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    Old 07-30-2009, 07:39 PM   #1
    nonie97
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    abnormal pap results asc-h

    i don't normally post on message boards, but i feel i have nowhere else to turn right now and the vibe here is comforting and supportive.

    today i got a call from my gyno telling me my pap came back asc-h. my last pap was a year ago, it was normal. i tested + for hpv (not sure if it was high risk) last year as well. hpv is still present. i've scheduled an appointment for a colposcopy. my doctor doesn't seem too alarmed just yet. i suppose she shouldn't be considering we don't really know anything.

    i'm frightened and depressed about this because my father just died from cancer, less than 2 months ago. to hypothetically be faced with the same disease that killed him is too much for me to handle. i don't want to tell my family just yet, until i actually know what's going on. likewise with my friends and workmates. my boyfriend is supportive, he's also just as scared as me.

    i guess my question is what are the percentages that the results of the biopsy will be very bad? i've never smoked, but cancer runs in my family (both grandmothers, also died from cancer, non-cervical). will the increased cancer risk have anything to do with what's going on with my cervix, keeping in mind this is probably all due to the hpv? assuming i have to have a procedure to remove cells, is this something i will have to have tests for, for the rest of my life?

    thank you for reading.

     
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    Old 07-30-2009, 08:02 PM   #2
    Pickle Eyes
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    Re: abnormal pap results asc-h

    Nonie, first of all, let me say how sad I am to know that your father recently passed away! I'm certain that is very difficult to deal with.

    The chances that you actually have cancer are quite small. The good news is that you have been to the doctor (at least twice in the last 2 years = 1x/year) and that the doctor is being proactive. If there is something wrong, it is caught early.

    At the colposcopy, the doctor will most likely do a pinch/punch biopsy of the exocervix. If you are over 30, then I suggest you ask your doctor about doing an ECC (endocervical curettage). It is the only nonsurical way the doctor can sample the cells in the cervical canal. Those cells are different from the cells on the outer cervix (outer cells = squamous; canal cells = glandular).

    Quote:
    assuming i have to have a procedure to remove cells, is this something i will have to have tests for, for the rest of my life?
    It depends on what the doctor finds.

    Hopefully the doctor can remove all atypical cells during the colpo + biopsy. At that point, you'd just need to be sure that you stay current on your paps. Nothing new there, except you know you have/had HPV and that problems can arise later so you want to always stay current on the paps.

    I hope that helps.

     
    Old 07-31-2009, 12:28 PM   #3
    jumpfesta
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    Re: abnormal pap results asc-h

    Hi Nonie sorry to hear taht you are going through this. It funny today I told one of my friends what I am going through with my high grade dysplasia and she told me she went through the same thing and actually told me about a mutual friend of ours who also went through the same thing. My auntie had stage three cervical cancer because she never did a pap untill she started having syptoms, she did chemo and today is cancer free, but her case is the minority,so many women go through this yearly and the vast majority never get cervical cancer. I am trying to keep my head up so please do the same, but in the mean time take your vitamins and eat properly as the body has a way of healing itself.

    May god be with you every step you take.

     
    Old 07-31-2009, 04:47 PM   #4
    oldfashiongirl
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    Re: abnormal pap results asc-h

    Hi Nonie,

    I too am sorry that you are having to deal with this. I'm also so sorry to hear about your dad.

    My paps had been coming back as a mixture of ASC-US and ASC-H over the past two years. The first colpo showed only Mild Dysplasia (CIN I) but a few months later I had another ASC-H pap which prompted my new doctor to order another colpo which picked up Severe Dysplasia (CIN III). I had a LEEP in late March of this year where the doctor removed three areas of CIN III. I just had my follow up pap this week to find out how well the LEEP worked.

    You are doing all that you should be doing at this point by following your doctor's advice and going through with the colpo. The pap is not a dignostic tool, but the results of the colpo will be able to tell you with more certainty what is going on.

    Quote:
    Originally Posted by nonie97 View Post
    what are the percentages that the results of the biopsy will be very bad?
    ASC pap results are very rarely already cancer. And taking into account the fact that you had a normal pap last year, it's even less likely. Cervical cancer typically takes years, sometimes decades, to develop and the important thing is to catch any trouble cells early in the process, which it sounds like would be your case.

    Quote:
    Originally Posted by nonie97 View Post
    i've never smoked, but cancer runs in my family (both grandmothers, also died from cancer, non-cervical). will the increased cancer risk have anything to do with what's going on with my cervix, keeping in mind this is probably all due to the hpv?
    You are right, these problems are caused by high-risk HPV. I am not sure if your family history of cancer is that relevant to this type of cancer since it's caused by a virus. The only genetic link I've read about in cervical cancer is when another female in the family has cervical cancer (not just any kind of cancer) because there is some thought that if more than one female in the family is getting cervical cancer, it might be due to a genetic disposition in their immune system of being unable to fight off the HPV virus.

