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Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index

I am new here and was wondering what the prognosis is after having a hysterectomy after being diagnosed with microinvasive cerverical cancer cells. my story starts in 1995 after the birth of my 5th daughter. The dr. found sispicious cells and told me to be checked regularily. However I didn't take it seroiusly, and didn't have insurance so I didn't have reg. pap smears, although I did have three paps during 1995 and 2006. In 2006 the dr. said I had abnormal cells (HSIL/ HPV ) and I had a LEEP. The first 2 paps after that were OK, and then no insurance again so I did not return for over a year. I had abnormal bleeding (I was now 51 and thought it was related to menopause) and the results came back again HPV with squamous and glandular cells. The Dr. did Ultrasound, ECC and Colpo. after which he told he told me I had ovarian cyst, and 3 fibroids. The ECC showed "scant atypical metaplastic cells suspicious for High Grade Dysplasia." Cone biopsy was done in Jan. and they found "microinvasive squamous cell carcinoma arising out of Carconima in situ involving endocervical glands. Carcinoma in situ extensively involves endocervical glands and extends very close to the base of the excision. Carcinoma in-situ present at the endocervical margin of excision" Complete hystrectomy proformed Feb 24, 2009. Can anyone tell me what these repot findings mean? They were concerned about the fact that the cells were close to the margin of the incision. Since I had a complete hystrectomy, and the cells were in the cervical area, what are the chances that the cancer will come back? I don't see how since everything was removed, unless the cells can invade the vaginal wall. Or is in the lymph nodes? I go back to the Dr. for the first pap since on May 18th and I am beginning to get nervous about it. Wish me luck!
Are you seeing a gynecological oncologist? If not, I highly recommend you see one. With the carcinoma (or is it carcinoma in situ?) and the glandular cell involvement, it is prudent to get an gyn/onc on your healthcare team!

Squamous cells are the outer part of the cervix. The part that is sampled by a pap and seen during a colposcopy. The glandular cells are further up in the cervix. The only nonsurgical way to sample them is the ECC. You had a cone, so that got a good sample of the cervical canal (and the glandular cells).

I'm not totally sure what else the report says, it seems to talk in circles and repeat itself (squamous cell carcinoma and glandular involvement).
Hi there --

I second what Pickle said regarding consulting with a gyn/onc.

The wording from your report is a little unclear, and was noting that basically you didn't have a very big margin from that surgery. However, since you've had a hysterectomy, the findings from that report are really not so relevant since you've had the entire problematic area removed. Metastasis to the lymph nodes with microinvasive cancer is very uncommon, and it's my understanding that often with Stage Ia1 they don't even check the lymph nodes since there is virtually no chance of them being infected. I was Stage Ia2/Ib1 and they checked my sentinel nodes (3) and took the obturator nodes (8 of them, and they were located near the ovaries), and thankfully all of mine were totally clean and disease free.

If you had squamous carcinoma, that is usually caused by hpv16. Without the cervical tissue to attack, there is a chance that persistent hpv infection could then attack the vaginal or vulvar tissue, but this is rather rare. Having the hyst was a smart move, and will in all likelihood end your battle with hpv. The recurrence rates for someone at your stage is approximately 4-5%.

One thing that is super important is that you faithfully keep ALL of your follow up appointments so you can be monitored to make sure nothing new pops back up. If you find yourself without insurance, there are programs that can help defray the costs. I believe the American Cancer Society has a program for cervical cancer screening and care, and there may be some others.

Good luck, and keep us posted how you are doing! Having been caught early, cervical cancer is very "curable," and your surgery should be all the actual treatment (aside from monitoring) that you will ever need :)

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