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Cervical cancer

Jellybean 3's Photo Jellybean 3 03 Feb 2019

Hi I’m not sure if I’m posting in right place - i haven’t been diagnosed but I have failed my Pap test (high grade squamous intraepithelial lesion) and need to have a colposcopy/ biopsy. My GP is being cheerful about it until we know more. I can’t get into public system for 3 months! Investigating private but no idea what cost or wait will be. Any advice pls?
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Soontobegran's Photo Soontobegran 03 Feb 2019

Hi there, the good news is that a squamous cell intraepithelial lesion is generally a pre cancerous lesion so the pressure is off somewhat for your colposcopy and biopsy to be done immediately so investigating doing it privately may not be needed.
The costs would vary according to the doctor and the hospital you go to but I would imagine it would be well over $2k out of pocket for a day stay, doctor, anaesthetist, pathology and the like which is all covered in the public system.

I sure understand how you just want it dealt with right now but if your GP feels there is no urgency then I'd be comforted by that.

Lots of good luck.
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Jellybean 3's Photo Jellybean 3 03 Feb 2019

Thanks for your reply- I didn’t realise I’d need an anaesthetic for a colposcopy/ biopsy. Or if you mean the next step ie actual removal?
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Dani_R's Photo Dani_R 03 Feb 2019

I'm not sure if this is the same thing but I've had an abnormal pap smear with precancerous cells graded CIN2/3 about 10 years ago.  I had a colposcopy done in the gyno's office, much like a pap smear but a bit more uncomfortable. Went on to have laser to the cervix to burn off the abnormal cells which was a day admission with a twilight sedation.  Talking to a work colleague about it and found she'd gone through it too, I think it's actually quite common. In the longer term I just had to have yearly pap smears until a few in a row were all clear (although don't know if it's different now with new 5 year test)
Best of luck!
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lizzybirdsworth's Photo lizzybirdsworth 03 Feb 2019

My colposcopy was just similar to a Pap smear and they took the biopsy then. They put vinegar on the area because apparently that shows the lesions. Smelt vinegar all day. It was probably done by 10 minutes. If that comes back positive you will then need some surgery to remove it. I had LLETZ procedure done under a light anaesthetic. Then colposcopy at the 6 and 12 months marks to check.
Good luck. I reckon I waited 2 months for colposcopy and then 6 months for the procedure but got a cancellation at the 2 month mark and I hadCIN 2 and 3
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lunariviera's Photo lunariviera 03 Feb 2019

 Kaylaballerina, on 03 February 2019 - 09:54 AM, said:

Thanks for your reply- I didn’t realise I’d need an anaesthetic for a colposcopy/ biopsy. Or if you mean the next step ie actual removal?

No anaesthetic  for a colposcopy and a biopsy might have a numbing shot but nothing expensive. If you went private if it might be $600 for the gyno and histology for the punch biopsy.

LLETZ if required may have general or local. This is the more costly bit.

Edited to add that you'd get an amount back from Medicare for the gyno and histology.
Edited by lunariviera, 03 February 2019 - 10:18 AM.
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Jellybean 3's Photo Jellybean 3 03 Feb 2019

Thanks Dani R that’s exactly what mine says CIN 2/3. Do you think it’s worth going private?
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~LemonMyrtle~'s Photo ~LemonMyrtle~ 03 Feb 2019

 lizzybirdsworth, on 03 February 2019 - 10:16 AM, said:

My colposcopy was just similar to a Pap smear and they took the biopsy then. They put vinegar on the area because apparently that shows the lesions. Smelt vinegar all day. It was probably done by 10 minutes. If that comes back positive you will then need some surgery to remove it. I had LLETZ procedure done under a light anaesthetic. Then colposcopy at the 6 and 12 months marks to check.
Good luck. I reckon I waited 2 months for colposcopy and then 6 months for the procedure but got a cancellation at the 2 month mark and I hadCIN 2 and 3

I had pretty much the same experience, but went private and had it done and dusted in about a month. I had the high grade changes too, but the LLETZ was the “cure” so all fine since then. I only had follow up Pap smears, the better one, mini prep or whatever it was called.

Not sure of the private costs OP, as we had private health insurance, so I think out of pocket was only about $500 in the end. My gyno was one of the cheaper ones too and often bulk billed me for quick follow up appointments. This was 6 years ago.

