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Colposcopy Procedure

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

I had my yearly OB appt in December. Today my doc called and informed me of my pap showing something "possibly" abnormal. Informed me nothing showed up but I'm on the border line. Now if I didn't have cancer 2 years ago he'd suggest I wait and not see him until a year from now. But...in my case he want's to be sure there's nothing going on here.

So...I'm calling his office tomorrow to setup a colposcopy. Anyone throw some insight on this procedure and what I can expect? I've been doing oh so well and just can't see more cancer in my future, at least for now. Boohoo!!! Okay I've got to get on my optimistic face and realize this is just another minor bump in the road.

I had a mammogram 2 years ago and it came back with some "unknown" on scan. Well off I went to get that one looked at again. Turns out the RN had my port showing in the scan and that was the "unknown". Gee!! can't we have some time away from our docs outside of the routine checkups?

I'll pick myself up and continue on, but sure frustrating isn't it?

Thanks ladies for your input...
Jan

Ro10's picture
Ro10
Posts: 1428
Joined: Jan 2009

In the fall of 2008 I had an abnormal pap and had a follow-up colposcopy done. That is when they take a biopsy (at the time it was of the endometrial lining). They tell you it might hurt "a little". They were mistaken, it hurt quite a bit. It did not last long, but it did hurt when they took the biopsy. I would recommend taking some ibuprofen before you go. I did not have any bleeding afterwords, but some people have said they did have some bleeding afterwards. I had not cramping afterwards either.

It is a quick procedure, and I hope you get good results. I'm glad you will "pick yourself up and continue on." Just a bump in the road. In peace and caring.

norma2's picture
norma2
Posts: 486
Joined: Aug 2009

I just had my first colonscopy a few months ago. It was pretty easy. The worst thing is the prep the night before. Someone has to come up with something that tastes better than that swill. Anyway, as positive as you are you should do fine. I had to eat a special diet after mine because there were several polyps removed. Clear liquids, jello (no red coloring, broth, tea, for two days. Then a full liquid diet. Custard, ice cream, soft foods, etc. for 2 more days. Then gradually adding foods, meats, roughage, last. I was starving by the second day. HAHAHA....

Good thing is they can remove anything that looks suspicious...snip...snip...

You will do fine. I know what a fighter you are, darlin. Let us know how it goes. I will be thinking of you.

hopeful girl 1
Posts: 454
Joined: May 2010

Here is info I copied from Wikipedia. Good luck, you have been doing so well, I am sure it will turn out to be ok. Cindy

ColposcopyFrom Wikipedia, the free encyclopediaJump to: navigation, search
Not to be confused with colonoscopy.

In this diagram, the canal of the cervix (or endocervix) is circled at the base of the womb. The vaginal portion of the cervix projects free into the vagina. The transformation zone, at the opening of the cervix into the vagina, is the area where most abnormal cell changes occurIntervention:
Colposcopy
ICD-10 code:
ICD-9 code: 67
Other codes:

Colposcopy is a medical diagnostic procedure to examine an illuminated, magnified view of the cervix and the tissues of the vagina and vulva.[1] Many premalignant lesions and malignant lesions in these areas have discernible characteristics which can be detected through the examination. It is done using a colposcope, which provides an enlarged view of the areas, allowing the colposcopist to visually distinguish normal from abnormal appearing tissue and take directed biopsies for further pathological examination. The main goal of colposcopy is to prevent cervical cancer by detecting precancerous lesions early and treating them. The procedure was developed in 1925 by the German physician Hans Hinselmann.[2]

A specialized colposcope equipped with a camera is used in examining and collecting evidence for victims of rape and sexual assault.

Contents [hide]
1 Indications
2 Procedure
3 Complications
4 Follow up
5 References
6 External links

[edit] IndicationsMost women undergo a colposcopic examination to further investigate a cytological abnormality on their pap smears. Other indications for a woman to have a colposcopy include:

assessment of diethylstilbestrol (DES) exposure in utero,
immunosuppression such as HIV infection, or an organ transplant patient
an abnormal appearance of the cervix as noted by a primary care provider
as a part of a sexual assault forensic examination [3] done by a Sexual Assault Nurse Examiner
Many physicians base their current evaluation and treatment decisions on the report "Guidelines for the Management of Cytological Abnormalities and Cervical Cancer Precursors", created by the American Society for Colposcopy and Cervical Pathology, during a September 2001 conference.[4]

[edit] Procedure
ColposcopeDuring the initial evaluation, a medical history is obtained, including gravidity (number of prior pregnancies), parity (number of prior deliveries), last menstrual period, contraception use, prior abnormal pap smear results, allergies, significant past medical history, other medications, prior cervical procedures, and smoking history. In some cases, a pregnancy test may be performed before the procedure. The procedure is fully described to the patient, questions are asked and answered, and she then signs a consent form.

