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Old 05-17-2011, 01:59 PM   #1
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Cryotherapy Regrets

I recently accompanied my mother to a cryotherapy session at a gynecologist's office. She had been diagnosed with very mild, CIN-1 dysplasia after receiving her first abnormal pap smear (ever) and further testing. She is in her early 50's and has not experienced menopause yet. Anyways, without having done adequate research beforehand, and with my urging, my mom decided to go ahead with the cryotherapy. The procedure sounded simple and quick enough, but now I feel that the decision was a mistake. I came across a Reuters article which quotes a Doctor saying that those who have had cryotherapy (older women in particular) are more likely to experience an recurrence of CIN or even full blown cancer!

In other sources, I have also found that cryo even makes future screening more difficult and that many women experience long term complications.

I was hoping people on this board would share their thoughts on the matter and offer some advice? I've definitely learned my lesson, but still feel horrible about the whole thing.

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Old 05-17-2011, 02:20 PM   #2
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Re: Cryotherapy Regrets

I had cryo almost 30 years ago, I was 23 at the time, and haven't had a problem since.
if your mom gets regular paps and follow up on everything, there shouldn't be a problem....don't worry! I think cryo is safer than the surgical methods they sometimes use

 
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Old 05-17-2011, 04:38 PM   #3
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Re: Cryotherapy Regrets

I had cryo about 25 years ago. It was the standard treatment for low-grade CIN back then; LEEP hadn't been invented yet.

I never had another abnormal PAP, and I don't even test positive for HPV anymore.
No doctor ever mentioned that it was "more difficult" to give me a PAP because I'd had cryo... although a new doctor once commented, upon examining me, "You've had a procedure. LEEP?" And I told her no, cryo, many years ago.
I asked her why and she said there was some visible scarring.

I think the fear with cryo- and the reason LEEP is preferred these days- is that cryo destroys the tissue it removes, leaving nothing for laboratory examination/evaluation. Therefore it is impossible to know, with cryo, whether you got "clear margins" or not, or whether the CIN was worse than first thought, as LEEP or a cone biopsy will tell you.

As far as it being worse for older women, well... any level of CIN is potentially more serious in older women.
That is because HPV is so common (over 70% of sexually active Americans have it at one time or another) that most women contract the virus within a few years of becoming sexually active. Typically, their immune systems clear the virus within a couple of years.
Some people are unable to clear the virus, however, and it remains in their system, causing increasingly severe levels of CIN.
When an older woman presents with CIN, doctors automatically wonder if she's been living with HPV for the past 20 years, unable to clear it (which, obviously, would be bad. It could mean she might have invasive cervical cancer).

One thing I've always heard about cryo (and LEEP too, to a lesser degree) is that it can cause fertility problems, although in my case it did not. I've never had any trouble getting pregnant and have had healthy, uncomplicated pregnancies and deliveries, despite the apparently "visible scarring" that cryo left on my cervix.

I'm surprised the doctor treated your mom with cryo. I know it's still used to treat a variety of minor conditions (such as cervical ectropion), but I was not aware it was used any longer as a treatment for CIN.

 
Old 05-17-2011, 06:06 PM   #4
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Re: Cryotherapy Regrets

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Originally Posted by Kali333 View Post
I'm surprised the doctor treated your mom with cryo. I know it's still used to treat a variety of minor conditions (such as cervical ectropion), but I was not aware it was used any longer as a treatment for CIN.
Yeah that's what the second doctor said...the one she went to after the fact, which adds to our frustration. We should have gotten a second opinion beforehand... *sigh*

Last edited by Skylar6334; 05-17-2011 at 06:13 PM.

 
Old 05-17-2011, 06:13 PM   #5
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Re: Cryotherapy Regrets

This post put me in a state of shock. I had cryo two years ago at age 48. I have had clear paps ever since, but now I'm terrified. I can't believe my doctor would have done this to me if it wasn't proven. I tested negative for HPV twice but I had an ASCUS pap at the time. Now I will always be waiting for the other shoe to drop.

 
Old 05-17-2011, 08:06 PM   #6
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Re: Cryotherapy Regrets

I would rather have cryo then the leep which sometimes need to be repeated and a little bit of the cervix is sliced off each time. with cryo the frozen tissue sluffs off and new tissue regenerates fresh.....and the cone is major surgery!
don't worry!

 
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Old 05-17-2011, 09:02 PM   #7
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Re: Cryotherapy Regrets

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Originally Posted by paticake35 View Post
This post put me in a state of shock. I had cryo two years ago at age 48. I have had clear paps ever since, but now I'm terrified. I can't believe my doctor would have done this to me if it wasn't proven. I tested negative for HPV twice but I had an ASCUS pap at the time. Now I will always be waiting for the other shoe to drop.
Hi paticake,

Yeah the problem is while the success rate is high in the short term, for whatever reason, the research results on the long term impact of various cervical treatments have only been coming out recently. Do you do all your screenings with the doctor? I'm not saying the screenings are inaccurate -- not at all, only that I think it's helpful to get different perspectives on things for the future.

It's sad but true: some doctors just don't keep up on the latest research as they should, or some DO know that cryotherapy is outdated or rather uneccessary for very mild dysplasia strains (which tend to go away on their own or, at the very least do not tend to become cancer) but they're in it for the quick buck and will scare patients into thinking they need it. After all things like cryotherapy are very easy to do on THEIR end...

