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Cancer: Cervical & Ovarian Message Board
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Old 08-23-2013, 12:45 PM   #1
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JwQuestions HB User
Abnormal pap after leep for adenocarcinoma in situ

Hi, I am 30 years old, no kids and not married yet. One year ago I was found to have endocervical adenocarcinoma in situ. I had a leep with clear margins. I went on to see a GYN oncologist and she gave me three options and made me choose my treatment path. My options were hysterectomy, trachelectomy, or surveillance to preserve fertility. I opted for surveillance since I still wish to have children. I have had routine paps and ECC for one year since the leep. Six months ago my pap showed endometrial cells, which we were going to reevaluate at the next pap. Now six months later my pap shows atypical cells. This call was made to me from the nurse practitioner since my gyn onc is out of town. The nurse practitioner was not very knowledgeable about my case and what to do. I am freaking out and now I have to wait a week to hear from my doctor. I am worried that I made the wrong treatment choice and to top things off I start a new job Monday and I won't be able to take any time off. Please help if you have had a similar situation.

 
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Old 09-17-2013, 12:06 PM   #2
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Re: Abnormal pap after leep for adenocarcinoma in situ

Hi JW, hope you have been able to connect with your doctor by now and get your questions answered.

As you know, adenocarcinoma in situ can be tricky to monitor. Even with clear margins, there is a 15 to 20% chance that there are other lesions elsewhere, since adeno can "skip around" - that is, have lesions in multiple places that don't touch each other. That is why continued monitoring is so, so important.

With your paps and your history, the next steps would be colposcopy and punch biopsy to look for more abnormal cells. If AIS is still present, you need to think about your next move. Trachelectomy is one option. You may also want to consider egg harvesting in case you end up needing a hysterectomy after all.

I'm so sorry you're having to deal with this again. Because I was done having kids, I chose to have a hysterectomy after being diagnosed with AIS but even then it was not an easy decision. I think you made a good choice based on the info at hand, and now is the time to consider the new info you are getting now and make a choice based on what you know today. Let us know how it goes. Sending hugs!

 
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