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Old 09-25-2008, 03:28 PM   #1
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Cone biopsy

I'm having a cone biopsy early part of next week (to determine exact day tomorrow). My pap smear on 8/21 came back with atyplical gladular cells and HPV positive and have had an issue with ASCUS in the past (however all clear right now on that!). Had a colposcopy, biopsy and ECC on Monday. The 2 biopsies from lower section of my cervix were not dysplasia. The ECC apparently was not sufficient enough for the pathology to conclude. So, we are moving on to a cone biopsy (cold knife) and as well my Dr will do an endometrial biopsy while I'm asleep just to be sure. I feel relieved with all of this...I feel that my Dr. is taking the necessary steps and is moving swiftly. My questions are...how much pain can I expect after the cone? I've heard about the scarring after a cone and that makes me nervous, but I guess at this point that's just how it is. My worry is that future pap smears will be difficult to read b/c of the scarring. Just to add, I'm 27 and am a single mom. While I'd like someday to have more kids, right now my main concern is being here and being healthy to raise my son. I'm willing to do whatever that takes, so if it comes to a hysterectomy, then I will handle that. Any advice or insight about what I can expect next week is appreciated!

 
Old 09-25-2008, 06:19 PM   #2
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Re: Cone biopsy

Hi Robyn, I remembered reading one of your posts elsewhere, but didn't remember your age. I'm glad you included that!

At my first cone biopsy, my doctor did another ECC, a D&C, an endometrial biopsy, and the cone. The cone biopsy came back adenocarcinoma Ia1. But my first ECC (2 weeks prior) had come back adenocarcioma in situ.

I was a nervous wreck before going into surgery. I remember sitting on the bed preop, in my ugly gown and non-slip socks SOBBING because I felt so out of control. I think I felt that way because I think I was in some sort of denial about the HPV and the precancerous cells that were found in my cervix during the ECC. As soon as I signed the final release forms they got some Versed in me. I love that stuff! I totally was chilled out. I remember being wheeled into the surgery suite, but that's it. The next thing I knew I was in postop (about 35 minutes later).

When I woke up, I felt nauseated, but the nurse was standing by my side and gave me some meds immediately. I remember having pain, which she gave me meds for that, too. Within 30-45 minutes of waking up, I went to the bathroom. Within 30-45 minutes of that I was dressed and being wheeled out the front door. I was home before noon.

I slept most of that day. I know I used the viocodin that they gave me, but I only used it the next day and 1 pill the 2nd day. I was back at work on day 3. I had the cone on a Friday and was back to teaching on Monday. I was a little sore, like very mild cramps for a few days. I had a discharge for a week or two. I only needed to wear a panty liner.

It was actually pretty simple. I had myself worked up for it to be so much worse than it was. I was terrified that I'd go in for the cone and come out with a radical abdominal hysterectomy. That was totally irrational. So, don't think about that. It won't happen that way! If I had been calmer when I signed the final release for surgery, I'd have noticed it only said: ECC, D&C, endometrial biopsy, and cone biopsy. There was NOTHING about a hysterectomy! :shrugs shoulders: I was totally irrational at that moment! Like I said, thank goodness for the Versed! hahaha

Man, the more I write the more afraid I am of making you panic and double thing. What I really want to say is that it was much easier than I had thought it would be. The results were not what I hoped for, but I am so relieved my doctor was proactive and that we found what we found.

 
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Old 09-25-2008, 07:31 PM   #3
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Re: Cone biopsy

You are not frightening me at all! I ask a TON of questions (I'm an auditor...it's my job to ask!!) and I like to know what I'm getting myself into. I know this has to be done. My Dr. is young but I have confidence in her. I feel that she is taking a conservative and "safe" approach. I guess I'm a little nervous b/c the pathology report apparently said that the ECC on Monday wasn't a sufficient sampling. Why would that be? I plan to ask my Dr. that tomorrow.

Oh, and I'm supposed to start my period in the next few days. Should I just continue to take BC pills and skip a period this month so that I don't get my period? I really want to get this cone biopsy over with in the next few days and don't want to have to wait because I get my period.

 
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Old 09-25-2008, 07:39 PM   #4
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Re: Cone biopsy

The sample might not have been sufficient because she might not have scraped enough tissue. That's all I can think of.

Ask your doctor about the pill. I can't remember what they said about me having my period when I had my cone. All I remember is it wasn't an issue. I know for the hysterectomy it didn't matter.

Take care and let us know how the appointment goes tomorrow!

 
Old 09-29-2008, 07:56 AM   #5
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Re: Cone biopsy

My cone is set for tomorrow. I'm not so much nervous about the procedure or the pain. That will go away pretty quickly. I saw the dr. on Friday...she told me that she believes the worst-case-scenario is possibly a cancer-in-situ. She had taken 2 biopsies from the exocervix and those came back with HPV changes, but not dysplasia. So, the bottom of my cervix is fairly clear. She's going to take out those two pieces with HPV changes with the cone. Pickle, did you have dysplasia on the exocervix? I can't remember what you said. Thanks for helping me out and answering questions!

