Hello. For the past two years I have been going through PAP tests and cervix biopsies every 6 months. Each time the results are the same. The PAP comes back normal but the biopsy is severely abnormal cells or CIN 3. I have had two LEEP treatments. Regardless of the treatments, the next PAP and biopsy is the same CIN 3. How is it possible for the severely abnormal cells to re-grow when the LEEP is supposed to destroy them? This makes me nervous. Are the new abnormal cells now growing in a different part of my cervix? Or did the doctor not remove all of the abnormal cells from the two LEEP procedures? I am almost 70 years old and honestly my preference is to have my cervix removed surgically. My anxiety over this is getting a bit too much for me. Your thoughts are appreciated. Thanks.
Hi Royalwood and welcome to the group
A smear test unfortunately may not identify all abnormal cells-it is a “sweep” of the cervix and can miss things, and the biopsy is the true result.
The nature of the hpv virus is that it come come and go-be active or put into dormancy by your immune system dealing with it. When it’s active it can cause abnormal cells, so unfortunately yes, they can come back after a LEEP procedure.
The surgical removal of the cervix is called a trachelectomy, and is not a common operation-it is used with younger ladies if at all, in order to try to preserve fertility if they have an early stage cancer. It is not a treatment for abnormal cells, which you have and which are not cancer. I’m not sure if you are in the UK, but if you are, it would not an option to offer this unless you had cancer, and not hospitals carry out the procedure.
Unfortunately even a trachelectomy is not a solution to the hpv virus as the surgery would not get rid of the virus itself for which there is no cure. So even if you had surgery it would be possible to have abnormal cells again in that area in the future. But as I’ve said the trachelectomy is not a treatment option unless there is cancer.
I realise this will not be what you’d want to hear and it must be stressful having to return for treatment. Unfortunately as we age it can be harder to get rid of hpv, as you need a strong immune system to get on top of it but we don’t always have that as we get older. The the immune system normally should be able to deal with the virus, not in the sense of curing it, but in the sense of making it inactive so that it is not causing any damage to cells.
Please let us know how you get on and if you have any more questions.
Sarah xx
Hi Royalwood
There will be a limit to the number of LEEP procedures you can have as each procedure is removing layers of cells which will eventually shorten the cervix. From the groups I’ve been in and reading about these, the most I have seen anyone have is 4.
In the UK, the first thing to be checked is the presence of hpv, and from there further checks for abnormal cells. Is this the same in Canada? If so, if you go back to smears from your regular doctor and hpv is identified, the process would be to go back to the colposcopy clinic for examination there and check for any abnormal cells again. You are lucky in Canada that you still get regular smears, as these are not offered after the age of 65 in the UK.
I have seen ladies who have had a hysterectomy for persistent abnormal cells, but again this doesn’t cure the virus, and abnormal cells can return on the vaginal cuff where you are sewn up in the hysterectomy, or in the vagina, or vulval area, so even if a hysterectomy is done this would need to be followed up by checks. Obviously a hysterectomy removes the cervix so the type of examination is called a vault smear rather than a normal smear.
It would be a good idea when you next visit the gynaecologist to discuss what the best option would be if you don’t get clear biopsy results.
Sarah xx
