I can't tell you how grateful I am to find this board!

I am 40 years old. A month ago I had my first pap smear in approximately 8 years. The results came back with severe dysplasia and carcinoma-in-situ. Sounded very scary to me!

I had a colposcopy last week but my ob/gyn said because of the pap results she wanted to go ahead and schedule a leep even though the biopsy would probably not be in yet. I am having that in 2 days. Does the doctor get a pretty good idea just from viewing the area with the colposcopy, even without the biospy results? I asked my gyn that question and all she said was, "it does look severe". Severe dyplasia? or severe what?

It looks to me, from the research I have done, that the best results I can hope for at this point is that it is only carcinoma-in-situ, but it seems like most people get worse result once the biospy report comes in.

Does anyone know if the pap smear would have shown invasive, if in fact it was? My gyn keeps trying to reassure me....but does she really know anything at this point?

Thanks in advance for any responses. My thoughts and prayers are with all of you going through this.

Hi,

This whole dysplasia thing is ridiculous isn't it? This whole thing is so scarey it can take over your daily thoughts. However, please try not to let this happen. I am a nurse that had an abnormal pap, then high grade lesion on byopsy. Just had the leep procedure two days ago and am awaiting to make sure they got everything. Knowing that cervical cancer is most likely not a killer, I should have not been so scared, but I was as well.
When you get your pap results the byopsy results do tend to come back differently, however, sometimes they come back slightly worse and there are many times, the byopsy comes back the cells are not as bad ie: mod dysplasia etc.
Lets say you had the carcinoma insitu, if you read on the internet about this, it is still not considered cancer. There is a classification of byopsy results, low grade mod grade, high grade dysplasia, carcinoma insitu, then cancer. Carcinoma insitu is not classified as cancer on the new classification. It definitly needs to be removed from the cervix because it can turn into cancer.
Even the first few stages of cervical cancer are totally curable like in the 90 some percent range.

The leep procedure was not that big of a deal.
read my new post

take care
iffer

Thanks for your response. For some reason, I am not all that worried about the LEEP, more anxious to get this over with as soon as possible.

Is it just assumed that I have HPV? Neither doctor has mentioned to me that I have that. I was tested for other STD's and everything was clear. I have been in what I thought was a monogamous relationship for 8 years, and I still believe that to be the case. But, if I do have this, shouldn't my husband and I take precautions when having intercourse? If we ever get to have it again, (ha, ha) Since I had the colposcopy just last week and am having the LEEP this Friday, it will be a while before we have to worry about that.

I have had no symptoms whatsoever, certainly no break through bleeding or bleeding after intercourse. Is this possibly a good sign that this has been detected early?

Usually abnormal bleeding is more of a symptom of advanced cancer, but abnormal bleeding can mean a lot of other things as well.
You should not assume you have HPV until told you do so. You do though, need to ask you dr to do typing for HPV off of your byopsy or pap smear, they can go back even a few weeks after your pap to check this. MOST WELL SEASONED DR's, when they see cervical dysplasia will test to see if HPV was most likely involved. The thing is, you do not need to have actual intercourse to get HPV, ie(could get from fingers etc), and HPV is a virus that can remain dormant for many years, so you could have gotten it prior to your husband if you had had any other partners, but your virus just became active thus causing bad cells. What causes the virus to become active? stress, smoking any blow to your immune system. etc.
Some people do have these issues such as yours however, and do not have HPV, but usually the bad cells that can cause cancer are from having HPV.
If you have it of course, talk to your dr about safe sex practices. But I will tell you that my husband and I never use safe sex practices and he has never had a prob. HPV usually is the virus that either causes genital warts and then the other strain can cause dysplasia of the cervix instead of warts.
I hope this helps. If you have HPV, 80% of the population has been exposed to hpv, many people never develop problems from this however, some people run into some issues. Which can come and go as the virus goes in and out of a dormant state.

I hope this has helped, you do need to ask your dr. I bet you have a high poss that this is hpv, however, you may be one of those people who just has the dysplasia without hpv as the cause.
iffer

Had the same thing. I got a laser cone biopsy done last week. Piece of cake. The worst part was the anesthesia (I get nausea and vomiting). My doctor called a week later to tell me my pathology report came back excellent. :bouncing: Anyway, through this whole process whenever I had a nagging feeling about something she said, I called her and asked her directly. Don't make yourself crazy wondering what she meant by severe...call up and ask. I read in a book about hpv and abnormal paps that severe dysplasia/carcinoma in situ (usually lumped together to bring attention to the severity) look different than invasive cancer during colposcopy. That in only 1 in 1000 women was invasive cancer found after a diagnosis of severe dysplasia/cis on colposcopy if the doctor was an adequate colposcopist. Best of luck to you! And update us when you can.

So, all the pap does is tell whether or not further tests need to be done?

