Does repetitive vaginal surgical ablations ultimately lead to cervical cancer?

Hi Linda T and welcome to the group

I’m glad you come to join us-I already said hello to you initial post when you first posted. I’ve not heard vaginal ablations being mentioned in the group before, so this is new to me, and I’ve actual never heard of this procedure before. It must be very difficult to cope with these regular and invasive procedures and biopsies, 

I wonder if it’s a term that’s not used in the UK generally? As you used the word “pap” I wondered if maybe you’re not UK based as we would typically call it a smear test here. I’m just trying to get an understanding of what the process is and why you are having it. Is it for abnormal cells of some sort?

You asked if this is how it all begins for those of us diagnosed with cervical cancer, so for me I would have to say no. Almost all cervical cancer develops because of an inability of our bodies to clear the hpv virus, which can start to cause cell changes which then have the potential to develop into cervical cancer. Smear tests are not a diagnostic test for cervical cancer here, but a check initially for the hpv virus and from there, if it is identified, for abnormal cells. 

Smears are not a 100% accurate test, as certain types of cervical cancer can be missed, and a tiny proportion are not caused by the virus. For me, I was diagnosed with cervical cancer following post menopausal bleeding and pain. 

I think if you are able to share a little more information on the procedures you have had, and the reason for your close monitoring, more ladies might come along and post. I’m assuming from what you’ve said, you don’t have a cancer diagnosis-would that be correct?

You are very welcome to be with us, and to ask any questions. Ladies here are happy to share their experiences.

Sarah xx

Thank you Sarah. You are right, I am not UK based, I am in America.  Here a PAP is used like a smear test to discover abnormal cells and to check for HPV 16 or 18.  The Dr.s here will use a vinegar based liqud inside the vagina to accentuate any abnormal cells and use a coleposcopy (sp) to look closer and then take a biopsy or a few biopsy's of suspicious cells.  It takes a couple of weeks to get the results of the biopsy.  If it's a CIN 3-4 then a surgical ablation (a lazer that burns the abnormal cells) will be scheduled.  So far my Oncologist has performed 5 different ablations and a full hysterectomy.  We are staying ahead of the cells turning to cancer by frequent monitoring and procedures.  So I am lucky to have a great team staying ahead of cancer.  Even though the I am anesthisized for the surgeries the biopseys and healing from the surgery is quite painful.  What is bothering me the most, is that there seems to be no end to it.  What I'm going through is not as severe as what most of you have gone through, nevertheless I am feeling very anxious as I wait to hear the results of my recent biopsy.

I do feel comforted by what you said about this not necessarily being the prelude to a cancer diagnosis.  

Sending holiday cheers to all.

LInda

Hi  

Thank you so much for coming back with this extra detail. This explains my confusion as we’re just using different terminology here due to being in different countries! The ladies in this group are mainly based in the UK, as Macmillan is a UK based charity, so they will understand all about colposcopies and the procedures which can follow them. However it’s absolutely fine for you to use the group and the community

We have colposcopies as a next step on finding high risk hpv where the solution is applied to identify any abnormal cervical cells, and CIN at 3 levels, 1 to 3. There is no level 4 here though. 

CIN3 is dealt with by a LLETZ/LEEP procedure where the cells are removed with an electric wire or loop, but typically there is a limit to how many times this can be done as it depends on the length of the cervix and how much is removed each time. The most I’ve seen done here is 3 I think. Ultimately, when hpv is persistent, and high grade precancerous cells recur, that can result in a hysterectomy, which I see you’ve already had.

So, I’m wondering if the abnormal cells have returned after your hysterectomy in the vagina now you’ve had the hysterectomy? This is called VAIN, where these abnormal cells grow in the vaginal lining so could explain the term vaginal ablation. VAIN is basically the vaginal equivalent of CIN, and it can develop if not treated into vaginal cancer. I’m assuming your cervix was removed in your hysterectomy?

You have certainly gone through, and are still going through, a great deal, so this must be really tough for you. The good thing is you are having close monitoring and have a proactive team, but it must be exhausting and so worrying to have had so many procedures. Is there a limit to how many ablations you can have if your biopsy shows high grade precancerous cells again in the vagina? Other treatments can be used here in the UK to treat this, so I wonder if that’s maybe an option for you?

I will be hoping that your biopsy indicates you don’t require any further treatment, but please let us know how your results go. It must seem endless for you going through this so often, so I’m sure other ladies who’ve had multiple procedures could identify. I went straight to a cancer diagnosis so was in a different situation as regards treatment.

Will you have your results before Christmas? We can have quite long waiting times here for biopsy results due to backlogs in our health service, but I’m guessing with insurance things might be different for you in the States. I hope so!

Sarah xx