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Old 02-15-2006, 10:27 AM   #1
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Abnormal Pap

Back in the summer, the test results of my pap came back as having abnormal cells but not dysplasia or cancer (at least that is how the letter my doctor sent me read). At the time, I was back on the pill and was having light breakthrough bleeding in between periods. The doctor switched me to the Nuva Ring and I no longer have had any breakthrough bleeding.

The followup was to have another pap in March and just wondering what others with cervical cancer can tell me regarding symptoms, what's next, etc.

 
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Old 02-15-2006, 12:53 PM   #2
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Re: Abnormal Pap

Hi db18, you probably got a reading of ASCUS - meaning the cells that were read were not quite normal, but they were not quite abnormal (as in dysplasia) either. There are many reasons a pap might be read as ASCUS, the main thing is that you keep your follow up appointments to make sure if the cells start changing then it can be caught early and dealt with. As far as symptoms go, there are usually no symptoms until there is invasive cancer. Sometimes there is bleeding after sex, or mid cycle bleeding, or there may be a profuse watery like discharge. Many times there are no symptoms at all.

Cervical cancer typically takes many years to become invasive. Most times it is caught when the cells are just starting to change, called pre-cancerous cells. There are four levels of pre-cancerous changes that occur, it is not considered to be invasive until the cell changes break through the basement membrane of the cervix. For more information on the different levels of cell changes, you might want to do a search for the Bethesda system for reading pap smears. There is quite a bit of information about this online, key terms are ASCUS, CIN 1 (mild cell changes, a.k.a. LSIL), CIN 2 (moderate cell changes, a.k.a. HSIL), CIN 3 (severe cell changes, a.k.a. HSIL), and CIS (cervical carcinoma in situ - meaning cancer in place - this is not yet invasive cancer, however, if not treated is likely to become invasive).

Be sure you keep your appointment in March, keep on top of it and you should be fine. I hope your next pap turns out normal. You may want to consider requesting copies of your pap reports so that you can have the terminology used, making your research about what kind of cell changes much easier. If you have any questions, go ahead and ask

 
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Old 02-15-2006, 01:22 PM   #3
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Re: Abnormal Pap

What are the ways that the ob/gyn will use to get rid of the pre-cancerous cells if my next pap were to reveal that as my condition?

 
Old 02-15-2006, 03:33 PM   #4
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Re: Abnormal Pap

Depends on what type of cell changes are seen. Usually for mild dysplasia CIN 1 they do a watch and wait, and re-pap in six months. For anything higher, it depends on the size of the lesion(dysplasia) and location. Cryotherapy can be done if the cervical canal is not affected. Laser can also be done if the canal is not affected. Usually if there is high grade (CIN 2 or higher) dysplasia around the cervical canal (transformation zone) they will do a LEEP or cold knife cone biopsy. Lots of information online about each of the above procedures. If your pap comes back ascus or higher again, you will be sent for a colposcopy, where they put the speculum in, apply a vinegar wash (that highlights cell changes) and look at your cervix through a high powered lens. The doctor will take punch biopsies (tiny pieces of tissue) of any lesions that are seen, these are then sent to pathology to determine what level of cell changes are present. Once the pathologist has submitted the report, then a treatment recommendation will be made by your doctor. The pap smear is only used as a screening tool, the colposcopy and biopsies are considered for diagnosis. Hope that helps.

 
Old 02-16-2006, 08:03 AM   #5
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Re: Abnormal Pap

Thanks for your advice and insight. I am hopeful that the abnormal cells were due to the pill not being right for me, but either way, I am keeping my March appointment and am going to be vigilant.

 
Old 02-16-2006, 12:43 PM   #6
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Re: Abnormal Pap

Good for you, db!! Good luck!

 
Old 02-16-2006, 03:30 PM   #7
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Re: Abnormal Pap

Im glad to see that ur taking this serious an not getting yourself all worked up to the point that u wont go back. I have read about woman doin that and it ends up worse. When caught early enough this can very easily be treated. I didnt visit my gyno for about 2 yrs. an I probably wouldnt have even gone last Nov. if it wouldnt have been that I had a bacterial infect. I'm glad I did go now, I had an adnormal pap, an did the punch biopsy that Karen has mentioned which lead to having a cold cone biopsy. The results from that came back high grade dysplasia (CIN II and CIN III) with presents of carinoma in situ. I now have to have a hysterectomy March 1st. My point is that if I wouldnt have gone when I did, It would have gotten even worse. We can take care of this now an I will be ok. I cant stress enough to my friends an family that they need to have their yearly pap.
You have a good attutide, keep with that an everything will workout. Keep us updated an good luck.

 
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