I am just so confused on a biopsy with the colposcopy and then another with the LEEP. It just sounds to me like this is something that is going to go on and on and on. Should I just resolve myself to the fact that I am going to be living with this the rest of my life, long or short? If that is the case, then I suppose I should stop worrying and just deal with it.

its a virus and you will have it for life- though i have read that your body fights it off in a few years and then recurrance is not likely. however, if it is going to come back, it usually does so within the first 2 years of having it. i am 24 and i had severe dysplasia then a conization. a year later my pap showed moderate dysplasia so i had the cryo. i am going for my follow up pap in 2 months. i have stopped taking bc pills (been on them for 6 years) and i am using rubbers with my bf of 3 years and taking a multi vitamin. i am hopong this helps.
when the dysplasia came back i started crying to my doctor - she told me, "Melissa, you can cry but you have this virus and its a stupid virus and we will take care of it. its part of life. go with the flow. we will deal with it." since then, i just decided not to get myslef sick over it. no reason to. im being watched so closely that i have no need to worry. its the people that dont go to the doctor and that dont follow their dr advice that should worry, and we are not in that category.

So, all the pap does is tell whether or not further tests need to be done?

I am just so confused on a biopsy with the colposcopy and then another with the LEEP. It just sounds to me like this is something that is going to go on and on and on. Should I just resolve myself to the fact that I am going to be living with this the rest of my life, long or short? If that is the case, then I suppose I should stop worrying and just deal with it.
Yes, the pap is used for screening not diagnosing. As far as the biopsy they do with the colposcopy, if the "bad" cells extend throughout the whole sample the pathologist has no way of knowing how far they go past that. With the LEEP or cone, hopefully your doctor will get all of the dysplasia. They biopsy that to make sure they got everything.

Oh, I think I get it. Thanks for clearing that up for me!

I have Adenocarsinoma In Situ and will have "laser conization" on May 10th. My Doctor told me this is not real CANCER. It is called "pre-cancer".... So, don't worry. You shold be fine. By the way, I'm 28. I am more scared than you..... Wish you the best of luck!!

jjg06,

It is scary, I know. In a way, I am glad I am older (for a change) and not going through it when you are, just because I know for sure I am not having any more children.

My doctor ( gyn) had told me the carcinoma-in-situ was that there were cancer cells present, but not invasive and easily removed/ cured (if found early) by doing the LEEP. She said you treat that (in situ) just as you would severe or moderate dysplasia (pre-cancer cells). It's confusing as heck and I think it just depends on who you talk to!

I did read your initial post and I am so glad you got another opinion. The procedure is not bad at all, at least it wasn't for me. Not the most fun you are ever going to have in your life, but mine was very similar to the colposcopy biopsy, only not quite as bad!

Good luck to you and let us know how you are doing.

JLTJR,

Hi there. I had a laser conization done Monday. It took 45 minutes to complete the surgery. Guess what? My experience wasn't bad at all. I had no pain and very little bleeding. And today my period came, it is not bad either. I will give my Doctor a call on next Monday to find out the results. (Margins, etc.) Fortunately, I have less fear now. Things got to be better. I pray every day.

Kim

Hi all,

Bad news, bad news.... My Doctor called yesterday. The pathology report came back and showed Possitive margins - in other words, they did not get all the bad cells. He suggested a second cone biopsy in 2 months or so. I felt like hell. He said if I am done with children he would probably suggest hysterotomy, and he hopes the second cone biopsy will take care of all the bad cells. He said the good news is there is no cancer, it is still the pre-cancerous condition: Adeno Carsinoma In Siti! What?? I am so confused. Anyone out there please give me some thoughts. What should I do? If you know someone who have had a hysterotomy, can you please share your experience with me? I am 28. What type of side effects should I expect if I decide to get hysterotomy? Thank you thank you thank you!! God bless you all!

Love,

Kim

Hi there. Sorry to hear about the news, but it is true that the good news is that there is not cancer. My margins weren't clear either but so far, my doctor hasn't suggested a hysterectomy, just another pap in 3 months and take it from there. (although, I'm 40 and would just rather get the hysterectomy rather than keep doing this). Just from reading the boards and from other people I know who have had it done, I've really not heard of side effects being bad. I had 2 aunts that had it done in their early 30's and actually, they were glad they did. I know it's probably not an easy decision for you. Just to clarify, did your doctor suggest a cone and then a hysterectomy if the 2nd cone didn't get it all, or was he/she suggesting just to go ahead with the hys. if you don't plan on having any/more children, or having both procedures done?

Take care and I'll keep you in my thoughts.

They will take care of it. Thank God its not Cancer and just be brave and deal with the second procedure. They were probably being conservative with your first procedure as to not take too much off. My doc told me with my first cone that once you take it off you cant put it back, so we will be conservative. She said she would rather have me go back then take too much off in the first place. Your news can be stressful, but one more procedure will not be that big of a deal and I am sure they will get it all. Cheer up! Things will be back to normal soon!!

OH.. Thank you all! My Doctor only suggested a second cone biopsy and did not mention hys at all. But I am going to see him next month anyways, I will bring this question up. Personally I want to request for hys if the second cone biopsy does not work. It is too much to handle. :( By the way, anyone knows how the "margin" works on pathology reports? How do they come up with negative or posstive margins?