Dear OncoLink "Ask The Experts,"
I had a biopsy and it came back with carcinoma in situ (CIN III) and adenocarcinoma in situ. I have seen two doctors. One (a regular gynecologist) tells me that I should just wait and have pap smears every three months and see what happens. The other (a gynecological oncologist) says that I should have a hysterectomy right away. I am 40 years old and plan on having no more children. Should I get a third opinion or go with what the oncologist recommends?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
If colposcopically directed biopsies that show CIN III and adenocarcinoma in situ have been performed, we generally recommend patients speak with their physician about a cervical cone biopsy to make sure there is no invasive cancer present. If the cone biopsy shows no invasive cancer, the edges of the biopsy are not involved with abnormal cells (in other words, if the cone biopsy excised the entire problem area), and the endocervical curettage does not show any abnormalities, some experts would recommend no further treatment except frequent Pap tests. On the other hand, if a woman is sure that she does not want to have more children, it is also reasonable to undergo a hysterectomy as treatment.
Nov 7, 2012 - Women with a history of cervical intraepithelial neoplasia can be screened more cheaply and effectively post-treatment by testing for human papillomavirus, while women with CIN who complete post-treatment follow-up still have an increased risk of cervical cancer, according to two studies published online Nov. 1 in BMJ.