It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....

Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index

I'll back up and give (hopefully) an abbreviated version of my last 13 months. Prior to that I had 26 years of annual, good paps.

December (07), annual pap and doc offered HPV/DNA test. I said ok.
January (08) I got the results: good pap, but positive for high risk HPV.
January (still) 2 appointments with the doctor to discuss hrHPV. Originally she said we'd wait and retest in 3, 4 or 6 months (don't remember how many). After my 2nd appointment she said she would go ahead and send me for the colposcopy.
March (misunderstanding about if my 1st appt with the gyn was a consult or the colpo, I had to reschedule in March) colposcopy. While doing the colpo she didn't take any biopsies because there was nothing on the exocervix to biopsy. "Just to check" she did the ECC to check the cervical os/endocervical canal.
March 21 results from ECC was adenocarcinoma in situ
April 4 cold knife cone bipsy, another ECC, a D&C, and an endometrial biopsy
April 11 I called the doctor's office to get pathology report. Doctor called back. ECC, D&C, and endo biopsy were fine. CKC came back adenocarcinoma Ia1. The lesion was 1.2mm across and 1mm deep.
April 18th I was sitting in the gyn/oncologoist's office listening to my treatment/surgical options
June 18 another cold knife cone biopsy to determine if my hyst could be done as we hoped/plan/expected (looking to see if there were more lesions and how large/deep they were)
June 19 returned to the hospital for my LAVH to remove just my cervix and uterus
My CKC on June 18 removed one more lesion (about 1mm across and 1mm deep).
The cervix and uterus contained "no sign of residual tumor" - - - no more cancer.

I don't know why the ECC didn't detect the AdCA at stage Ia1. I don't know if it is because the tissue sample didn't have any lesions that had breached the cervical wall (however thick that is) or if it is because the ECC can't sample that deep.

Let me give you a little bit of simple cervix, uterus, vagina biology. This description is courtesy of my best friend who is a lamaze teacher.

Think of a pear sitting in a tall thin glass. The narrow end of the pear is in the glass, the large end is outside (and above) the glass. You have pulled the stem from the pear. The glass is your vagina. The pear is your cervix and uterus. The cervix is part of the uterus, it is just the narrower, bottom end. The cervical os is like the hole where the stem use to be.

Now. Let's talk just the cervix. This is how *I* imagine/picture the cervix. Think of a frosted donut (but you are holding it so the frosted end is facing down - don't let go or it'll get ruined! ;) LOL - sorry, I got distracted hahaha). The pap scrapes the exocervix - that's where the frosting is. The doctor usually aims to get cells from the TZ (transition zone) that is a little further into the donut hole, but they can't always get very far in there. The colposcopy is similar to the pap, in that the doctor can't see much beyond the TZ. The doctor looks at the exocervix under magnification (3 different powers, I think). Sometimes the doctor will take a pinch/punch biopsy of the exocervix (the frosting). If the doctor has reason to suspect there is a problem further in the cervical canal (that's the donut hole), then he/she can do an ECC to scrape the canal, way down in the donut hole where you can't really see. (At that point, my image goes to a bagle since a bagel has a smaller hole than a donut).

Ok, I'm silly and think of strange analogies, but it all makes a lot of sense to me.

Now, the cervical wall, I guess the best way to describe that is if you peel off that frosting from the donut, the donut underneath is the cervical wall. You know how a candy-sprinkle is on the frosting, but doesn't get down into the donut itself? Well, these lesions are usually caught while they are still part of the frosting. Since we are actually talking about lesions, they CAN grow down into the donut instead of just staying in the frosting, but they are seen in the frosting, but they just go deeper into the donut itself.

Does THAT makes sense? That's the first time I've tried explaining the cervical wall. So I hope it makes sense.

We could think of the cervical wall as being like the skin of that pear. A blemish on the pear might just be on the skin, but it could go deeper into the pear. Again, we’d be talking about a blemish in the little hole where the stem use to be. When the doctor does the ECC, he/she is scraping in that little hole. When the doctor does a LEEP or CKC, then he/she is cutting into the pear (or donut) and making the hole larger.

When it comes to the oncologist, I’ve read (and agree) that if a woman has severe dysplasia (CIN II) or higher (including insitu), then it is prudent to seek the advice of a gyn/onc. He/she might just verify what the gyn says, but I think it is best to check. ESPECIALLY since we are talking adenocarcinoma and its sneaky ways. Then, if additional surgery (beyond the first cone/leep) is needed, I strongly suggest the gyn/onc do it. He/she knows what to look for if things are not as good as hoped/expected. He/she is best trained in what to do to make sure a bad situation is handled so it causes the least problems later. (like if a lesion is larger/deeper than expected or if pelvic wash (during a hyst) contains cancer cells), etc.

I wish you the absolute best when you go to the doctor. I hope he answers all of your questions and makes you more comfortable in understanding your diagnosis. You are in my thoughts and prayers. Please write back and let us know how your appointment goes!

I’m sorry for talking your ear off! I hope this post isn’t too long to post in one post! Yikes! ;)

All times are GMT -7. The time now is 12:30 PM.

© 2021 MH Sub I, LLC dba Internet Brands. All rights reserved.
Do not copy or redistribute in any form!