Hi there - In Jan 2013 my regular smear PAP test came back with severe dyskaryosis - query invasion. I've never had abnormal smears before. I'm 56 and just postmenopausal. At colposcopy in Feb 2013 the gynae couldn't see any abnormalities as my cervix was tightly closed so she booked me in for a LLETZ on 12 Feb. She took 1cm of tissue but it came back with no abnormalities present.
My gynae sought advice from a gynae/oncologist who said we needed to look further up the cervical canal. On Tues 26 Feb I had a GA laparoscopy, hysteroscopy, D&C and the gynae removed 2 'areas' from high up the cervical canal which have now gone for testing.
I've discussed options with my gynae and she is definitely going to do a hysterectomy, whatever the outcome, but wants to see these latest results first. She said if they come back pre-cancerous then her oncologist colleague said to do another smear test in a few month's time followed up by the hysterectomy. If there are cancerous cells present now then they will act straight away. What I am struggling to understand is why a hysterectomy cannot be performed sooner rather than wait months for another smear? Does anyone know the reasoning behind this?
Any help or advice will be most appreciated. My gynae is now on holiday for several weeks and I'd really welcome any opinions. Thank you so much.
I can understand your concern but since the earlier biopsy has come out normal, hence you should wait for these biopsy reports so that a decision can be taken. Usually if the iopsy report comes normal, we do smears at regular intervals. If PAP smears come out abnormal then LEEP is done. 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.
Hi there - many thanks for your help with my query. The results of the second biopsies higher up the cervical canal and from the D&C have now come back. My gynae is away on holiday for another 2 weeks but her secretary read the results out to me over the phone.
Benign looking abnormal cells were seen however they stressed that all the samples they had were scanty (a word that keeps cropping up). They summed up by saying no malignancy could be seen but these were scanty samples.
The gynae's secretary says she has found in some cases that this will be seen as inconclusive because of the scanty samples.
I will see my gynae on 26 March to discuss what happens next. Whilst I feel relief that no malignancy was found in these samples, it still leaves me concerned as to where the original severe dyskaryosis cells came from?
As my gynae has said she will perform a hysterectomy whatever the outcome I just wish it could be done sooner rather than later. When I had the op on 26 Feb she said if nothing was found, the gynae/oncologist said I'd have to have a follow up smear in 6 months followed by the hysterectomy. That is the part I just don't understand. Why can't it be done now? These are obviously questions that I hope she will be able to answer.
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