 
Old 05-18-2011, 04:33 AM   #8
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Re: Cryotherapy Regrets

I don't mean to be argumentative, but I really don't think that's the case.
Cryo works fine for treating low grade CIN.
It is not appropriate for high grade CIN, because it does not remove anything but the surface tissue.

The reason LEEP is preferred is because the removed tissue can be sent to a lab for analysis.
With cryo, the tissue sloughs off and is gone, and there's nothing left to examine, therefore no way for doctors to check for "clean margins" or know if they got it all.
For known low grade CIN, however, it is sufficient, and in fact it's all there was for many years, up until about fifteen or twenty years ago.

I hope others who have had cryo will not be alarmed.
Look at my story, and the story of the other lady who had cryo 30 years ago.
The CIN has never come back, for either of us, and in fact I no longer have HPV and I'm sure she doesn't either.

Millions of women have received cryo. I'm positive there is not a rash of women suffering from returned CIN many years after cryo.
I stay on top of medical research, especially when it comes to gyno issues, and I have never heard of any such thing.

Please just remain calm.
Best wishes.

 
Old 05-18-2011, 05:53 AM   #9
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Re: Cryotherapy Regrets

Thank you, Kali... It was just such a surprise to read about this study. I keep saying to my doctor "if I don't have HPV then I shouldn't have to worry, right?" and she'll agree but not to the degree of reassurance that I need. I guess I will just consign myself to a lifetime of 6 mo. checkups and pray for the best.

 
Old 05-18-2011, 11:49 AM   #10
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Re: Cryotherapy Regrets

Well, the idea that CIN could disappear and then pop up decades later- because of cryo or for any other reason- is just silly.
CIN is caused by the HPV virus, and follows a well-documented, progressive course.
Of course it's possible that cryo might not get it all... just as it's possible that LEEP or a cone biopsy might not get it all, or that the HPV infection might not clear, causing CIN to develop again.
But if that were the case, the CIN would return quickly, probably within six months or a year. It would not go into remission for thirty years, only to return as invasive cancer. Nothing that is currently understood about HPV and CIN suggests that this could happen.

There is nothing about cryo that would cause CIN and HPV to go into remission for decades and then suddenly return with a vengeance.
The virus simply does not behave in that way, no matter what method one uses to treat it.

Please do not worry about this.

Last edited by Kali333; 05-18-2011 at 12:02 PM.

 
Old 05-18-2011, 12:09 PM   #11
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Re: Cryotherapy Regrets

Quote:
Originally Posted by paticake35 View Post
Thank you, Kali... It was just such a surprise to read about this study. I keep saying to my doctor "if I don't have HPV then I shouldn't have to worry, right?" and she'll agree but not to the degree of reassurance that I need. I guess I will just consign myself to a lifetime of 6 mo. checkups and pray for the best.
Meh. I never did six month check-ups after my cryo. I was supposed to, but I didn't get around to it. Once a year for me.
Twenty-three years of normal PAPs now. No doctor I've ever heard of recommends "a lifetime" of six month check-ups. After you've had a couple of years of normal PAPs, you no longer have to do that. You just go back to a regular, once a year schedule, like everyone else.
At age 35, they offered me an HPV test along with the PAP.
I tested negative for HPV (and have every year since) and I was shocked.
I had thought that once you had the virus, it would always remain in your system, but my doctor explained to me that this is not the case. Your immune system usually clears the virus within two years after infection, and at that point you are at no higher risk for CIN or cancer than someone who never had HPV.

So don't think of this as a lifelong thing; for most people, it's not.
Over 90% of women clear the virus on their own, even without treatment.
For some unfortunate women, it lingers and causes repeated problems... but the odds are you will not be one of them.

Best of luck.

Last edited by Kali333; 05-18-2011 at 12:10 PM.

 
Old 05-23-2011, 10:22 PM   #12
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Re: Cryotherapy Regrets

Sorry about your mom's CIN. Cryo is one of the least invasive forms of actual medical treatment.
I think it would more valid to compare long term reoccurrence rates comparing each category separately, CIN1, CIN2, and CIN3. Many CIN1's do not receive any real treatment at all, many times it is just watch and wait and see if it clears when retesting.

I had cryo for CIN3 due to my young age and not having children yet in our marriage. I had CIS within some months after. It was not effective long term, however, I was more advanced than CIN1.
I suggest your mom also consult with a valid naturopath and consider certain immune boosting supplements/healthy lifestyle changing. I did not smoke or drink and took a multivitamin but still found good advice upon seeking naturopathic doctor advice.

 
Old 05-29-2011, 08:36 PM   #13
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Re: Cryotherapy Regrets

Did any of you experience bloating that lasted for a few weeks afterward?

 
Old 05-31-2011, 06:54 PM   #14
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Re: Cryotherapy Regrets

No, never any bloating. Watery discharge for 10 days and that was it.

 
Old 06-13-2011, 12:59 AM   #15
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Re: Cryotherapy Regrets

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Originally Posted by Skylar Rae View Post
Did any of you experience bloating that lasted for a few weeks afterward?
No.

 
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