My Story – Uterine (Endometrial) Cancer: Biopsy & Re-reviewed Pap Results

Photo Copyright 2003, Nelson Soucasaux

In the July 10, 2014 post, I explained why I underwent a colposcopy and biopsy on July 9. It took two weeks minus one day to get the results, which I received by way of a phone call from an assistant in the doctor’s office at noon today.

I don’t know why it takes so long to get simple lab results, but something is wrong with a healthcare system that supports one of the most anxiety-producing problems facing patients: waiting. Most of the phone calls I receive are solicitations, but every time the phone rang recently, I went into “yellow alert.” The young woman who called said that the biopsy was “benign,” which of course is very good news. But when I asked about the re-reviewed Pap, she said the report came back showing the same “atypical glandular cells of undetermined significance (AGUS),” which of course is still equivocal news, as discussed in the previous post.

What bothered me was that she said the doctor wanted me to return in three months for a repeat colposcopy. This might not sound too bad, and the three-month period actually sounded encouraging. But a repeat colposcopy? This wasn’t encouraging at all. Not only is this a painful exam, but it contradicts what the doctor told me when I was in the office two weeks ago—that I should return in a month for a repeat Pap. And, of course, the previous colposcopy did not elucidate the Pap results. So I asked her to ask him why he had changed his mind.

About three hours later, I received a call from another woman in the doctor’s office re-giving me the same results. I explained that I had already received a call and had left a message for the doctor about the altered instructions. She looked in the computer and found notes, including a response from the doctor to the first woman that it was fine for me to return a month from my previous visit (two weeks from now) for the repeat Pap. That was a relief, even though the appointment is sooner rather than later. But this episode reinforced to me that patients really do need to ask questions and be on top of their own care plans until they get answers that make sense to them.

In addition, I asked the second woman to fax me the lab results, and she asked me to fax her a release first—which I haven’t had to do previously. Anyway, I received the reports:

• Vaginal Biopsy: Squamous Mucosa. No Pathologic Changes. In other words, this was benign vaginal tissue, normal squamous (“scaly”) cells, as the doctor thought when he took the specimen on July 9.
• Cytopathology Consultation Report: General Diagnostic Category—Atypical Glandular Cells of Undetermined Significance. In other words, an equivocal and somewhat worrisome result that remains unchanged since the previous report of the specimen taken on June 19. This seems to go along with my problem of light vaginal discharge, although we don’t yet understand why.

I was surprised to see that this second Pap report (of the same specimen) was read by the Department of Pathology at Saint Barnabas Medical Center, whereas the first report came from a private lab. In retrospect, this makes sense—getting a second opinion on the same slide.

Only time will tell what all this means. My next appointment is on August 12, so it will be two weeks after that—or about a month or so from now—before I get a new Pap reading.

Thanks for bearing with me.

In the meantime, I have several more topics to explore—including more thoughts on the art of waiting (see the January 12, 2014 post)—so please check back soon.

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Resources

Highlighted/underscored text, images, and media contain links to external resources for further education, empowerment, and encouragement.

The stories, information, and resources on this site are intended to supplement—not replace—the advice of your clinical team.

Articles

About.com Video: Getting a Colposcopy Exam

American College of Obstetricians and Gynecologists (ACOG) – Colposcopy

American Family Physician – Evaluation and Management of the AGUS Papanicolaou Smear

Cigna – Colposcopy and Cervical Biopsy

For Women’s Eyes Only – Debates about Pap Tests

Google Images – Colposcopy

Health Communities – Colposcopy and Cervical Punch Biopsy*

*Source: The Johns Hopkins Consumer Guide to Medical Tests; Simeon Margolis, M.D., Ph.D., Medical Editor; Updated by Remedy Health Media (see Books below; this is a consumer reference)

HysterSisters – Colposcopy after a hysterectomy?

Mayo Clinic – Colposcopy

MD Consult Preview: Colposcopy of the Vagina**

**Source: Colposcopy Principles and Practice, 2nd edition; Barbara S. Apgar (see Books below; this is a clinical reference)

MUM.org: Museum of Menstruation & Women’s Health – This site is “odd, funny and well-researched” according to the New York Times

New York Times Health Guide:

– Cervical Biopsy

– Colposcopy-Directed Biopsy

– Pap Smear

Society of Gynecologic Oncology (SGO) – Choosing Wisely: Five Things Physicians and Patients Should Question

WebMD – Colposcopy and Cervical Biopsy

WomensHealth.Gov:

– Pap test

– Pap test fact sheet

World Health Organization / International Agency for Research on Cancer (IARC) – Chapter 7: Colposcopic assessment of cervical intraepithelial neoplasia 

Books

Colposcopy Principles and Practice, 2nd edition; Barbara S. Apgar (a clinical reference)

The Johns Hopkins Consumers Guide to Medical Tests: What You Can Expect, How You Should Prepare, What Your Results Mean; Simeon Margolis (a consumer reference)

General References

Medical Dictionary – The Free Dictionary

mediLexicon.com – Medical Dictionaries, Drugs & Medical Searches

Merriam-Webster Medical Dictionary

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For more information about my personal story with uterine cancer and also about diagnosing and treating this disease with surgery and radiation, please see the Uterine (Endometrial) Cancer page for links. 

And stay tuned for more information about this very important topic.