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Possible AIS?

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Penny_williams
Possible AIS?

Hello everyone, my name is Penny and I am 35 years old.  I have a couple of questions I was hoping someone with a similar experience could answer.  Here's my story:

  1. January 2017 my first pregnancy.
  2. February 2017 I'm informed that I have miscarried.
  3. March 2017 I undergo a D&C to remove the baby and a fibroid is found (I'm uncertain if the fibroid was removed).
  4. July 2017 It's confirmed that I am 14 weeks pregnant.
  5. August 2017 I'm told I have low grade cervical changes and to wait until the baby is born to check again.
  6. January 2018 my beautiful daughter is born.
  7. February 2018 LSIL has persisted and I'm invited for a colposcopy.
  8. April 2018 colposcopy results show 2 areas of CIN 2 and 1 area of CIN 1.  I am told that I will need a leep/loop procedure.
  9. June 2018 leep results come back: Extensive cervical intraepithelial neoplasia, grade 3 (HGSIL) with glandular extension.  High-grade lesion extends to endocervical margin, multi foci, re-excision recommended. (Was asked to wait and see as my OB/GYN felt that he had gotten it all with the burn).
  10. July 2019 Pap shows High grade CIN3.
  11. July 2019 Another Leep procedure is done and the results came back as: High-grade squamous intraepithelial lesion (CIN III/carcinoma in situ). - HSIL extends to the endocervical margin.

Okay my questions are this:

The pathologist sent me a paper explaining that I may have AIS... 

Does this mean that I could have cell changes higher in the cervix or womb that has been missed?  Also I have been trying to preserve my fertility because I have not yet completed my family, and yet...  I want to stay alive for my only child.  I wouldn't complain if I couldn't have another,  she is a miracle to me. I also have PCOS so it was extremely difficult for me to get pregnant.  I thought I never would.  I suppose what I'm asking is, should I think about getting a hysterectomy?  My OB/GYN thinks it's a good idea.  Otherwise I will have to be screened every 3 months.

Any info would be great and much appreciated.  Especially in regards to the Adenocarcinoma in situ.  Thanks all and best wishes for everyone in a similar situation to mine.

Lotty9000

Hi Penny

Sorry you’ve had all this uncertainty. 

AIS is sometimes also called stage 0 cervical cancer,it means that it’s confined to the surface and not invasive. However this has not been found/confirmed in your leep specimens. 

An alternative to hysterectomy is trachelectomy,which would enable you to preserve your fertility. 

I had stage 1A1 adenocarcinoma and have clear margins from a second lletz procedure,however I am having a hysterectomy as my family is complete. If I’d wanted to preserve my fertility I could’ve had 6 monthly colposcopy to monitor any changes. The issue with adenocarcinoma is it can develop in the endocervical canal and be harder to detect. They also have potential to develop skip lesions so can be multifocal. 

I suppose it depends on what you want to do family wise and recommendations from your doctor. 

Good luck xxxx

 

11th March 2019- 1st ever abnormal smear. (Never missed a smear)

1st May 2019 - Colposcopy with LLETZ

9th May 2019 - diagnosis ?1B Villoglandular adenocarcinoma 

22nd and 23rd May 2019 - MRI/CT

29th May - MDT meeting. MRI/CT clear. Amount of tumour 1A stage.

13th June 2nd LLETZ with top hat procedure 

3rd July Confirmed staging 1A1, clear margins on 2nd LLETZ. Scheduled for laparoscopic hysterectomy, keeping ovaries.

29/8/19 Total Laproscopic hysterectomy with ovarian conservation.

Awaiting final pathology results 

Penny_williams

Thank you very much for your reply, I am grateful and It's much appreciated.  I truly would like to complete my family before I choose to do anything drastic.  However my OB/GYN has told me that should it return he would consider doing a hysterectomy as there would not be any cervix left to take.   I think the waiting game is wearing on my nerves a little and my paranoia is getting the best of me lol.  However I just need to trust in my doctor and what he thinks is best.  He's a good man and has done alright by me and my family.  Thanks again and I'm glad to hear that your treatment has been successful. :)

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