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  • Second cone or wait and see ?

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    Old 03-16-2007, 03:06 AM   #1
    luzon
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    Second cone or wait and see ?

    I got the result of my cone for CIN 3 yesterday . The good news if confirmed CIN 3 ( nothing worse ,so that is a relief ) . Bad news there is involvement in the exocervical margins . I was offered or wait and see paps,biopsies ..or to have a cone . I think my oncologist was for the wait and see approach which he said they usually do in the UK as the cone using LOOP should have destroyed some tissue and I might not even have CIN3 . I however being a scary cat ( and having a very young sister who two years after cone had vulva cancer ) decided on the Israeli way , another cone .

    I am now debating the decision and wonder if there are others out there who have been faced with this choice who can advise ?

    Miri

     
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    Old 03-16-2007, 08:49 AM   #2
    happymom28
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    Re: Second cone or wait and see ?

    If it were me, I would have another cone. You could take a wait and see approach, but with it being CIN 3 I don't see it clearing up on it's own (or at least that's what I've been lead to believe). I am one of those people who would rather get it taken care of then wait and see and have it get worse.

    I hope that helps. Hang in there, everything will work out. You will be in my prayers.

     
    Old 03-16-2007, 09:19 AM   #3
    luzon
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    Re: Second cone or wait and see ?

    Quote:
    Originally Posted by happymom28 View Post
    If it were me, I would have another cone. You could take a wait and see approach, but with it being CIN 3 I don't see it clearing up on it's own (or at least that's what I've been lead to believe). I am one of those people who would rather get it taken care of then wait and see and have it get worse.

    I hope that helps. Hang in there, everything will work out. You will be in my prayers.

    Many thanks happymom for your input , just wanted to see if I made the
    right decision . This is the fourth time I have posted and the first time I got a reply and it really helps to have opinions from people going through the same things .

    Again many thanks and good health to you too .

    Miri

     
    Old 03-16-2007, 12:53 PM   #4
    dc2006
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    Re: Second cone or wait and see ?

    Hi luzon, I think you made the right decision too. From my limited understanding, CINIII is one step away from cancer. While its true that it may take years and years to progress to that or may actually never progress to that -- its still one step. And, as another poster pointed out -- there is a much lower chance your body will clear CINIII on its own. I would get it out.

    I am facing a decision about what to do after my first procedure was unsuccessful too. I am certain I want to take action, rather than wait and see, I have no clue what to do.

    I had my first abnormal pap in September. I had a colpo a couple of weeks later that showed high grade dysplasia and CIN II-III in both the endo and ecto cervical tissue. I had a leep a couple of weeks later -- the pathology showed the same (CIN II-III) but the margins were unfortunately not clear, I had a follow up colpo at the end of January and surprise surprise, high grade dysplasia with CIN II. The good news was that the ecto cervical tissue came back normal, so I am now just dealing with the endo cervical tissue (I think that’s how you phrase it).

    I am 29, determined to have kids at some point and sick of worrying about this. I want to be aggressive, but not do anything to risk being able to have children. I know the more procedures I have, the greater the chance of stenosis or cervical incompetence….so, I decide to really investigate what to do. I have met with two gyn. oncologists. One says have a second leep 7-8 mm in depth as an in-office procedure. the other says, have a cold knife cone as an out-patient procedure.

    Here are my questions….
    1. Is there any difference between a LEEP and CKN (other than using a loop vs. a scalpel)?
    2. Is one technique more aggressive than the other?
    3. Does either have a greater risk of causing pregnancy complications (stenosis, incompetence)?
    4. (bonus question….do you have any idea how you are supposed to choose a doctor or make these type of decisions!!!)

    I know this is a different issue than your post Luzon, but if you (or anyone else) has any idea how to answer these questions or experiences that would help me think about it, I would really REALLY appreciate a reply.

    Again, I think you made the right call. I don’t see any reason for us to sit around worrying about this progressing to something worse -- get rid of it.

     
    Old 03-16-2007, 03:20 PM   #5
    fairydust7
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    Re: Second cone or wait and see ?

    If I was in your position, I would get another cone done as well.

     
    Old 03-16-2007, 05:34 PM   #6
    DiamondLight
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    Re: Second cone or wait and see ?

    I had CIN III several years ago. I remember the doctor saying he might even be able to get it all with the biopsy, but he didn't...it took two leeps and a cone. I would get the cone too, good luck.

     
    Old 03-17-2007, 05:10 AM   #7
    luzon
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    Re: Second cone or wait and see ?

    For dc 2006 ,

    Thank you first of all for your response . I am sorry to hear that you are going through all these problems , and especially at such a young age .
    As to your questions , not that I am an expert , however I have read loads in the few months since all this happened to me .
    When my oncologist ( whom I trust ) told me over the phone that I was going to have a cone for CIN 3 I assumed he meant cold knife cone , my sister had this many years ago . I had read a lot as I say and was happy with this as I had read that the pathology was better with a scalpel as the edges were clearer . When we met he told me he was using LOOP I told him about what I had read , he maintained that though not wanting to argue with me using the scalpel was outdated and would not be done in Israel ( or the UK where he had also worked ) in this day and age . Afterwards I read articles written for surgeon and in the end thought he was correct . I insisted on general anaesthetic though . I also had read that a larger area could be taken with a the knife , but he said he would take a large chunk anyway !
    I know that the bleeding and recovery time is supposed to be longer with cold knife .As for pregnancy I see that after either of these procedures it shouldn't be a problem ,I think you are supposed to mention what you have gone through so you can be monitered . I have friends who have had children after a cone , I think the complications are rare , I am sure you can find information on this .

    Hope this helps you and that you will get some more information to help you with your decision .
    Miri

     
    Old 03-17-2007, 05:12 AM   #8
    luzon
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    Re: Second cone or wait and see ?

    Thank you Diamondlight ! Now I am sure that I made the right choice ,hope this will be my last cone ever !
    Miri

     
    Old 03-17-2007, 05:14 AM   #9
    luzon
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    Re: Second cone or wait and see ?

    Quote:
    Originally Posted by fairydust7 View Post
    If I was in your position, I would get another cone done as well.
    Thank you fairy dust .I will have the cone and hope it's the last -ever !

    Miri

     
    Old 03-21-2007, 03:38 PM   #10
    dc2006
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    Re: Second cone or wait and see ?

    Thanks to everyone for your replies. It convinced me to call and talk with my doctor(s) again and ask more questions...

    The doctor who recommended the cone explained there were two reasons for the recommendation: (1) generally, this doctor is more comfortable with the scalpel because that it is how he was trained and (2) because my first leep has positive margins, this is most likely residual disease and so the doctor would feel more comfortable with the cone because it gives a better picture of what is happening at the margins. Otherwise, I figured out the doctors did not intend to do much different -- one would use the leep and go about 7-8mm in depth and the other would use a scalpel and go about 7-8 mm in depth.

    In the end, I have decided to go with the cone. I have no idea if I made the right choice. Partly, I made this decision because I feel more comfortable with that doctor. hopefully that isn't crazy. I am having the procedure on Monday. I guess I won't know for a coupld weeks what the margins look like, but I will let you all know when I find out.

    thanks again for your responses.

     
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