Adenocarcinoma in Situ + 7 week pregnant

Recently diagnosed with cervical cancer
1

Hi!

 

I'm 32 years old. Last month (Jan 2018) my boyfriend and I decided to start conceiving a baby. I went to my gynecologist, removed my IUD and did a Pap Smear.

It came back abnormal with HPV high risk. I then did a colposcopy+biopsy, and they found AdenoCarcinoma In Situ, but also that I was 5 week pregnant.

My gynecologist recommended that I wait for the end of my pregnancy to get a conization, as it could lead to miscarrage if performed during pregnancy.

I then asked different opinions, and basically got all sort of answers:

- Wait for baby delivery then hysterectomy

- Do a conization ASAP because ACIS is pretty tricky and risky, so if I want to put my heath first, that's what I should do

- Do a conization at the beginning of the 2nd semester to lower the risks for the baby, but still detect any invasive cells early enough for me

 

The last solution is the one I think I'd rather do, but it comes from a doctor in France (I'm originally from France), who is specialised in my tricky case.

I've moved to California in the Bay Area 3 years ago, so if I decide to go back to France to get the surgery, no insurance will cover the costs.

 

I find it so hard to find a good gynecologist/oncologist/surgeon for my case. So if anyone has some good suggestions, I'd love to hear them.

 

Thanks!

 

2

Hi wildow,

I am newly diagnosed with a low-grade (well differentiated) adenocarcinoma. I am in my late 30s and I live in the Bay Area too.

- While we were trying to have a baby, I had my routine pap and it showed AGUS (atypical glandular cells) at the end of January (2018).

- During colposcopy, I removed my cervical polyps (usually benign) and I had a biopsy from the root, hoping that the result will show low or high abnormalities. (I never had abnormal Pap tests but I knew I had the hpv virus)

- The biopsy showed adenocarcinoma and polyps were malign.

. Ob/Gyn suggested a biopsy of my uterus because the glandular cells can be found in both the cervix and the uterus. The uterus biopsy came negative.

- The Ob/Gyn decided to have a conization but after I met an oncologist-gynecologist at UCSF I chose a different approach. Since atypical glandular cells are more tricky than squamous, a Pap test or a cervical biopsy during colposcopy is not an accurate tool to diagnose the stage. Also, I was told that images may change after conization and he wanted to have a clear image before I do any procedure.

- I had a PET/MRI. It showed no metastasis and we proceed with conization since it looked confined to the cervix. 

- I had a cold knife conization 2 weeks ago. My recovery was very smooth and fast. The cone biopsy at UCSF confirmed the low grade and stage of the adenocarcinoma (1b1). This is good news for my life but I need to have a follow-up operation because the margins were semi-clear (negative inside, positive on the sides).

- My doctor is discussing my case with a group of other specialists and I will meet him the following days. We are trying to preserve my fertility so I hope that we will proceed with a radical trachelectomy instead of a hysterectomy. I only had a brief discussion with him but it seems that open surgery has better results than robotic.

To be honest I don't know a lot of things about your case. On the news, I read cases that pregnant women had conization and trachelectomy but this was risky for the mother and the baby. I suggest you find an oncologist-gynecologist to guide you. I experienced some miscommunication between providers. Cancer needs to be addressed by the right specialist in order to get it removed before it becomes invasive. They have seen thousands of cancers and they will be able to assess your case based on the type and the stage of cancer. 

I know this is overwhelming, especially for women who are trying to have a baby or they are already pregnant. 

Hope the best!