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Cancer Guide

Maryann Gromisch RN Guide

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ask: Adenocarcinoma vs. Carcinoma? Second opinion?

By MissStevious
 
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I was just diagnosed with Adenocarcinoma in Situ. My doctor said that I had the severest of severe dysplasia, but that is basically all I've been told. I had a LEEP procedure done last week, which "supposedly" has gotten rid of it. He never discussed with me how many lesions I had, how big they were, treatment options, what to expect after LEEP, never tested me for HPV, and never told me how much tissue was removed from my cervix. He seems very unprofessional and quite inconsiderate. He wants me to come back in 6 months for a pap smear, is this normal? Shouldn't it be sooner considering how severe it was? Should I consult with a new GYN or an Oncologist?? And I was wondering what the difference was between adenocarcinoma and carcinoma? Thanks!!

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Anonymous

Can you tell me what CIN2-3 and ACIS means? I had leep done in December 2012 and now have been told I have this, and it doesn't say what it is!!

March 21, 2013 - 12:23am
Maryann Gromisch RN Guide (reply to Anonymous)

Hello Anonymous,

LEEP, loop electrical excision procedure is a treatment procedure to remove or destroy the neoplastic or abnormal cervical cells.

Cervical intraepithelial neoplasia or CIN is the potentially premalignant transformation and abnormal growth or dysplasia of squamous cells on the surface of the cervix. CIN is classified in grades. CIN 2-3 indicates moderate to severe dysplasia. This type of lesion may also be referred to as cervical carcinoma in situ.

Adenocarcinoma in situ (ACIS) of the uterine cervix is a premalignant glandular condition. Adenocarcinoma in situ is the only known precursor to cervical adenocarcinoma.

I hope this information is helpful,

Maryann

March 21, 2013 - 5:49pm
Pat Elliott HERWriter Guide

Hi Stevie -
Thank you for writing back and providing more information so that Dr. Tenney could respond. I hope we have addressed all of your questions and concerns, and that you're breathing a little bit easier now. Please keep us posted as you continue to go through treatment, and you're always welcome to share information you think will be helpful to other members. Best wishes to you, and thanks again for writing.
Take good care,
Pat

November 16, 2009 - 5:16pm
drtenney

Hi MissStevious,

Cervical dysplasia terminology can be very confusing and I am sorry that you were not better informed by your physician.

CIN 3 is classified as severe dysplasia of the cervical cells. Adenocarcinoma in Situ (AIS) is a sub category of Atypical Glandular Cells. This means that in addition to having cervical dysplasia, rated as CIN 3, you also have atypical glandular cells on your cervix, rated as AIS.

The CIN 3 is not cancer but could lead to cancer if not treated and may recur after treatment. The AIS is considered cancerous.

The follow-up for both of these conditions is a LEEP procedure, which you have had already. After that you need to repeat a pap in 4-6 months.

Here are some things that contribute to cervical dysplasia and cervical cancer, changing lifestyle habits could help prevent recurrence:
Smoking
Oral contraceptive pills
Intercourse before age 16
Multiple sexual partners
Unprotected sex and condom use
Uncircumcised males
Multiple pregnancies
HIV
Chlamydia infection
Herpes infection
Obesity
Poor diet

I hope this information helps, good luck and keep us posted

November 14, 2009 - 10:06pm
MissStevious

Hello,

Thank you for this information.

I had the LEEP done last week and the biopsy report said CIN 3 and Adenocarcinoma in Situ. What does this mean? What is Adenocarcinoma in Situ? Does this mean cancer?

I appreciate your help and concern. Thank you for answering my questions.

Stevie

November 13, 2009 - 7:08pm
Pat Elliott HERWriter Guide

Hello MissStevious –
First, I’m sorry to hear that feel you weren’t given enough information from your physician, and that you’ve been left with so many questions. This must weigh on your mind quite a lot. Let’s see how we can help.

Yes, there is a difference between adenocarcinoma and carcinoma. The prefix "adeno" means "gland". The word "carcinoma" in both of these words means "malignant tumor". Adding the prefix "adeno" means it is a particular type of tumor, specifically "a tumor of the gland". All cancers begin as in situ, meaning early cell growth.

You’ve said that you were diagnosed with adenocarcinoma and that you were treated for dysplasia. These are two very different conditions. Cervical dysplasia is abnormal changes in the epithelial cells covering the surface of the cervix. Dysplasia in some cases is precancerous. It may lead to cervical cancer if not treated.
Treatment of cervical dysplasia depends on the severity of dysplasia, location, and size of the area of abnormal cells. A high or low grade is also an important factor in treatment decisions.

I’m going to list a range of treatment methods below so you have this information. Please note that your doctor should have conducted a biopsy during the LEEP procedure, and you should have been given the biopsy results. I would contact the physician’s office immediately and ask for a copy of that report as well as a clarification of your exact diagnosis. You will be better able to make a decision on your next move after you have that information.

One of the key elements in being able to take care of our own health, and be our own health advocate, is to have a partnership with healthcare providers that’s based on mutual respect. It’s clear you feel you were not treated in a manner that supported your well-being, and I doubt you would be comfortable returning to this same physician. Finding another physician for your follow up care seems critical for your well-being. Knowing your biopsy results and clarifying your diagnosis will enable you to determine whether to see an oncologist or gynecologist.

Please let me know if you have more questions or need more information. I wish you the best in getting the information you need, and hope you will write back and let us know how this goes for you and what you learn. We’re here to support you so you don’t have to go through this alone.

Take good care,
Pat

Cervical dysplasia treatment methods include:

Cone Biopsy

This biopsy is the removal of a tiny cone-shaped piece of tissue from the opening of the cervix. The biopsy will be analyzed. The results will show whether any of the abnormal cell growth is cancerous.

Loop Electrosurgical Excision Procedure (LEEP)

A small biopsy of the cervix is taken with a wire loop heated by electric current. The results will show whether any of the abnormal cells are cancerous.

Cryosurgery

Cryosurgery freezes and destroys the dysplasia on the cervix. This method is not recommended for treating large areas of dysplasia.

Laser Treatment

Laser treatment uses a concentrated, high-energy beam of light to destroy abnormal cells. This method is more favorable than cryosurgery because there is less destruction of surrounding normal tissue than with some other methods. Although healing is faster than with other methods, laser treatment is expensive, and not always widely available.

If Cancer Is Found

Cone biopsy and LEEP are usually curative for dysplasia. However, if the cone biopsy or LEEP biopsy shows cancer, surgery, radiation therapy, or chemoradiotherapy may be used. Your doctor will discuss these options with you.

Follow-up:

All women who have had cervical dysplasia should continue to follow up with frequent pap tests every 3-6 months, or as prescribed by her doctor.

November 9, 2009 - 6:03pm
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