 
Old 09-29-2008, 07:45 PM   #6
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Re: Cone biopsy

Hi Robyn, my exocervix was clear. The only atypical cells that were found were in the canal (found by the ECC). I went from normal paps every year for 25 years to high risk HPV positive (in Dec 08), to atypical glandular epithelial lesions and adenocarcinoma in situ (March 08), to cervical cancer (April 08) to the hysterectomy (June 08). I was exposed to the HPV at least 16 years ago.

Let me get this correct, your exocervix is looking pretty good but your doctor thinks there might be a problem in your cervical canal. Is that right? Hopefully you'll be one of the lucky ones where the cone biopsy is diagnostic and treatment. <crossing fingers, toes, and eyes>

Take care and report back when you can!

 
Old 09-29-2008, 09:06 PM   #7
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Re: Cone biopsy

Yes, you understood right. My problem is in the canal. Do you think it's correct to say that it's a good thing that the exocervix is clear??? I mean, to me, that at least means that I know my cervix isn't eaten up with bad stuff. Yes, I pray tomorrow will be treatment as well as diagnosis! Do you remember if your Dr. was able to see (naked eye without microscope) that you had cancer during the cone? I asked her on Friday if she would be able to see it and she said if it was an actual cancer lesion that she would see that, but if it was pre-cancer or in-situ she would not be able to see it.

 
Old 09-30-2008, 05:20 PM   #8
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Re: Cone biopsy

How did you do, Robyn?

My doctor never made a comment about whether my lesions could be seen with the naked eye or not. I know my first lesion (found in my first cone biopsy) was 1.6mm across and 1mm deep (a dime is 1mm thick). I suppose it could be seen with the eye, but they are in there with a scope of some sort, so it is already magnified (at least that's the idea I have). My second lesion was found on my second cone biopsy (the day before my hyst). It was less than 1mm across and it was 1mm deep. FORTUNATELY when she did the hyst the next day there was "no evidence of residual tumor" :happy dance: She got it all in the cone the day before.

Robyn, I hope you are doing well. Check back with us and let us know, ok?!

 
Old 09-30-2008, 08:37 PM   #9
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Re: Cone biopsy

Hi! It went well. When I first woke up I was hurting pretty badly, but the anesthesiologist gave me some more meds before she left and I got comfortable. I felt really pretty amazing the rest of the day. I'm starting to feel yucky tonight though, but nothing too bad. I was able to move around much easier today and less bleeding than after the ECC last week. Wierd. My doctor told my mom it went well, that she did not see any lesions with her naked eye and that she hadn't expected to. (This gave me some comfort) We should have pathology report in 2 days...seems fast to me! I feel at peace with it all and so glad that my doctor has moved swiftly. Thanks for checking!

 
Old 10-01-2008, 05:28 PM   #10
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Re: Cone biopsy

Be sure you rest after the cone biopsy. Follow your doctor's directions regarding lifting (or pushing/pulling) heavy things, etc. You only get one chance for healing.

I'm glad you feel some comfort and relief from what the doctor has said so far. It REALLY helps to have confidence in your doctor, and it sounds like you have that! yay!

One thing I was really glad of is that my doctors were proactive and timely. My gyn/onc said that if the cancer hadn't been found I'd have been symptomatic within 1 year (meaning it would be stage II or higher) which would have resulted in chemo and/or radiation, etc. I'm SOOOO glad my doctors did what they did and when they did!

I hope you are feeling better today. (((hugs)))

 
Old 10-01-2008, 06:39 PM   #11
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Re: Cone biopsy

Ha! Well, your advice about resting was a little too late. I woke up this a.m. and felt just fine so I didn't limit myself. I ran 2 errands with my mom and really over did it. I am feeling better now and am resting on the couch with the heating pad. So, should hear from dr. tomorrow or Friday. ; 0

 
Old 10-01-2008, 07:32 PM   #12
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Re: Cone biopsy

:wiggling finger at Robyn: Now go rest and don't over do things!!!

(((hugs)))

 
Old 10-02-2008, 07:56 AM   #13
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Re: Cone biopsy

So, I came to work today. Had a rough morning. Not much bleeding but still crampy. So, got very good news back today. My dr. called and said that the cone showed CIN II with clear margins!!! Endometrial biopsy was clear. Yea! She also wants me to get the Gardasil shot to protect against future infection. She said it might not do much for me but worth a shot. Unfortunately my insurance won't cover it b/c I'm a whopping 40 days over the age limit. So, it'll be 3 shots at $200 each for total of $600. Oh, well. It's worth a shot, right, to protect against this crappy HPV? Thanks for all your support.

 
Old 10-02-2008, 08:15 PM   #14
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Re: Cone biopsy

I'm so glad you got good results and that it looks like she got it all! Yay!!!

 
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