A colposcope is used to identify visible clues suggestive of abnormal tissue. It functions as a lighted binocular microscope to magnify the view of the cervix, vagina, and vulvar surface. Low power (2× to 6×) may be used to obtain a general impression of the surface architecture. Medium (8× to 15×) and high (15× to 25×) powers are utilized to evaluate the vagina and cervix. The higher powers are often necessary to identify certain vascular patterns that may indicate the presence of more advanced precancerous or cancerous lesions. Various light filters are available to highlight different aspects of the surface of the cervix. Acetic acid solution and iodine solution (Lugol's or Schiller's) are applied to the surface to improve visualization of abnormal areas.

Colposcopy is performed with the woman lying on her back, legs in stirrups, and buttocks at the lower edge of the table (a position known as the dorsal lithotomy position). A speculum is placed in the vagina after the vulva is examined for any suspicious lesions.

Three percent acetic acid is applied to the cervix using cotton swabs. The transformation zone is a critical area on the cervix where many precancerous and cancerous lesions most often arise. The ability to see the transformation zone and the entire extent of any lesion visualized determines whether an adequate colposcopic examination is attainable.

Areas of the cervix which turn white after the application of acetic acid or have an abnormal vascular pattern are often considered for biopsy. If no lesions are visible, an iodine solution may be applied to the cervix to help highlight areas of abnormality.

After a complete examination, the colposcopist determines the areas with the highest degree of visible abnormality and may obtain biopsies from these areas using a long biopsy instrument. Most doctors and patients consider anesthesia unnecessary, however, some colposcopists now recommend and use a topical anesthetic such as lidocaine or a cervical block to diminish patient discomfort, particularly if many biopsy samples are taken.

Following any biopsies, an endocervical curettage (ECC) is often done. The ECC utilizes a long straight curette or a cytobrush (like a small pipe-cleaner) to scrape the inside of the cervical canal. The ECC should never be done on a pregnant woman. Monsel's solution is applied with large cotton swabs to the surface of the cervix to control bleeding. This solution looks like mustard and turns black when exposed to blood. After the procedure this material will be expelled naturally: women can expect to have a thin coffee-ground like discharge for up to several days after the procedure. Alternatively, some physicians achieve hemostasis with Silver Nitrate.

[edit] ComplicationsSignificant complications from a colposcopy are not common, but may include bleeding, infection at the biopsy site or endometrium, and failure to identify the lesion. Monsel's solution and silver nitrate interfere with interpretation of biopsy specimen, so these substances should not be applied until all biopsies have been taken. Some patients experience a degree of discomfort during the curettage, and many experience discomfort during the biopsy.

[edit] Follow upSee also: Cervical cancer#prevention
Adequate follow-up is critical to the success of this procedure. Human Papillomavirus (HPV) is a common infection and the underlying cause for most cervical dysplasia. Women should be counseled on the benefits of safe sex for reducing their risks of contracting and spreading HPV.[5] One study suggests that prostaglandin in semen may fuel the growth of cervical and uterine tumours and that affected women may benefit from the use of condoms.[6][7]

Smoking predisposes women to developing cervical abnormalities. A smoking cessation program should be part of the treatment plan for women who smoke.

Treatments for significant lesions include cryotherapy, loop electrical excision procedure (LEEP), and laser ablation.

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

I agree to take some form of pain-reliever prior to procedure. Crazy how that hurts, but when read they can cut out things for testing...ouchie! I'm really trying to be calm and realize this is just part of the journey with cancer. Many times tests are required and we have to go with the flow. Not easy when I was always healthy and never needed doc appts outside of my yearly routines. We can wish all we want for our prior lives back, but not happening....so might as well just go with the flow.

Norma, I think you misunderstood the procedure I'm having...called COLPOSCOPY, not COLONOSCOPY. The latter I had Dec '09 and all clear as a bell. Yep the junk to drink is probably the worst part of the procedure....think? Glad I'm clear from that test for 5 years.

I'll keep you all posted... you know I feel better getting responses for hope...thank God we all have each other..

Jan

hopeful girl 1
Posts: 454
Joined: May 2010

Your comment about how we can wish and wish for our old lives back, but just not happening....really hit home with me.

We sure all do share an unbreakable bond in our journeys.

I too am thankful we all have each-other on these boards to encourage one and other and share information.

Keep us posted what happens.

I go for my thyroid surgeon evaluation tomorrow-so I am also feeling nervous as well.

Your posts have always been very helpful to me since my diagnosis last Feb 2010.

Hugs,
Cindy

norma2's picture
norma2
Posts: 486
Joined: Aug 2009

Sorry about that, Jan. I have to slow down reading these posts. Have had a colposcopy too when I was first diagnosed...it was uncomfortable but short in duration. Thinking of you and hoping it is goes well.

