2nd surgery and possibly cancer

4 years ago after going in for my annual exam i was diagnosed with high risk HPV and high grade dysplasia. I went through the normal steps, colposcopy, LEEP then a year of pap smears every 3 months to make sure it was gone. I went 3 years with no problems and the dysplasia hadn't come back. Last August i went in for my annual and my pap came back abnormal. I had no income at the time and also no insurance so i just waited. This last August my OB/GYN called me asking if i had gotten it taken care of and after explaining i hadn't she begged me to come in and she would do another one for free. This time my pap came back with 3 forms of HPV, high grade dysplasia and cervical lesions. I had my first colposcopy in September and she took 4 biopsies to send in, this came back saying the same thing and told us that the my dysplasia was grades 2 & 3. Because my normal doctor does not do surgery anymore she referred me to a womans health surgeon. I saw this doctor for the first time at the end of October and he insisted that we do another colposcopy. This time he took 5 biopsies and they all came back showing grade 1 & 2 dysplasia. Because my pap and first colposcopy showed more abnormal results than the newest one he decided to do yet another one in November and took 5 more biopsies. These all came back grade 2 & 3. In December I had a LEEP procedure done in hopes that it would get rid of the abnormal cells and i could go back to enjoying life. Monday i went in for my post op visit and found that every bit of the biopsies done during the leep came back showing grade 3. He decided to set up surgery again and in a few weeks i am having a cold knife cone done. He explained to me that if any of the pathology came back showing any dysplasia that we would have to do a hysterectomy. I am 30 years old and even though i don't want any more kids i also don't want to be on hormone replacement therapy for the next 30 years. Neither doctor has ruled out cervical cancer so i am very very scared on what to expect with this next procedure. Has anyone else had this problem?

[Bhupinder Kaur, MD]

Hello,
Stage 3 dysplasia means severe dysplasia to carcinoma in situ. After LEEP, usually cone biopsy is usually done. Hysterectomy, or the surgical removal of the uterus, is used to treat almost all cases of invasive cervical cancer and may sometimes be used to treat severe dysplasia or dysplasia that recurs after any of the other treatment procedures. So if the PAP comes abnormal even after cone then unfortunately hysterectomy may need to be done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.