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Cancer: Cervical & Ovarian Message Board


Cancer: Cervical & Ovarian Board Index


Hello,

Three days ago I found out that my most recent pap result came back with atypical glandular cells (AGUS or AGC). This is my first abnormal pap result (I'm 36), and I'm still in a bit of shock. I definitely wasn't expecting this to happen, but who does?

I've been doing a lot of reading since I got the results, and I realize that the AGUS result needs to be taken seriously and tested thoroughly. I really appreciate the members here who have provided such great information and support to others in the same position. Thank you!

My colposcopy is scheduled for 3 weeks from now (May 6), and I assume I'll need to have an ECC and endometrial biopsy (and HPV test) done at that time. I'm also guessing that if they don't find anything at first, I'll need to continue having these tests done for a while, considering the possibility of glandular involvement. I also plan to request a pelvic ultrasound if things come back normal the first time.

Unfortunately, I've read some of the horror stories here about the ECC and endometrial biopsies, so I'm pretty nervous about the pain involved with these procedures, especially if I have to get them done on a regular basis. I'd like to ask a few questions of those who have had one or both of these procedures done, or of anyone who has knowledge about these procedures.

* What is the most painful part about the procedures -- the actual biopsies, or when the doctor inserts the instruments into the cervix?

* Is there anything I can do to relax my cervical muscles during the procedure, hopefully to make it easier to pass the instruments through the canal?

* How long does the pain last? How would you describe it -- pinching, cramping, stabbing, sharp? On a scale from 1 to 10? Please be honest! I want to know what to expect.

* I've called a couple of OB/GYN offices (one was actually a gyn/onc) and asked if they would use a local anesthetic before these procedures, and neither of them will. Is this common? Why won't they do it? Does the local anesthetic not help?

* Has anyone been prescribed pain killers (stronger than Advil or Tylenol) before these procedures, and did it help relieve the pain?

* Do you think that these procedures are just "uncomfortable" for most women, but that a few women have severe pain? I can't understand why the medical establishment would subject women to such painful procedures if the majority of women have severe pain.

Thanks in advance for sharing your experiences. I really appreciate it!

Angel4747
Hi ladies,

Thank you SO much for your feedback, not only about the tests but about AGUS/AGC as well. I find myself going back and forth between worrying about the tests and worrying about the possibility of cancer, so advice in both areas is greatly appreciated.

It was quite helpful to read about your experiences with the colpo, ECC, etc. I知 so relieved to know that not everyone has a horror story to tell about these tests, although I certainly feel bad for the women who have experienced major pain during them. I hope I知 not one of them! I知 willing (I think) to do the first round of tests with only ibuprofen (800 mg!), but if things go badly, you can be sure I値l demand stronger pain meds the next time I have to get these tests done.

I知 sure I値l have tons of questions throughout this process, and I thank you in advance for your help. Here are a few new questions for you when you have time:

* Is 兎ndometrial sampling different from 兎ndometrial biopsy?

* Can the endometrial biopsy and ECC be performed during the same doctor痴 visit, or does the endo biopsy have to be performed separately?

* How does the doctor prevent the endo biopsy from being contaminated with cervical/vaginal cells when pulling out the instrument?

* My thoughts behind the pelvic/transvaginal ultrasound are that I may need to have my ovaries checked if my initial tests come back OK. I致e read that a small percentage of women with AGUS pap results are diagnosed with cancer of the ovaries or fallopian tubes. Your thoughts?

* Regarding the HPV/DNA test, my thinking is that if the initial tests are negative, it would be helpful (to both my doctor and me) to know whether I have high-risk HPV when making decisions about next steps/future testing. Do you think it might be helpful to know HPV status in that regard? (For some interesting reading, see pages 8-9 of this chart from the American Society for Colposcopy and Cervical Pathology: http://www.asccp.org/pdfs/consensus/algorithms_cyto_07.pdf)

* Although I worry about what the doctor/pathologist will find, I知 also worried about what they WON探 find. I know that sounds odd, but it seems with an AGUS pap, you can稚 be too sure of anything if your results are negative. I have some other unrelated medical problems, and it痴 been my experience that health issues can be very hard to pinpoint. I知 half expecting a cancer diagnosis, and I知 half expecting them not to find anything wrong at all. If you received an AGUS pap result and then were told that the ECC and other tests were negative, what course of action would you take? Get a second opinion? Request additional testing? What tests? Would it change anything if you knew my father died of colon cancer at age 47 and that I had a small skin cancer lesion (basal cell carcinoma) removed from my back when I was 31? I know I知 probably getting ahead of myself, but it makes me feel better to know what my various courses of action will be.

Thanks again for your help!
Hi there,
I am going through the exact same thing as you. I got a pap that said AGUS nos, I got an ECC and Endo biopsy, plus colposcopy. The pain is determined by the method your doc uses. I asked for the Cytobrush for the ECC...much less painful, but still campy. I just had the ECC 2 days ago. The first one came with CIN 1, my endo was normal. Then my pap came back again with AGUS, Favor Neoplastic. Not good. the last ECC I had on Tuesday hurt a bit more. It is nothing to be scared about though. Take some Ibuprofen. Now, the Endo biopsy is a little more painful. Again it is helpful to know what method is being used. My doc used the Tao Brush. The worst part was when they put the tube into the cervix. The biopsy itself was a bit crampy. My cervix wouldn't open, so they were going to use forceps. I was like "No thanks, just keep trying please!". When it went it it did hurt, for 3 seconds, then he put the brush in and scraped the uterus, which honestly didn't hurt much at all.
I am scared to death. I cannot concentrate on work at all. I am terrfied. I have ovarian cysts that are causing me problems as well. Arrgh! I want the results back so bad.
Well, I finally got my tests done on Thursday. It wasn't easy, but I'm thrilled to have it over with.

As expected given my AGUS pap result, I had a colposcopy with 2 biopsies, an ECC, and an endometrial biopsy. I didn't feel much pain at all with the first two procedures (thank goodness!) and the doctor didn't have any trouble moving the instruments through the cervical canal, but the endometrial biopsy itself was quite painful. The pain was far more than "bad cramps" as I've heard it described. Unfortunately, I think they used the pipelle method rather than the Tao brush, so perhaps that's the reason for the high level of pain. The doctor started the biopsy and said "I'll need to do this for about 30 seconds." And I said, "OH OH OH (in pain)...30 seconds, really? Please hurry, hurry, hurry!" I think she stopped after 15 seconds, thank goodness, because I'm not sure how much more I could have taken. Hopefully the sample was large enough, because I definitely don't want to have that done again!

Unfortunately, the doctor said she saw two white spots on the outer cervix/transformation zone during the colposcopy. She said they weren't "overly concerning" and that "they might be something or might be nothing." She biopsied both sites, so we'll see. I'm pretty bummed about that, but I guess I'll be thankful if they can find the problem quickly so this doesn't turn into a never-ending "treasure" hunt.

It's still possible that the spots she saw were yeast patches, given that my pap results showed Candida. After my last post, I actually contacted the pathologist to ask if Candida could cause the AGUS pap results. He was extremely helpful and said it was definitely possible, and that Candida could affect squamous cells too. I'm still hopeful that yeast could be the culprit, but my gut says this probably isn't the case. I hope the test results come back quickly next week so I don't have to wait much longer to find out.

In answer to a previous question, my PAP results showed "atypical glandular cells" only, with no mention of "favor neoplastic." That's somewhat reassuring, but I know an AGUS pap of any type is pretty concerning. My OB/GYN is taking it very seriously and plans to continue an aggressive workup if needed, so I think I'm in good hands. Depending on what comes back from the recent biopsies, I may still consult with a gyn oncologist for a second opinion before going any further.

Thanks again for all your help and support!
I really cant comment about the ECC however, I found out yesturday I have to have one June 8th. My doctor said it is like having a the procedure colposcopy (sp??) which I have had at LEAST four times. My experience with that was fine. A little cramping and spotting after. It felt like cramps! I take ibuprofen 800mg before I go. So if the ECC is anything like getting pieces of your cervix snipped...you can do this!!! If I can anyone can (I am a big baby!). I will say a prayer for us both.
Angel, I've read your posts with great interest as I has atypical glandular cells with a Pap in Jan. Following this, Ive had a colposcopy, d & c, LEEp, cone, and ultimately a hysterectomy on May 28. I am wondering about those glandular cells and although everyone, including my gyn-onc was convinced the hys would end my troubles, I have been diagnosed with a rare gynecological cancer known as adnoma malignum or minimally deviant adenocarcinoma. I hope all has gone well for you and if you get a chance, tell me of your hopeful progress. I was anxious about the glandular cells from ther beginning asnd I suppose, my fears have been confirmed.
Thanks for your reply. My CA125 is slightly elevated. I have asked for an abdominal ultrasound but my gyn won't order one since my cone biopsy was normal. She said that the abdomen isn't her area and she wouldn't know what to do with the results anyway. I do have endometriosis but haven't been told if this could be the cause of the agus favor neoplastic.....so far I have no idea where the abnormal cells are originating from. The cone wasn't nearly as bad as I thought it would be. I thought the bleeding would be quite heavy but it wasn't. I had a brown discharge for about 4 weeks. I didn't need any pain medication. I have been having trouble with acid reflux for months now. I had a gastroscopy done and see my dr on Fri for results. I don't go for further testing until Nov which will be more than a year since my original diagnosis. Then she will do a repeat pap. ECC and colposcopy. I had a colonscopy a year ago since colon cancer runs in my family. Are you having a cone? ...what is next for you? Thanks again for responding to my post. It isn't easy to find someone else who has this diagnosis. I will keep you in my thoughts and prayers too.
I am sorry for what you are going through. I have the same diagnosis. But I will tell you I had an endovaginal ultrasound it was not painful at all. Two biopsies taken from different places of the cervix like 6 samples no pain at all. I also had pap smears colposcopy and ECC no pain until now. My next step is another biopsy and possibly a cone biopsy. I hope not to have an hysteroctomy. Even if I am 45 and not plannning on kids.

best of luck to u and don't worry there is no other worse pain than waiting and waiting
that is the only pain I felt even though I have a great health insurance.
Mine came back AGCUS so..... Colposcopy, Endometrial Biopsy, Endocervical Biopsy and Cervical Biopsy.

Endometrial came back normal, Endocervical came back normal but the Cervical came back mild dysplasia. We are at the watchful waiting stage and I am a nervous wreck. I freak out over every burn, ache, itch or cramp. I am a total psycho :)

Thank you SO much for responding...... Seems like that there is never any good news here!

I go back in July for a follow up pap. Wish me luck and PLEASE keep me in your prayers. I will do the same.

God Bless - Teresa





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