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Cindy, I do appreciate how you've been strong thru your journey and glad today is the doc appt. I know you've been stressed and worried as I was when first found out. But...today after a nice workout at the gym I'm coming back down to earth. Gosh what could be the worst that could happen? Does the stress of worry get me anywhere -- basically like a rocking chair that goes back and forth (this was posted on the wall at my chiropractors office...remember it today).

Plse keep us posted on your appt as you're in my thoughts. See we're all thinking we're the only one with the abnormal issues and life will end, when in fact we're all here together with very similar issues. I'm such a positive thinker but when it comes to this cancer stuff, I tend to crumble at first, then pick myself up and go forward. What other alternative do we have???

What I'm curious about, if this pap shows some "abnormal" things, and it's not cancer what else could it be??? I've read possibly inflammation...

Not to worry I'm doing better thanks to you ladies...

Thanks again,
Jan

hopeful girl 1
Posts: 454
Joined: May 2010

Jan,

I know it.......it's a rollercoaster ride we have after a cancer diagnosis.
Any little new pain, we wonder if it is coming back or spreading. Going for tests are always terrifying. We try to put ourselves in as calm of a mental state as we can because what other choice do we have.

Sometimes it all feels surreal. I hope for both of us that our latest issues will turn out to be minor, or a watch and monitor kind of thing, and make us appreciate even further our lives as they are complete with worries and all.

I am very nervous......I have fears not just of the thyroid, but of cancer spreading to other lymph nodes in the neck and below neck area etc. Afterall, I did have lymph node involvement, and I have been off the chemo for 2 months now. I actually felt safer on the chemo, because at least you are doing something to fight the cancer.

As far as what your pap shows as "abnormal" not sure-could be scar tissue from surgery possibly? Not sure if my oncologist's statement refers to paps as well, but he told me that scans done too soon after treatment can be misleading. (I believe because of the healing that continues to occur, and the internal scar tissue).

Did you set up your appointment? When is it?

I will let you know what I find out today. I am sure there will be a fine needle biopsy in my future.

Hugs,
Cindy

hopeful girl 1
Posts: 454
Joined: May 2010

Jan,
I was also curious. When you had your first scare, which was the spot on your liver I believe, it was then determined to be no cause for worry-and only showed up on higher level test. What did that mean? Were they able to tell that the spot was just scar tissue? How were they able to determine it was not cause for alarm?

Just curious.

Hugs,
Cindy

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

I had my first CT scan after completed chemo and found the spot on liver. It was a non-cancerous spot which many of us have, but don't know it as mentioned. No cause for worry, but each time have CT they do have it noted in the system and watch for a size change. It wasn't scar tissue but some type of general growth.

I've had 3 scares now with this one, so you'd think I'd be comfortable...nah!

I do my deep breathing and yoga which slows me way down....

Catch up later.
Jan

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

I had my first CT scan after completed chemo and found the spot on liver. It was a non-cancerous spot which many of us have, but don't know it as mentioned. No cause for worry, but each time have CT they do have it noted in the system and watch for a size change. It wasn't scar tissue but some type of general growth.

I've had 3 scares now with this one, so you'd think I'd be comfortable...nah!

I do my deep breathing and yoga which slows me way down....

Catch up later.
Jan

daisy366's picture
daisy366
Posts: 1493
Joined: Mar 2009

Jan, Darn it!! These are tests, I think - lest we become too comfortable or complacent being NED. Of anyone, you are my ideal model of healthy lifestyle. I will pray that it is nothing, like that spot on liver. I too have some spot on a periaortic lymph node - they are acting like it's nothing but ordering ANOTHER PET scan in 3 months - hmmm.

On the up side, I remember my doc saying that if there is recurrence in vaginal cuff, this if VERY treatable. I do think it is good that they are checking and keeping a good watch on things - as I should be grateful for the vigilance too.

Keep up that deep breathing and yoga - that's where I'm going tomorrow!!

Sending you lots of positive energy. Mary Ann

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Thanks for your positive vibes. You hit the nail on the head when you mentioned "lest we become too comfortable or complacent being NED"...bingo!! That's me exactly. Rolling along as we all are doing and feeling great, then we hit the wall....blast!!!! Just no warning and that's exactly what this disease is like...hits us fast out of the blue!!

Just makes me more determined to get my mind in the proper gear -- positive!!! Visualization is what I need about now and don't you have a certain author you've been following???

How are you feeling? Talking about going thru a lot...you're the gal! You've turned the corner it sounds like and I'm so glad you're back up and running again. Should be a bit easier without the full time job...less stress. We all know stress is a huge "negative" for any person fighting disease.

