subspacepilot2 -> RE: Confused and afraid of dying (8/27/2010 5:26:55 PM)
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Caveat: I'm not a medical practitioner so please keep that in mind. Firstly thickened uterine lining can actually be normal for some women. It is perceived as a warning sign because sometimes it can indicate cancer, (especially in women over 40) but it does not necessarily indicate cancer. From what I know it would not be better if it was the other way around. The pap smear showed abnormal cells. Almost all abnormal changes comes from HPV (one of many strains, but three strains cause >90% of changes. (HPV is endemic, meaning that a huge proportion of sexually active women have HPV, so don't feel badly, it is so endemic that recently a vaccine Gardasil was created to impart immunity to 4 strains of virulent HPV, it is for girls/women aged 8-26, and has recently been approved for boys also.) Initial changes are called pre-cancerous meaning that these are not cancer cells, but cells that have a greater likelihood of potentially mutating into cancer cells. That your uterine biopsy was negative is a good sign. That she wants to do a cone biopsy indicates that there are cellular changes that may not be cancer, but show cells that have significantly increased chance of becoming cancerous. Abnormal cells are graded, some might be removed by freezing, other changes that have a higher risk of mutating to cancer cells indicate the need for a cone biopsy to see the extent of the abnormal cells as they may go deeper into surrounding tissue or farther along the cervical canal. The cone biopsy removes material for microscopic pathology and cone biopsy may remove all the suspect tissue. If the outside edge of the removed cone shows only normal tissue then no further tissue removal will be performed--at that time you are essentially "cured," though she will want you to come in for fairly frequent pap tests, just in case. If the edges of the cone shows abnormal tissue I believe that sometimes more tissue (a larger or deeper "cone") will be removed. This might get all abnormal tissue. If not, then further surgery would be warranted. By the fact that the uterine biopsy only returned normal results this seems to me that if you did have cervical cancer it has not spread far along the cervix into the uterus. The ovarian cyst can cause abnormal bleeding. I think that your cervix does not, as you say: "show otherwise." It simply may be that the cyst is leading to hormonal imbalance, resulting in thickening of the uterus and may well be totally unrelated to the finding of pre-cancerous cells in the cervix. I can only imagine how devastating this must be for the both of you and hope that things can be resolved much easier that you are fearing. Reading is good, but be careful as often people read "selectively" and can jump to conclusions that are not correct. Hopefully the cone biopsy will remove all the abnormal tissue. If it does, though not often suggested, I suggest that if you smoke that you quit. There is very strong evidence that HPV and smoking increase the risks exponentially. Quitting will be easy, simply explain to Martin that if you cheat then the discipline will be that you will not be spanked for a week.
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