Likelihood of Cervical Cancer

Before I post my (ahem) completely hypothetical question, I want to assure everyone that I have a follow-up doctor’s appointment Wednesday. I’m just dong my traditional unnecessary obsessing about possible catastrophic outcomes.

Let’s say that a hypothetical 41-year-old woman had an abnormal Pap and a positive HPV test. She went in for a colposcopy and the doctor who performed the test said she saw something abnormal in the transitional area (?) of the cervix, inside heading up towards the uterus. The doctor did a biopsy and when she discussed it with the patient, she described the next likely procedure, a LEEP, as if she thought it was a probability and she asked the patient to think about what gynecologist she’d like to see for that procedure.

Now, a week and a half after the biopsy and four days before the patient is scheduled to go in for her followup consultation, she is experiencing some lower abdominal/back pain that feels a little like menstrual cramps. It isn’t cramps, and the cramping that the colposcopy brought on is long over. The patient, being a somewhat obsessive sort of person, is now wondering a) what are the odds that this is cervical cancer of any serious degree (I know, I know, it’s impossible to say for certain, but would anyone be able to make an educated guess?) and b) is it likely that this kind of achy lower abdominal pain, which the patient has been experiencing on and off for months, might be a symptom of cancer? What are the likely next steps in this saga?

And, if no one can answer those questions, does anyone have any suggestions for getting one’s mind off morbid thoughts?

Kidney Stones.

Had there been cancer in the biopsy they would have told you. I bet your having kidney stones and you’re going to tend to think more negatively than positivly.

No, I haven’t gotten the results of the biopsy yet. That’s what the follow-up appointment is for.

Hmmm…kidney stones, eh? I’ll try pondering that one for a while!

There’s lots of stages of abnormality. And as I understand it (as with many cancers) there really isn’t any pain, which is why you need regular check ups.

Any pain could be a symptom of anything, but if the patient is obsessive, it could also be psychological. Or rather like that thing when someone says the word “lice” - and every area of your body starts itching. (Oh god I’m itching right now!!)

For a LEEP they take more tissue for analysis. There are many options for surgery afterwards, if they do find something abnormal, including freezing, conisation (where they remove a cone of tissue from the cervix, with abnormal cells). I have not personally experienced these, but having had an abnormal pap - desribes as “pre CIN 1” - which I understood as pre-pre-cancerous changes (and the next pap a year later was clear without any treatment) I did ask a lot about it. The full recovery rates from most of the early-stage procedures seem to be extremely high.

All sympathy, and I hope it goes well. (And thank you for reminding me that I should be going for another check up!!)

I’m not in exactly your situation, but similar. Last year’s pap came back positive for HPV. I went for the colposcopy and they found nothing–cells were sent out for testing and everything came back fine. I went for the follow-up pap six months later and everything was fine. Just last month I had my annual and the cells came back abnormal again–not HPV this time but a possibly pre-pre cancerous situation. Another colposcopy has come back fine. Of course, now I’m worried what the six month follow-up pap will reveal.

As I’ve reasearched all this–because it was all freaking me the hell out!–I found that abnormal paps aren’t uncommon (and aren’t always an indication of cancer) and treatment at an early stage proves very successful. It’s easy for people to say “don’t worry”, but I’ve always been a compulsive worrier. The way I got my mind off of it was housework–I must do that a lot because when my cousin came over and saw my house all clean and shiny and organized the first thing she said was, “okay, what’ wrong?”

Relax, take a break, catch a movie, but whatever you do, don’t torment yourself about this when you don’t even know exactly what you’re dealing with yet. I hope this didn’t come off as too preachy. I wish you luck–let us know how it goes! If you need to chat with someone, my email is in my profile.

I had a LEEP for cervical cancer last November. I can assure you that I had absolutely no idea that I had cervical cancer until the Pap, followed by colposcopy, caught it. No pain, no abnormal periods, nothing.

The advantage to a LEEP rather than laser, etc. for early-stage cervical abnormalities is that it can be used for diagnosis AND treatment, since the procedure doesn’t destroy the removed tissue.

If you want more info about diagsnosis and treatment options, I heartly recommend Our Bodies, Ourselves. The NIH web site and the National Cancer Institute site also have some good background info.

How not to stress until your results are back? I sure as hell wish I knew! Just keep in mind that the overwhelming majority of cervical cancer, when caught early, is highly treatable; my doctor likened it to skin cancer. You remove it, and 99% of the time if it’s only on the surface, you’re perfectly fine afterwards.

The vast majority of mortality is among women who have either never had a Pap, or who haven’t had one in 5 years or more. Also, the overwhelming majority of abnormal Paps/colposcopies are not cancerous; they are precancerous, but it normally takes many, many years for a precancerous condition to turn into cancer. Me, I was just lucky; I’m apparently a freak of nautre or something. My doc almost didn’t believe the results when they came back, it was so weird. You’ll probably be fine. In the meantime, I suggest taking solace in some good chocolate and a backrub.

Oh, and cervical cancer and related mortalities are much more common in the developing wold, where women have less access to regular preventive/diagnostic care. There are only a few thousand case s of cervical cancer in the U.S. every year, and most of them are caught very early if women have regular exams. So go every year, ladies!

(P.S. I had my first post-LEEP exam on Valentine’s Day - ironic, I know - and I’m clean! Yippee! My doc recommended taking folic acid to keep up the immune system so the HPV doesn’t act up in the future, so I decided to go crazy and just take a daily multivitamin, and the increase in energy level has been quite notable. At least something good came out of this. It’s simple enough to do, so I highly recommend it for everyone.)

Thank you all for the reassurance and the commiseration. I’ve just taken a vitamin - that’s just the sort of thing that helps when I’m in a hypochondriac mood (“Look, I’m treating something!”). I don’t know about the housecleaning, though. That seems like a pretty drastic step, so I’ll save it for the next round of testing, if I get to that.

Although I already knew that most cervical cancers are easily treated and that most abnormal tests turn out fine in the end, it really helps to hear from women who’ve gone through it themselves. Thanks again.

Lot’s of great advice so far ladies. Last fall I had an abnormal pap, + for HPV, coloscopy - had my follow up last month and I’m clear for cervical cancer. The hardest part is the waiting, as you well know. The internet is a wonderful tool, but it is very easy to overload our circuits while trying to sort out the good info from the bad. Cervical cancer is usually very slow growing. That is why our annual or semi-annual visits (as the case may be) are so important. From what I have read and absorbed - most cancers are not painful. Abnormal paps can be caused by a lot of different things, including lab errors and being taken at the wrong time of your cycle. Try not to let it consume you. I can totally relate to every ache and pain sending off an alarm in your head. Hang in there… we will be thinking about you :slight_smile: