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Old 04-08-2011, 02:44 AM   #1
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Confused and Worried - PAP

Here is a brief history -

Menopausal with a history of irregular PAP (twenty plus years ago, treated with cryo).

CIN I - 2009 - followed by colposcopy and then LEEP. Doctor wanted to do a cone because he prefers it and thinks it is easier on the patient. I requested the LEEP which he said was just as good and knowing myself would be easier for me than the anxiety of anesthesia. LEEP showed CINI with CLEAR margins. Also HPV positive.

Every six months from there on PAP was ASCUS. Doctor thought first was scar tissue and from then on cell changes due to menopause. Wanted me to try hormone cream - declined, have never and do no want to use hormones.

Two weeks ago PAP came back CINI again. Colposcopy done yesterday. Nothing was seen. He said this was a bad thing, not a good thing, as it could mean cells further up so wants to do a cone.

I am very confused as I have been told it was all taken care of and that it was menopausal changes. When this PAP came back he still wanted me to try the cream, but I had discussed at the time of the PAP what we would do if it came back as CINI and he said a colposcopy. So, I called him on that when the nurse called with the results and his treatment and he said yes we should do the colposcopy and when I went yesterday he said he suggested the cream as he was trying to "be nice"!!! He has also hinted at a hysterectomy many times as just a way to be "done with it". That seems highly extreme to me for a CINI and something I would not do unless this became much more advanced. I have gone round and round with this and with the diagnosis or reasons why with him. Confused - HPV or hormonal, got it or didn't, clear margins so why this?

I am going for a second opinion today as I need to feel comfortable with all of this and hopefully get some better answers to my questions. But for all of you who have been through this, I could use your thoughts. I am an educated woman, do research, and do not enter into things without thought.

I know that CINI is a long way from cancer, but still needs treatment. However what treatment after all of this? Does anyone know if things are seen easier when doing a cone, or are they just taking a major piece without knowing exactly where? If nothing is seen on the colposcopy, is the cone really necessary? Is another LEEP just as effective? My doctor said yesterday that a LEEP is very effective, but a cone gets a tiny bit more. Again, confused! I don't want unnecessary or more invasive treatments because it is easier for me or easier for him. I want to feel comfortable while still being smart and protective of my body.

Thanks for any help you can offer.


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Old 04-08-2011, 11:18 AM   #2
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Re: Confused and Worried - PAP

After two opinions, I am in going in for a cone next Friday. I am scared, worried, and upset about all of this and if anything worse will be found. Everything has stayed at a level I all the way through this, so the chances of it being cancer (according to the doctors) is very small. However, it is still frightening. I would love to hear from others who have had a similar experience. I have to say that my stress level is very high and has been. Our daughter-in-law has severe breast cancer so we are needed and doing everything we can for her, our son, and grandchildren. I did not need this right now so my anxiety is very high. Thank you for any thoughts, experiences, or encouragement that you can share. glowing4

Old 04-08-2011, 04:05 PM   #3
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Re: Confused and Worried - PAP

Really sad that no one has responded. Is it because I am older? Is it because I have not waited long enough for a response?

Old 04-08-2011, 04:59 PM   #4
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Kali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB UserKali333 HB User
Re: Confused and Worried - PAP

I don't know why they'd want to treat your CIN1 so aggressively; in most cases, they don't treat it at all, but take a watch-and-wait approach instead, because in over 90% of cases, CIN1 will resolve itself without treatment in about a year. Usually in cases of CIN1, doctors just recommend more frequent PAPs until the CIN either resolves or progresses to a more advanced stage, at which point they treat it, usually with LEEP.

I assume the reason they're treating yours now is because of your age. There seems to be an assumption that hpv-related CIN is more serious in older women than in younger ones. I believe there have been studies which show that CIN is less likely to resolve spontaneously in older women, more likely to progress, and quicker to progress.
So your doctor's probably just trying to be on the safe side.

Best of luck! Let us know how it goes.

Old 04-09-2011, 02:29 AM   #5
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Re: Confused and Worried - PAP

Thank you Kali for responding. I most appreciate it. They are being aggressive due to age and the on going, non resolving pap's. I am very upset by all of this and just need to get through it. Would still like to hear from others who have had a cone and what the experience is like.

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