 7th year on the same birth control and wonder if this played a role. This one site is the only one I have found that also says that high risk HPV, which I have, and hgsil wil usually lead into cervical cancer. No other site uses "usually". I just want to know where I stand in the severity of things. Is all of this bad? How does having a LEEP effect me having childre? I am only 26, almost 27 and want to finish school before children. With the fear of cancer risk looming in my mind, will it change my life plans? Any answers would be great.
Pepper, I am just a little further along this road than you. I still don't understand the lgsil and hgsil, but think it refers to abnormal squamous cells. I don't know a lot about squamous cells except to say they are the cells on the exocervix (outer cervix). I've also read that 90% of women who have atypical pap/biopsy results have atypical squamous cells. Atypical squamous cells are more common and slower growing than atypical glandular cells.

That's about all I know. My diagnosis history began with a positive HPV/DNA test, clear paps (for 20+ years), clear colposcopy and no biopsy taken, but doctor also did an ECC. The ECC came back adenocarcinoma in situ and atypical glandular epithelial lesions. That lead to a cone biopsy and endocervical adenocarcinoma Ia1. Remember, my atypical cells are different from yours (the way I understand what you've written). The good news is that my only treatment will be a hysterectomy (cervix and uterus only) no chemo and no radiation. I am 44 and do not plan to have children.

I'm sure someone else will come a long and give you better information than I've given to you. I really just wnat to let you know you are not alone in this. (((hugs)))
Hi're right...there's alot out there and sometimes difficult to figure it all out. I'll do my best and I'm sure others will chime in as well.

HPV is a virus. There are many strains of the virus some are considered HIGH RISk and others are considered LOW RISK. Both kinds can cause cellular changes on the cervix however the HIGH RISK strains cause changes that if not monitored or treated can progress to cancer. I'm told this progression is usually very slow and can take many years. The good news is there is alot that can be done during that time to stop the progression and remove the dysplasia. The low risk HPV can cause changes but these changes are not thought to progress.

Now when changes occur on the cervix, the PAP or colposcopy will grade the changes. PAPS(screening) are not as accurate as colposcopy with biopsy (diagnostic). The changes or dysplasia are classified as
1. ASCUS-atypical (mild abnormality)
2. CIN 1 (LGSIL)
3. CIN 11
4. CIN 111 (HGSIL)
5.CIS- Carcinoma In Situ--Cancer in its place (i.e has not spread)
6.Invasive Cancer

The options for dealing with the changes (dysplasia) include "waiting and watching"--usually for ASCUS or LGSIL, then LEEP, Cryo, Cone, Hysterectomy etc. for higher grades and/or CIS.

From your post, it sounds like you have hrHPV (high risk) with moderate+ dysplasia and to treat it your doc wants to perform LEEP. This procedure from what I understand is highly successful. There are several women on the board who have had the procedure so hopefully they can weigh in more on the procedure.

Hopefully this helps somewhat. Take care!:angel:
Hi Brexmom, I totally understand your confusion and worry. You have found the right place to ask questions, though. There are many women here who will help you all they can.

Please forgive the length of this. I just started typing and got carried away.

Very much like you, I never had a bad pap and I went every year since I was 19 (and I am 45). My doctor did an HPV/dna test at my last pap in December. My pap came back normal (as usual) but the HPV test said I was positive for high risk HPV. I went to a gynecologist who did the colposcopy. There wasn't anything for her to biopsy, so she did an ECC (endocervical curettage). That came back adenocarcinoma in situ (AIS) (highest level of precancer). From there, she scheduled a cold knife cone biopsy. When she did the cone I went to day surgery. At that time she did another ECC, the cone biopsy, a D&C, and an endometrial biopsy. My cone came back adenocarcinoma Ia1.

I then scheduled an appointment with a gynecological oncologist. She told me since I had adenocarcinoma that I needed a total hysterectomy (uterus and cervix) but I could determine the fate of my ovaries. I did not need chemo or radiation. I scheduled my hysterectomy for June 19th. The day before that I had another cone biopsy which found another cancerous lesion, but it was still Ia1, so I was ok to have the total hyst. If the lesion had been larger/deeper, then I would have had to have had a radical hyst and lymph nodes removed. The pathology report from my hyst said that there was no residual cancer. All cancer was removed during the cone biopsies.

The reason I had to have the hyst anyway is because of the type of cancer cells I had (glandular/columnar, not squamous). They might skip over good tissue and have a lesion just outside of the cone sample. So the recommendation is total hyst.

Why did my doctor do a D&C? She wanted to sample my uterus and its lining to determine if there were atypical cells (or cancer) there. For me, those came out clear.

Since you said you have HGSIL, I believe that means your atypical cells are squamous cells. This is better news than if they were glandular. Squamous cell dysplasia grow more slowly than glandular cell dysplasia. Squamous cells dysplasia is easier for the doctor to see and sample because they are on the outer third of the cervix (glandular cells are on the inner 2/3rds). Squamous cell dysplasia also spreads outward (as opposed to glandular which can "skip" over cells).

My thoughts (and hopes for you) are that your doctors have found this early enough that the cone biopsy might be diagnostic and treatment meaning that the cells they remove during the cone will remove all dysplasia. For me, it was just diagnostic since it found the cancer.

I have a few recommendations for you.

Get an appointment to a gynecological oncologist since you have CIN3 (CIN3 is precancerous). A regular gyn can do the cone and other biopsies, but you want a gyn/onc's expertise in how to treat your precancerous cells.

Get copies of your pap tests, the biopsies, and the HPV test. Learn what they say.

If you haven't gone to the Center for Disease control, I strongly suggest you do so. It will help explain a lot of things regarding HPV and cervical dysplasia. Personally, I was reading about cervical cancer when I got my HPV diagnosis, then REALLY read about it after the AIS diagnosis.

When you go to your doctors' appointments, take a written list of questions. Be sure to leave room to write the answers. You might consider taking 2 copies, one for you and one for the doctor.

I took a folder that had all of the information I had (pap results, blood test results, pathology reports, etc). That way, I had all pertinent information at my finger tips.

I hope that helps. Please check back with us!

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