    Quote:
    Originally Posted by nonie97 View Post
    assuming i have to have a procedure to remove cells, is this something i will have to have tests for, for the rest of my life?
    I can speak from experience that if they do find CIN III, and once it gets cleared up, you will be required to have annual paps for at least 20 years afterward. I am not sure about the requirements for lesser degrees of severity. But, the good news is that with treatment, cervical dysplasia is very highly treatable and that if you do need treatment, statistically it is very much in your favor that you will only need treatment once and then you'll be done with it!

    Hang in there and keep us posted - especially when you get the results of your colpo!

     
    Old 08-07-2009, 07:04 PM   #5
    nonie97
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    Re: abnormal pap results asc-h

    thank you ladies for the kind regards and comforting words. i had my colpo and biospy this week. it was more painful than i was expecting. the doctor didn't say what she saw, but she told the assistant she was going to need more containers; that she was taking more samples than originally planned. after the procedure when i was getting dressed, i looked at some of the samples and noticed they were white. from reading about the biopsy process, i know abnormal cells turn white from the vinegar wash. both of these things leave me more frightened than i was before the procedure. i may get the results this week. if not, i will have to wait until september because my doctor is on vacation. i have an appointment this coming week to at least ask questions if the results haven't come back.

    on a slightly different note, my new fear is about oral cancers from hpv. i would imagine it's highly possible to be infected with hpv vaginally and orally at the same time. as far as i know there are no yearly or bi-yearly pap smear type tests for your mouth. how does one go about being tested for oral hpv? what prevention can be done for these types of cancer? my doctor told me she only tests for high grade hpv, but does not do a dna test. will she need a new sample from me if i ask for a dna test? strain 16 seems to be the highest risk for oral cancers....

     
    Old 08-07-2009, 07:41 PM   #6
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    Re: abnormal pap results asc-h

    My doctor did the HPV/dna test when she did my pap. It only indicated that I was positive for high risk HPV; it didn't tell which strain(s) I have/had.

    When you go to the dentist (suppose to be every 6 months) one of the things the doctor looks for is any lesions. I don't know that they do a swab or anything, but one reason they look at your cheeks, under tongue, etc is HPV lesions.

     
    Old 08-08-2009, 04:55 AM   #7
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    Re: abnormal pap results asc-h

    Pickle is right about the dentist.

    Most squamous cell problems are caused by hpv 16, and most adenos are caused by 18. 25% of all oral cancers are hpv related, and nearly 90% of that portion are caused by 16.

    A lot of docs are funny about doing further testing to type for which strain you have, mostly due to financial/insurance concerns. It's crazy. A lot also take the position that once you have developed problems, it doesn't really matter which strain you have; also crazy.

     
    Old 08-11-2009, 07:19 PM   #8
    nonie97
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    Re: abnormal pap results asc-h

    thanks for the info. i guess i will have to talk to my dentist the next time i go for a checkup.

    got the results of the biopsy today. had to rush to the doctor's office unexpectedly (my appointment was supposed to be thursday). 7 areas were biopsied, 6 were normal, 1 came back as CIN 2. The scrape was normal too. the doctor said i can either have another colpo in 3 months or just have a LEEP when she gets back from vacation.

    i'm weighing the options, but leaning more towards the LEEP. i'm thinking that's probably going to be the end result anyway and i'd rather avoid another biopsy that tells me either nothing has changed or things have progressed. my boyfriend is worried about the complications the LEEP may cause to a future pregnancy (premature labor). he wants me to look at the percentages of progression and regression if a LEEP is not done, as well as get more specifics about the labor stuff. the statistics i found online did not persuade me against the procedure (something like 43% regresses, 35% stays the same, 22% progresses to CIS). i still have time to think about it though; meeting with the doctor in september.

    the results, while not good, are better than i was expecting. i'm relieved that i know what's going on and i can get treatment now. i feel well informed, in part thanks to this message board. thank you to the ladies who responded to my posts with helpful information and support. my doctor was surprised by how much information i already knew! and i wasn't a crying mess because i already had a good idea of what could be happening.

     
    Old 08-13-2009, 09:03 PM   #9
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    Re: abnormal pap results asc-h

    That's a lot of biopsies! No wonder you were in pain. This is just my opinion, but I would agree with your inclination to just go for the LEEP. I had over two years of abnormal paps/biopsies/colpos because my doctor recommended the "wait and watch" approach and in the end, I ended up having the LEEP earlier this year, which came back with three areas of CIN III. Plus, it's my understanding that usually CIN II is treated (not watched) and is even commonly categorized as CIN II/III because it is challenging for pathologists to distinguish between the two levels. So, my vote is for the LEEP. I believe the risks for future child bearing are relatively little but it is still something you should talk to your doctor about. Good luck!

     
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