February 5, 2012

Malignant Cervical Dysplasia

For those of you you may have heard of Cervical Dysplasia or Cervical Cancer or even only the HPV vaccine, here is my story.

I was 19 when I had my daughter.  After her birth, I went to the doctor for a Pap smear.  It must have been late in the summer of 1993.

It can take 2-4 weeks to get the results of a Pap smear and usually doctors don't call you back unless the smear shows something.

So I was quite shocked when my doctor called me after a few weeks about my smear.  I became quite worried when she insisted on seeing me right away.   My doctor was the doctor associated with the local college, and even tough I was seeing her outside of the college, she wanted me to go see her at the college, that very same day.

So I went to see her at the college clinic.  She took me in right away even though there were other people waiting.

She informed me that I had tested positive for severe cervical dysplasia, she explained that the results were CIN3


Dysplasia that is seen on a biopsy of the cervix is called cervical intraepithelial neoplasia (CIN). It is grouped into three categories:

    CIN I -- mild dysplasia
    CIN II -- moderate to marked dysplasia
    CIN III -- severe dysplasia to carcinoma in situ

When I read up on it these days, there seems like there should have been a second test or biopsy before getting this diagnosis.  There may have been a second one but I honestly do not remember that part if there was.  We ARE talking close to 20 years ago now.  Then again maybe there was as this Pap smear was supposed to have been done 6 months after I had given birth and my daughter was born in late November.

She referred me to a gynecologist/oncologist  (this doctor delivered no babies).  I know she did a biopsy on me, I remember that one.  I figure the referral didn't take very long by today's standards.

She started with Cryosurgery, (I don't know how many times)  then did a cone biopsy (which is why I had trouble staying pregnant later on and why my son is such a miracle).  The cone biopsy determined that the cells were reproducing faster than the cryosurgery were destroying them.  They also determined that the abnormal cells had become malignant.

The doctor then informed me that she would have to use more aggressive treatment.  For years I have been referring to this "more aggressive treatment" as laser therapy, but in order to make sure that I was telling all of you the absolute truth I actually went and researched it.  My researched determined that laser therapy:

1. was NOT used to treat cervical cancer and was a more expensive less effective way of treating mild to severe dysplasia
2. neither the cryosurgery nor the laser therapy cause the intense burning I remembered for weeks after each treatment.
3. the laser therapy machine of the 90's did not look like any machine my doctor was using.

What I realized through my research was that the "more aggressive therapy" was in fact brachytherapy.  

Brachytherapy (from the Greek word βραχυς brachys, meaning "short-distance"), also known as internal radiotherapy, sealed source radiotherapy, curietherapy or endocurietherapy, is a form of radiotherapy where a radiation source is placed inside or next to the area requiring treatment. Brachytherapy is commonly used as an effective treatment for cervical, prostate, breast, and skin cancer and can also be used to treat tumours in many other body sites. Brachytherapy can be used alone or in combination with other therapies such as surgery, External Beam Radiotherapy (EBRT) and chemotherapy.

Specifically I received HDR brachytherapy, on several occasions, intermixed with cryotherapy.  
 High-dose rate (HDR) brachytherapy is when the rate of dose delivery exceeds 12 Gy·h-1. The most common applications of HDR brachytherapy are in tumours of the cervix, esophagus, lungs,] breasts  and prostate. Most HDR treatments are performed on an outpatient basis, but this is dependent on the treatment site.
This treatment lasted a few months, with biopsies on a regular basis.  After several months (I know it was winter when I got the news) I had a clear biopsy.

I then had pap smears every three months for a year or so, then every six months and eventually every year.


Well that's my story, thanks for reading!

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