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Old 11-06-2009, 06:19 PM   #1
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Very Confused...Dr. Concerned because no HPV

Going to apologize in advance ladies, please bear with me if I get the lingo wrong.

My fiancee had an abnormal pap test, atypical squamous cells.

She went to the Dr. today for a colposcopy. The Dr. told her that she tested negative for HPV. However, even if the biopsy test today comes back negative, she wants to schedule her for a cone test, since there must be a reason why the cells are abnormal.

Again I am sorry if I have this wrong. She is very scared and I do not want to press her for more info.

Does this make sense? Is this cone test just a precaution? Should we be really worried?


Appreciate any advice, thank you.

Last edited by JOG1151; 11-06-2009 at 06:20 PM.

 
Old 11-06-2009, 07:42 PM   #2
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Re: Very Confused...Dr. Concerned because no HPV

May I ask how old she is? That might be one factor in why the doctor wants to do the cone. What type of cone biopsy is recommended? CKC? LEEP?

 
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Old 11-06-2009, 08:03 PM   #3
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Re: Very Confused...Dr. Concerned because no HPV

Quote:
Originally Posted by Pickle Eyes View Post
May I ask how old she is? That might be one factor in why the doctor wants to do the cone. What type of cone biopsy is recommended? CKC? LEEP?
she is 48

I'm not sure about your other question, CKC? LEEP?

What does each mean? Thank you

Last edited by JOG1151; 11-06-2009 at 08:04 PM.

 
Old 11-07-2009, 12:19 PM   #4
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Re: Very Confused...Dr. Concerned because no HPV

There are a variety of cone biopsies that a doctor might perform. One is a CKC (cold knife cone biopsy) which is done under general anesthesia in day surgery. Another cone biopsy is a LEEP (laser can't remember the words procedure) which is usually done in the doctor's office using local anesthesia.

 
Old 11-08-2009, 07:31 AM   #5
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Re: Very Confused...Dr. Concerned because no HPV

Quote:
Originally Posted by Pickle Eyes View Post
There are a variety of cone biopsies that a doctor might perform. One is a CKC (cold knife cone biopsy) which is done under general anesthesia in day surgery. Another cone biopsy is a LEEP (laser can't remember the words procedure) which is usually done in the doctor's office using local anesthesia.
I believe it is the cone biopsy under general anasthesia

Is there a positive, or negative to either procedure?

Is it possible that the Dr wants to do the cone biopsy as a precautionary measure?

We have not got the results back of the colposcopy...the Dr said even if the results are negative she still wants to do the cone biopsy...is this standard?

My fiancee gets pap tests regularly, she told me she had one abnormal test many years back, but her next pap test was fine.

Again, how worried should we be?

 
Old 11-08-2009, 12:33 PM   #6
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Re: Very Confused...Dr. Concerned because no HPV

Cone biopsies (LEEP or CKCs) are done for at least one of two reasons: diagnostic and/or treatment. Hopefully it does both at one time. After that, if the cone was a treatment, then there will likely be close follow up appointments for a period of time.

Yes, there are pros and cons of the CKC and the LEEP. The LEEP is faster and can be done in office without general anesthesia. An electrified loop/wire is used to cut the cone shape from the cervix. The intact tissue is cauterized by the wire and bleeding is reduced. If the doctor suspects squamous cell involvement (only), then the LEEP is probably the best option.

The CKC is performed under general anesthesia because the doctor uses a very small knife to cut the tissue from the cervix. This gives the doctor more time to carefully remove the needed part(s) of the cervix. The edges of the cut tissue are not burned, so the pathologist can better see if all of a lesion was removed (looking at the tissue's margins). With a CKC, the doctor can also perform other procedures at the same time like a uterine biopsy, etc. Many doctors now run the LEEP tool over the intact tissue to cauterize the tissue to reduce bleeding. There are a variety of reasons for a doctor to do a CKC over a LEEP. The doctor may suspect the lesion is larger than is visitlbe, the lesion is further up in the canal than he/she can see, or that there might be glandular involvement.

How worried should you be? That's a good question. I think you need to know what your past pathology reports say from paps and other tests. I think you need to go to your appointments as educated as possible. I think you need to go to appointments with a written list of questions and space to write answers. But when it comes to actually being worried . . . I think worrying doesn't do anything except occupy our mind. Worrying will not change the way the body is nor will it change the outcome of the upcoming tests/procedures. Do what you can to be prepared and informed, then spend time living life. Do fun things, Be with people you enjoy. Yet be prepared.

Good luck and let us know how things go!

 
Old 11-08-2009, 01:13 PM   #7
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Re: Very Confused...Dr. Concerned because no HPV

Quote:
Originally Posted by Pickle Eyes View Post
Cone biopsies (LEEP or CKCs) are done for at least one of two reasons: diagnostic and/or treatment. Hopefully it does both at one time. After that, if the cone was a treatment, then there will likely be close follow up appointments for a period of time.

Yes, there are pros and cons of the CKC and the LEEP. The LEEP is faster and can be done in office without general anesthesia. An electrified loop/wire is used to cut the cone shape from the cervix. The intact tissue is cauterized by the wire and bleeding is reduced. If the doctor suspects squamous cell involvement (only), then the LEEP is probably the best option.

The CKC is performed under general anesthesia because the doctor uses a very small knife to cut the tissue from the cervix. This gives the doctor more time to carefully remove the needed part(s) of the cervix. The edges of the cut tissue are not burned, so the pathologist can better see if all of a lesion was removed (looking at the tissue's margins). With a CKC, the doctor can also perform other procedures at the same time like a uterine biopsy, etc. Many doctors now run the LEEP tool over the intact tissue to cauterize the tissue to reduce bleeding. There are a variety of reasons for a doctor to do a CKC over a LEEP. The doctor may suspect the lesion is larger than is visitlbe, the lesion is further up in the canal than he/she can see, or that there might be glandular involvement.

How worried should you be? That's a good question. I think you need to know what your past pathology reports say from paps and other tests. I think you need to go to your appointments as educated as possible. I think you need to go to appointments with a written list of questions and space to write answers. But when it comes to actually being worried . . . I think worrying doesn't do anything except occupy our mind. Worrying will not change the way the body is nor will it change the outcome of the upcoming tests/procedures. Do what you can to be prepared and informed, then spend time living life. Do fun things, Be with people you enjoy. Yet be prepared.

Good luck and let us know how things go!

Thank you very much for all the information.

She does go for pap tests every year, so I have to believe that even if somerthing is wrong, it would be caught in the very early stages.

My fiancee is actually a nurse, so I am pretty sure that she will know what questions to ask.

I did not get the sense that she wanted to discuss this at length with me, so I did not want to push her for answers.

I am actually the worrier...old habits die hard, thank you again, we are going to see the doc on the 16th to get the results of the colposcopy, hopefully will be reporting back with good news.

Appreciate your help.

 
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