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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for cervical cancer

I was diagnosed Cin 3 beginning of this year... Had Leep in March and doc told me he didn t get all of it. Never felt comfortable with him... He never knew my name or what procedure he did on me. So I switched doctor, and I m very happy with the new one. He took a long time to talk to me and explain everything . But now I m left in limbo again, first doc gave me impression it s no big deal. Your body will clear it on it s own, new doc is concerned and recommending hysterectomy. I m 52 and in overall good health. Pathology report after the Leep said cancer in situ with endocervical gland involvement. What do I do? I m scared!
Mon, 22 Aug 2016
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OBGYN 's  Response
Hello, and I hope I can clarify what all this means for you.

CIN III is another word for Carcinoma in situ, which is a PRECANCEROUS (not cancer yet) abnormality of the cells of the cervix that can turn into cancer if left untreated. It can take up to 5-7 years to develop cervical cancer from carcinoma in situ, but it is recommended that all patients with CIN III have the abnormal cells removed via a procedure of some kind... the most commonly performed one is called a LEEP procedure. LEEP permanently cures cervical dysplasia (another word for the abnormal cells) in 90 percent of cases within 2 years.

In your case, the doctor who performed your LEEP may have said he didn't get it all because the chance of the dysplasia coming back is higher in pateints with endocervical gland involvement. However, if you haven't even had a PAP yet since the procedure, it is possible the LEEP has already cured you, so until you have a follow-up PAP smear there is no way to know.

So certainly it is acceptable to wait and see and it is a good possibility that you will clear the dysplasia on your own, as the second doctor said. But you do have a risk of recurrence, so it is very important you are followed closely with PAP smears... at least 2 in the year after the LEEP, and yearly PAP's and HPV tests until 20 years from the LEEP.

Because you are 52 and childbearing isn't an issue, one way to guarantee you won't get cervical cancer is to remove your uterus and cervix (hysterectomy). This is probably why the second doctor recommended it.

But you have a choice, and I hope my advice helps you to make one that works for you. Some information on cervical cancer and management of CIN can be found on the American Society for Colposcopy and Cervical Pathology website, www.asccp.org It is written in doctor's language, but it is the basis for the standard of care for screening and treatment of cervical cancer in the US.

I hope this information was helpful, and best of luck in your health and making a decision.

Take care, Dr. Brown
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OBGYN, Gynecologic Oncology Dr. Sujatha's  Response
HI
As the pathology report shows cancer in situ with endocervical gland involvement ,it is better for you to under go hysterectomy as there is invasion chances of disease progression is more and it is difficult to do follow up screening do not worry as you are lucky to get diagnosed in early stage so that it is curable
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