Best to you girl!
Jan

kkstef's picture
kkstef
Posts: 706
Joined: May 2008

I was so sorry to hear about your new "issue" but am confident it will turn out fine. You take such good care of your mind and body, that I am sure it will pay off for you!!

It is normal to be scared....but you always have such a positive attitude and you will find that again soon!

We anxiously await with you

Sending positive energy your way!

Karen

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Thanks for the nice complements. I've always been the ultimate optimist and that's one area my doc told me would pull me thru this mess. Okay so I'll see as my daily visualization has me speaking with my doc and him telling me nothing showing up...yeah!

Being scared I'm learning is just part of the journey...now not to say I've not felt like jumping off a bridge, but I know whatever happens is meant to be....control is in God's hands, not mine.

Did you ever have any goofy results from tests? Best to be safe vs. sorry is what my doc told me...

Hope all is well with you...thanks again!
Jan

daisy366's picture
daisy366
Posts: 1493
Joined: Mar 2009

I'm with you on that complacency scale! I think I'm doing most things right but I'm not totally obsessive about the diet thing - I eat some sugar and white flour. My doc - who is very good and I have great faith in - is not sold on the benefits of diet because there is not much SCIENTIFIC research yet. But there will be, I'm sure - it seems to be a big thing. I need to get my body moving and exercise more.

I'm doing well with relaxing - perhaps too much since retiring. And my hubbie is very patient and undemanding with me being a couch potato!!

I saw My rad doc yesterday and thought it would be my final BUT - he said he wants to monitor me closely and ordered a PET in 3 months. This surprised me alot. He said "it could come back, you know" (yes I did know that!!) I didn't think a PET would be needed so soon. I see my gyn-onc in March and I will discuss with him. Don't know if this is prudent or overkill - I'll get his feedback. They downplayed the danger of getting too many PET scans - hmmm.

Hang in there, Jan. I think we need to get used to these things and if we EXPECT them they are not too shocking. If we don't get them then that even more to be GRATEFUL for!!

Hugs and positive energy to you. Mary Ann

imackie48
Posts: 92
Joined: Nov 2011

Jan, I was just reading your post regarding having a colposcopy after a abn pap, I too, today had the same diagnosis, "grouping of cells" now I'm waiting for the results. The colposcopy was not painful during the procedure, but after hours passed, I was in real pain, needed a pain med.
How did your results come out? My first pap three months ago was normal. I'm a wreck, can't think about anything but that.
I'm so glad to see you are NED for so many years.
My best to you,
Irene

plantlady2012
Posts: 49
Joined: Dec 2012

(((jazzy1))). I am really sorry you are having to deal with this! You have such a wonderful attitude, I have read many of your posts, and am always uplifted by them!

If this is the procedure I am thinking of, then I had one as part of my diagnosis procedure, and it involved taking a little snip of tissue from the cervix, too. There was some sort of stain that made abnormalities visible to the doctor with the use of a tiny camera on the end of a tube. I actually had to go back a second time, because I was way too tense (I have an anxiety disorder). For the second try, the doctor told me to take some extra-strength advil, since it was probably the FEAR of pain that was making me so tense. Second time went okay. Oh, I took a tranquilizer before the second try, too (remember, I was dealing with an anxiety disorder).

You asked on one of your posts if anyone else had had abnormal tests that turned out to be nothing. I have! Early in my chemotherapy, a PET scan showed a possible spread to bone (gasp!!), so the doctor ordered a bone scan. It turned out to be nothing!

There is just no way around the fact that it is scary to have suspicious results on test. It is either a false alarm, in which case no problem, or it is something that needs further treatment, in which case, good catch!

You have the most beautiful, positive attitude, so, no matter what, you are going to do great!

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Yes I responded somewhere else today about an abnormal PAP. This was procedure I had, as was thinking it was something else...darn I was wrong earlier..sorry!

I had NO pain at all during procedure and doc gave me results right away before I even got dressed to leave the exam room...very easy! Yes I will agree quite scary as all I could think about was CANCER IS BACK. BUt..mine was fine.

Plantlady, thanks for the kind words about me and my positive attitude. I have always been like that, but can be a worrier at times, thankfully not as bad as I used to be. Nothing really is worth worrying about is it? My doc even told me after my total hysterectomy in 2009, keep that positive attitude as it will get U thru this cancer scare. Well...thusfar, doing okay, but at times it's unnerving when have abnormal testing. Guess the alternative could be worse.

Keep us posted on any results!!
Jan

plantlady2012
Posts: 49
Joined: Dec 2012

LOL, Jazzy1, I saw this at the top of the discussion forum, and thought that you had JUST gotten this news! I see now that it is from quite some time ago! SO glad to hear that it was resolved long ago! I will have to remember to read the DATES on the original posting!!

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