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Cancer: Cervical & Ovarian Message Board
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Old 04-18-2010, 11:32 AM   #1
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Update: Mild dysplasia on ECC - Dr. will do LEEP under general

Hello -

In Feb 2009 in Washington DC I had a normal Pap and was tested negative for HPV. I moved to California and in March 2010 my new family doctor did a pap which turned out ASCUS and positive for HPV. I have a lot of anxiety anyway, have not had sex with anyone but my husband since I met him 19 years ago, and had a lot of angst both about my health and my marriage until I could get into see a gynecologist over a week later.

My gynecologist told me that the switch from HPV negative to HPV positive was probably due to the fact that different labs test for different strains of HPV and I could have had the strain I have for 30 years.

I am post-menopausal. After the doctor did the colposcopy, she said my cervix looked perfectly fine (she didn't even take a biopsy) but she did do an ECC and said her staff would get back to me if the pathology results were normal, which she expected. She said that Pap smears can look atypical in post-menopausal women even if there are no pre-cancerous cells. I was very relieved.

Instead over a week later, her staff called to say I had mild dysplasia of the endocervix and the doctor wants to discuss treatment options. They gave me an appointment for over a week from now. My anxiety is reaching new highs. I really hate the idea of having pre-cancerous cells in an area that can't be seen.

Does anybody have any idea of what the treatment options are? Any questions I should be asking the doctor?

Thanks in advance for any replies to what I know is a long message.

Update below.

Last edited by onestitchatatim; 04-26-2010 at 02:55 PM.

 
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Old 04-18-2010, 12:55 PM   #2
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Re: Mild dysplasia on ECC - Dr. wants to discuss treatment options

Hi onestitchatatime, your story sounds very similar to mine.

Your doctor's explanations sound reasonable to me. I suspect your doctor will want to do a cold knife cone or a LEEP. If you have glandular cell dysplasia, then I suspect the doctor will opt for the CKC.

I know it is difficult to not be anxious. I've been there. All I can say is that worrying won't change the outcome.

Please keep in mind that high risk HPV is not a good test for fidelity. high risk HPV can be in someone's body for years or decades without being detected.

 
Old 04-18-2010, 04:00 PM   #3
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Re: Mild dysplasia on ECC - Dr. wants to discuss treatment options

Thanks so much for your reply. I was wondering whether I should call the doctor's office and ask to see the pathology report before my appointment. Part of me says it might ease some of the anxiety if it is squamous cell. The other part says that I stand to be even more anxious and it would be better if I had the appointment and let the doctor put it in context.

I know worrying won't change anything. I just don't know how to stop.

I'm going to go for whatever procedure has the greatest chance of eliminating those cells without my having to go through more atypical paps. I have a book called "Abnormal Pap Smears - What Every Woman Needs to Know" by Lynda Rushing, MD and Nancy Joste, MD that I think is very good but is also somewhat scary.

Thanks again for your response. I have been lurking around here for several days and know you have been a great resource to many women.

 
Old 04-26-2010, 03:52 PM   #4
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Re: Mild dysplasia on ECC - Dr. wants to discuss treatment options

The endocervical curretage showed mild squamous cell dysplasia - LSIL. I felt much better after I went to get the pathology report from the office before my actual appointment.

The doctor said she wanted to do an outpatient LEEP under general anesthesia and at the same time do a deeper ECC and a D&C. The reason for the surgery is that the lesion is up where it can't be seen and there is no other way of knowing if there's anything else going on. She said if the lesions had been visible during the colposcopy she would have used cyro plus "wait and watch".

If nothing more serious is discovered, I will need to have a pap smear every three or four months until I have three normal paps in a row.

I have vowed to save all my worrying for the days between the procedure on May 24 and June 1 when I have my post-op appointment. We'll see if I can do it ...

 
Old 04-26-2010, 05:31 PM   #5
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Re: Mild dysplasia on ECC - Dr. wants to discuss treatment options

Quote:
Originally Posted by onestitchatatim View Post

I have vowed to save all my worrying for the days between the procedure on May 24 and June 1 when I have my post-op appointment. We'll see if I can do it ...

That sounds like a good idea! Do you know if your doctor will be doing a LEEP or a CKC (cold knife cone)? They both are cone shaped biopsies, but they use different tools to remove the biopsy. Since your lesion is suspected to be higher in the canal, I would hope the doctor would do the CKC.

How are you recovering from the colpo? I can't remember, did you have discharge? Is it all gone? Mine stopped after about 4 days, I think.

Keep us up today, ok?

 
Old 04-27-2010, 09:20 AM   #6
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Re: Mild dysplasia on ECC - Dr. wants to discuss treatment options

Thanks for your response. Thanks you and this board I inquired about the CKC. The doctor said the procedure had more risks and was more expensive and she doesn't recommend it for an LSIL.

It was kind of a weird conversation in one way. First she told me that I had to have the LEEP because there might be more and more serious lesions up above where she did the ECC (she's also going to do a D&C of the uterus). Then she shifts to "it's only an LSIL, it's not cancer, you could wait 6 months to have the LEEP done (No. Thank. You.), 80% of LSIL's resolve themselves even in women of your age (58)."

I went it with the idea that I was going to reject any "watch and wait" approach. I guess I'm "lucky" that the lesion is in the endocervix. Her policy with LSIL's on the exocervix is cyro + further pap smears.

 
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