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rivertime
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Joined: 27 Jun 2006
Posts: 4
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 Posted: Wed Jun 28, 2006 10:54 pm Post subject: chronic abnormal paps |
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I've got a somewhat unusual situation that I wondered if anyone has experience with.....in Nov 2004 I had an abnormal PAP that was just atypical cells. I had a followup pap in Feb 2005 that came back HGSIL so a colposcopy was ordered. The biopsies came back "changes consistant with HPV effect". Since the Colpo didn't support the PAP findings, they did a LEEP that also showed no high grade dysplasia. I had a followup PAP in Nov 2005 which once again came back LSIL and I also tested positive for infection with high risk HPV. They did a second Colpo that came back with moderate dysplasia followed by a second LEEP that came back moderate dysplasia with clean margins. My endocervical tissue has always been normal. So now I have just completed my followup PAP smear which once again, has come back LSIL.
Each time I have the colpo/LEEP procedures, I am told "this should take care of it" and yet it doesn't. Three different doctors have been involved through this process. At this point I have one doctor telling me to have another colpo possibly followed by a cone biopsy (rather than a LEEP) and to hurry up and have any kids I plan on having so I can get a hysterectomy. Another doctor is telling me to just monitor the level of dysplasia by getting followup PAPs every 3-6 months. Pretty different treatment options! Has anyone else had this sort of ongoing dysplasia scenario and what do you suggest? |
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krazeydazey
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Joined: 11 Aug 2006
Posts: 7
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| Posted: Mon Aug 14, 2006 1:47 pm Post subject: Re: chronic abnormal paps |
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Hi there, sorry to hijack your thread but when I saw your post and it made me think of something. I have had abnormal paps since my son was born 8 years ago. I have changed Drs since the original discovery.
My current Dr says the cells are in the first stage of change, I am just wondering if you know how many changes occur before cancer is the reason.
Last edited by krazeydazey on Thu Aug 17, 2006 10:53 pm; edited 1 time in total |
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rivertime
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Joined: 27 Jun 2006
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| Posted: Mon Aug 14, 2006 4:22 pm Post subject: Re: chronic abnormal paps |
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krazeydazey,
From what I understand, abnormal cells seen on a PAP are categorized as follows....
1) ASC - Atypical Squamous Cells
2) LSIL - Low-grade squamous intraepithelial lesions
3) HSIL - High-grade squamous intraepithelial lesions
4) Squamous Cell Invasive Cancer
If present, the cancer cells are then graded and the degree of invasion is staged as with any cancer.
As you can see from my original post, I have had PAPs and biopsies ranging from ASC to HSIL with the latest diognosis being LSIL. The conservative dr. wants me to repeat PAPs until they are either normal or start getting worse. That's what I'm going with for now. My next PAP is scheduled for mid-September.
BTW, if you haven't already done so, I would suggest having your doctor test you for HPV, so you can further understand your risk factor for developing cervical cancer. Both of my doctors also suggest doing wet-prep PAPs rather than the typical dry prep smear. The pathologists get a better sample of your cells with the wet prep. |
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krazeydazey
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Joined: 11 Aug 2006
Posts: 7
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| Posted: Mon Aug 14, 2006 4:57 pm Post subject: Re: chronic abnormal paps |
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Hmm, I think I will also have to ask my Dr for some actual details of the results. The thing that has concerned me is that each time I have a pap, the results come in and the Drs say we have to re-do the pap because there are abnormlities, with the new Dr I've only gone through it twice so far, but it feels like (and felt like with the last one) they haven't even looked in my file to see that this isn't the first time it's come up, and no-one has mentioned HPV but I had suspected it a few years ago when I started hearing about it, ie can have no symptoms and abnormal paps.
The only thing they have ever told me was that I need more frequent paps, and with the old Dr, he didn't bother the last one because he couldn't find my cervix all of the sudden, and somehow that still didn't concern him (which naturally led to me finding myself a Dr who may remember me from visit to visit).
Also, I have never heard of a wet pap but I am a little nervous of suggesting things to my Dr because he seems like the type who might respond negatively to info from the internet. |
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rivertime
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Joined: 27 Jun 2006
Posts: 4
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| Posted: Mon Aug 14, 2006 8:19 pm Post subject: Re: chronic abnormal paps |
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I would request all of your medical records, including lab results from all of your doctors. By law, they have to give them to you. I always request records so I can read everything myself and not rely on some uninterested doctor's version. I work in the medical field, so I may understand what I'm reading better than some people. If you are having a hard time, find a nurse practitioner or even make a consult appointment with another OB/GYN dr who can review ALL of your records and explain to you what's going on.
I've attached a couple of good sites that have general information about cervical cancer. They may answer some of your questions, and help you understand what your doctor is doing. Although it sounds like you need a doctor who is willing to spend a little more time explaining your condition so that you understand. I do understand his negativity towards internet info, because I've had plenty of clients come in thinking they've already diagnosed their ailments or already been through many (incorrect) treatment plans based on what they read on the internet. But I've been specifically told by two separate doctors to get wet prep PAPs and the first thing they did after I had my first HSIL PAP result was test me for HPV. Good Luck
http://www.nlm.nih.gov/medlineplus/cervicalcancer.html
http://www.webmd.com/hw/uterine_cervical_cancer/ncicdr0000062961-general-information-about-cervical-cancer.asp |
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