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Has undergone Wertheim's Hysterectomy. Recent pap-smear shows HSIL. Any problems ?

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OBGYN, Gynecologic Oncology
Practicing since : 1984
Answered : 99 Questions
My mother has undergone a Wertheim's Hysterectomy Done on Dec 1st 2010.
The Hsitopathology Report at that time had indicated that there is severe Dysplasia in the cervix and its not spread any where.

After that we were in regular checkup's in which we had done series of MRI's,CT Scans and pap smears and everything was normal in that and in April 2011 also a biopsy is done and it is also normal.

Recently on March 1st, CT Scan and Papsmear has been performed and Papsmear showed HSIL instead of LSIL and CT scan was normal and doctor suggested to come after 2 months.[He told that since CT scan was fine nothing to worry and come after 2 months]

Just before 5 days back we consulted him and he had some doubt of re-occurence after clinically examining and done a biopsy.The reports Came Today night and they are attached.Still we need to show the reports to the Doctor on monday.

Can you please look into the attached reports and tell us what is the problem and what is the treatment for it.And is there anything serious (or) life threatning?
Why the reoccurence has occured since at the time when she was operated it was only severe dysplasia and confined to cervix?

Posted Fri, 25 May 2012 in Vaginal and Uterus Health
Answered by Dr. Manjunath L Ramarajapalli 10 hours later

The reports attached suggest that your mother has recurrence of cervical cancer.

This can be treated by radiation & chemotherapy and she can be cured if there are no metastasis any where else in the body. Treatment of such a cancer requires coordinated efforts of a team of professionals. The membership of the team will depend on the patient, the goals of management, and the particular problems faced your mother. The team should include gynecologic oncologists, radiation and medical oncologists, palliative care physicians ( if your mother has recurrence of symptoms), specialized nursing staff, and psychologists (to improve the confidence levels of the patient).

Some times recurrences do occur and it is the biology of the cancer which determine about the aggressiveness of cancer. The majority of recurrences occur within 2 years of diagnosis and few within 3 years.

Let me know if I can assist you further.

Good luck.
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