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Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index

Sherrie, I'm one of those people who "doesn't do things the usual way" as my doctor said. I get unusual symptoms and unusual things cause things to happen. :shrugs shoulders: At least my doctor knows this. Maybe that thought went through her mind when she said I should go ahead and have the colposcopy.

Anyway, the way I understand it, the difference between the LEEP and a cold knife cone are the following. They both remove a cone shaped part of the cervix which is then sent for pathology to determine the extent of dysplasia. It can be diagnostic and treatment or it can be just diagnostic (which it was for me). The LEEP singes/burns the edges of the tissue as it cuts (on the removed tissue and the remaining intact tissue). This reduces bleeding. The cone biopsy gives clear cut edges to the removed tissue. This allows the pathologist to determine if a lesion has clear margins (a good thing) or if the lesion is at the edge of the tissue (meaning there is more left on the cervix). Because the LEEP burns edges, it doesn't allow for reading the tissue sample all the way to the edge. A cold knife cone can bleed more than a LEEP . . . BUT . . . after my doctor did the cold knife cone, she then took the LEEP wand and passed it over my cervix to cauterize it to reduce bleeding.

I don't know why so many doctors perform so many LEEPS over the cone. I wonder if it depends on whether or not the doctor suspects cancer. I would thing if he/she suspects it, then he/she would do a cone (to preserve margins). That is my suspicion.

A LEEP can be performed in office, but a cone can't be.

And ECC is an endocervical curettage. When the doctor is doing the colposcopy he/she scrapes the cervical canal with a brush like swab. It hurts. I won't lie. But the pain only lasts a minute or two (literally). It is the only nonsurgical way the doctor can sample the canal (otherwise a LEEP or cone would be needed).

With a CIN III diagnosis, I'd highly recommend the gyn/onc.

Something like 80% of diagnosed cervical cancer (carcinoma) is sqamous cell. Those cells are found on the outer cervix. Adenocarcinoma invovles the glandular/columnar cells. Those cells are found higher in the cervix which cannot be seen or swabbed during a pap or colposcopy. Adenocarcinoma is typically found with ECCs. My cancer was adenocarcinoma and was found with the ECC. So yes, in a sense, adenocarcinoma "hides." That's why I recommend the ECC to so many women. It helps "find" the cancer (if there is any).

My adenocarcinoma in situ was found with the ECC. A few weeks later I had a cold knife cone biopsy. The results from that were adenocarcinoma Ia1. This is early stage invasive cancer. My lesions were less than 2mm across and 1mm deep (a dime is 1mm thick). They were tiny, but invasive.

Two months after the results from the cone, I had a hysterectomy to remove my cervix and uterus. I do not need chemo or radiation. If I understand correctly, if the cancer had been deeper than 1mm (and larger than some other measurement across) then I would have had a radical hysterectomy and/or chemo, and/or radiation.

I could have had my hyst earlier than 2 months. I chose that because I am a teacher and didn't want to take off for the surgery unless I had to. It also allowed me the entire summer to recover.

I hope that helps.

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