Cervical adenocarcinoma in situ; what can I expect?

Aw, hon. I'm not sure I can say anything that'll make you freak out less, but really, there is NOT a lot of reason to freak out. Here's why: the worst, worst, WORST-case scenario isn't all that bad. Cervical cancer is an "indolent" cancer - it grows slooooowly by its very nature. If you've been getting Paps every year - and especially if your last one was normal - there is next to no chance that a massive blob of cancer has roared in and commandeered your innards in the past year. Could it be cancerous? Yes, absolutely. However, "carcinoma in situ" means that there are cancerous cells confined to a particular SITE ("situ") - which means non-invasive, which generally means easier to remove than the alternative. I myself have had a decade of bad-to-awful Pap results, colposcopies, vague test results, etc. I know how scary it can be - lots of late nights wondering about 1% probabilities and one's fertility. However, when it comes to one's cervix, the worst-case scenario is often more unpleasant/uncomfortable than dangerous/potentially-fatal.

To answer your first question, I have had a cone biopsy, with a diagnosis of carcinoma in situ. (about 10 years ago now, so memory is a little fuzzy). Everyone told me I wouldn't be able to work the following day, and I duly took the day off, but I would have been fine to work. I went the day after that.

Oh, and shall I answer your actual questions? :: According to the National Cancer Institute almost 100% of this type of in situ abnormality does not progress any further. As far as questions you want to ask, most would come up around hysterectomy. But before then, here are some things that may be on interest: :: How often do you see this stage of abnormality turn into full-blown cancer? :: What do you recommend if fertility is no concern? If it is a concern? :: How might a cone biopsy affect my fertility? :: When is hysterectomy the best post-cone biopsy step? (Something along the lines of, what size of margin are you comfortable with?) :: What is the follow-up to this procedure if the margins are good? :: Is there anything I can do to facilitate healing? (aside: Do Not Smoke.) :: Is my HPV strain high-risk? How does that effect treatment decisions? Also, let the doctor know if you have any detectable symptoms (like irregular spotting).

An update for future readers of this thread: things with the oncologist went fine, and we ended up doing a LEEP cone in the office the day of my initial appointment (surprise!). The margins were clear. Woot! Beyond some cramps the first three days and icky discharge for the first three weeks, recovery from that has been fine although the 6 weeks without sex and tampons is grating a bit at this point. The follow-up is colposcopy and endocervical curettage every 3 months for a year, and if things are good on that front we can maybe move back to frequent Pap smears/HPV testing instead. In general, the oncologist seemed a lot less freaked by this than my gynecologist, probably because the gynecologist doesn't see adenocarcinoma quite as often.

I am not a doctor, I am not your doctor; I have had dicey pap smears and colposcopies, but never had to go further than that. My evidence is anecdotal only, and is coming third-hand from my best friend's employee. Said best-friend's-employee did have to have some pre-cancerous cells removed; according to my friend, it was an outpatient procedure, and she took the day off. "It wasn't the most fun day she ever had in her life," my friend said, but it wasn't bad and she was okay the next day and the procedure took care of everything.

When a relative had cancer I was surprised to find that Google Books allowed me enough access to various medical textbooks to be pretty informative. There was also a medical library at the hospital where I could look up and cross-reference stuff.

I had the same diagnosis and had a cone biopsy. There were bad cells in the margins of the biopsy and my oncologist recommended a hysterectomy. I got a second opinion and decided not to have one. I'm 15+ years of clean paps past that experience. For the first year after the surgery I had paps every three months, slowly winnowing down to where I am now back to once a year. The worst part about the whole experience was waiting for appointments, results, etc. You can drive yourself nuts in those spaces. As much as you can, try to combat the catastrophic thoughts with some of the information you see here. You're going to be OK.

I would focus on taking really good care of yourself emotionally while you wait. Uncertainty in illness takes a toll on one psychologically, and waiting is the hardest part. Hot baths, good books, funny movies, healthy and delicious food, taking walks if the weather is decent, buying a few new things for your favorite hobby... all these things might help you while you wait. Good luck. Memail me if you want a care package.

Hi! I went through something similar this autumn. I had my lesion removed with a laser, under anethesia in the hospital. I was VERY freaked out until I spoke to the oncologist, who assured me that she was going to take care of it. It wasn't fantastic, but I had my surgery on Wednesday, and was back in the office on Monday, feeling fine. Mine was in a more sensitive location, so it was more tender, but honestly, I didn't even use the pain killers. Not one. You'll be fine, I promise.