Re: cin 3 - spreading to glands?
Hi Smiler. First of all ((((((((((Hugs))))))))))))) and some slow clear breaths.
I don't know much about the British health care system, but from what you've written I'd be very frustred. I recommend you push to be seen by someone else. This is a very long post, I apologize in advance. I'm mixing some general knowledge with my experience. I hope I've made my experience sound like "my experience" and not as part of the "this generally is what is true" part. If, at any point I confuse you, please ask for clarification. I'll check back in a few hours.
Next, do you know what type of atypical cells you have? It sounds like you have atypical epithelial (or columnar) cells, rather than squamous. If that is the case, then I have an idea of what you were told.
The cervix is made of two basic types of cells: squamous and epithelial. Squamous cells are on the exocervix (think of the frosted part of a donut - if the donut is the cervix). The exocervix is what is scraped during a Pap and it is what is seen during a colposcopy. Most women who have atypical cervical cell growth have squamous cells (something like 80%). Then there are epithelial cells are shaped like columns (hence, also called columnar). They "live" higher up in the cervix, in the endocervical canal. (think the inside of that frosted donut, or the inside hole of a bagel). They cannot be seen when the doctor does the Pap or when he/she uses the colposcope. The best (in my humble opinion) way to know what is going on in the endocervical canal is to do an ECC (endocervical curettage). This scrapes the cerivcal "hole" for atypical cells.
My doctor did an ECC when she didn't see anything to biopsy on my colposcopy. My results from the ECC came back Cin-III and Adenocarcinoma in situ (AIS). AIS is still considered a precancer. It is actually (the way I understand it) between CIN-III and Stage I cancer.
My doctor scheduled me for a cold knife cone biopsy after the AIS diagnosis came back. That came back Adenocarcinoma Ia1 (very early stage - microinvasion). The only needed treatment was a hysterectomy (uterus and cervix). I had that surgery June 18th. I will not need chemo or radiation. I am VERY Fortunate that my doctor did the ECC and that it found my cancer at such an early stage. (That certainly doesn't mean the last 2 months have been easy - not by a long shot. I still feel fortunate it was found before I had to have more aggressive treatment).
Now, those "glands." I went for my second (and final) biopsy the day before my hysterectomy. The doctor did another cold knife cone biopsy to see if there were more cancer cells and to determine what type of surgery I needed (radical vs. what I ended up with). The morning of the hysterectomy (and the day after the biopsy) she told me what pathology said about the second cone. They said there was cancer in one of the "glands." I about had a panic attack. I interrupted her and said, "hold on, what do you mean "glands?"" She explained that the "gland" was one of the mucous secreting glands in the cervix, NOT a lymph node gland (which is what I had thought). This means one of those columnar cells (I think) which secrete mucous in the cervix had cancer in it.
Even though that gland had cancer in it, it was ONLY in that gland. She went ahead and did the LAVH (laparoscopically assisted vaginal hyst) as we had previosly planned (not the abdominal cut) and she only took the cervix and uterus (not the radical hyst).
My cancer was still considered microinvasion, even though that gland had cancer in it.
The happy ending here is, I've had my hysterectomy. I am now on the mend. The pathology report from the hysterectomy said there was "no sign of residual tumor" which means there was no new cancer. The doctor got everything during the biopsy on Tuesday, so the hysterectomy on Wednesday was for safe measure (my words, not my doctors). I now return to her at 4 weeks post-op. I'm sure we'll then discuss my follow up appointments. I expect to visit her every 3 months for 2 or 3 years, then go to every 6 months for 2 or 3 years, then yearly visits. Even if I have to see her every 6 months for the rest of my life, it is a whole lot better than having cancer in my body!
I hope that information helps you understand a bit more of what the doctors might have meant when they said "gland" and to give you a bit of a my story (which sounds it *could* be similar to yours - though I hope your isn't as bad as mine was).
If you have ANY questions, please feel free to ask. I'll do my best to answer. There are many women here who are better informed than me and who are extremely helpful and supportive. You have found the right place to look for information and support.
Please let us know how things go! ((((hugs and prayers for you))))
Last edited by Pickle Eyes; 07-01-2008 at 10:22 AM.