Try not to worry too much OP, apparently cervical cancer grows slowly, and if they were more worried they would have you seen sooner.
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Jellybean 3's Photo Jellybean 3 03 Feb 2019

Would it be possible to go private for colposcopy to speed diagnosis but have removal/ treatment through public system?
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~LemonMyrtle~'s Photo ~LemonMyrtle~ 03 Feb 2019

 Kaylaballerina, on 03 February 2019 - 10:23 AM, said:

Would it be possible to go private for colposcopy to speed diagnosis but have removal/ treatment through public system?

I’d say it’s possible. Call and ask. Try to find a private gynaecologist that also works in a public hospital. It’s easier that way. Mine offered to do my LLETZ at the local public hospital, it was all the same to him. He worked at both. I picked the private as it was more convenient to me and we had insurance.
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Jellybean 3's Photo Jellybean 3 03 Feb 2019

Thanks lemon myrtle. Were you very concerned while waiting for diagnosis? Professionals seem to push the positive scenarios, which I completely understand, but I can’t help wondering what are ALL the potential possibilities and the chances of something worse than they are willing to discuss...?
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harryhoo's Photo harryhoo 03 Feb 2019

I was diagnosed with CIN 3 in 2007. Was referred to a private ob as we had private health insurance. I ended up having a LLETZ in her office with local anaesthetic - wasn't super awesome, but not too bad. 12 years later and everything has been fine since. I had pap smears every 6 months for 2 years to keep an eye on things. Had my last thin prep (or whatever it is now) 3 months ago and everything is still good.
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Jellybean 3's Photo Jellybean 3 03 Feb 2019

Thanks Harry Hoo - so LLETZ seems to be treatment of choice?
Edited by Kaylaballerina, 03 February 2019 - 12:23 PM.
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Nepheline's Photo Nepheline 03 Feb 2019

When my papsmear came back with the same result I went and saw a private gyno as referred by my GP. He did a colposcopy and a couple of biopsies on the spot. It was a few years ago but that appointment cost be about $400 (I got some back from medicare).

The results came back CIN3 and he booked me in onto his public list to have it removed the following week at the local public hospital under general anesthetic. I had a large patch of Cin3 right across my cervix. He used laser to remove (which apparently is a little controversial for CIN3) but he was a senior Gyno-Oncologist so I trusted him. I've had nothing but clear papsmears since! Good luck OP, it was super stressful at the time but it's a distant memory now. If I were you, and the budget allows, I'd book in to see someone for the colposocopy privately.
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JomoMum's Photo JomoMum 03 Feb 2019

I had a CIN3 Pap smear in January 2016. Smack on 2 years since last Pap smear too.

I happened to already have an appt with my Gyno the following week regarding having a long standing prolapse surgically repaired. My appt with him was I think the last day of January and I was due to go away for 2 weeks the following week.

I was happy to hold off on the prolapse surgery (i’d only just returned from Mat Leave 3 months before) as I would require 6 weeks recovery, but he wanted the cervix tended to quite urgently.

He performed a LLETZ procedure for me the day after I got back from holidays, while he was doing my prolapse repair (and stuck a mirena in for good measure). Removed the pre cancerous cells with good borders and I’ve been fine ever since.

But I will always continue to have my Pap smears two yearly from now on, even if I have to pay.

OP, I you have the option to go private, it would always be my choice. Generally much lesser wait times, and I do prefer a private hospital experience (that’s just me..).

Good luck x
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limakilo's Photo limakilo 03 Feb 2019

Ask lots of questions about what will happen and what you can do afterwards.
Ask if you can go on the wait list, or if there is another hospital nearby that you can get into sooner.
I had the same and had the lletz laser.
I have a cyst on the site now, over 18 years later, apparently that's quite common too, wish someone had told me so I wasn't freaking out.
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BeachesBaby's Photo BeachesBaby 03 Feb 2019

Hi OP - I had this exact situation about 7 months ago, the pap came back CN2-3, with possible high grade lesion. I'm TTC, so I wanted this resolved asap, and went private. My biopsy/colposcopy was somewhere around $250, it might have been a bit more, but it wasn't anywhere close to $1k, I'd say maybe between $250-$400 at the private gynaecologist and including the pathology fees which were separate. The gynae saw me within the same week as I got my initial results. As an fyi, they don't use any anesthesia or even a local anesthetic, and it's sore but lasts for maybe 10 seconds of pain, then it's fine.

Once my biopsy/colposcopy came back it was actually low grade, CN1. This can happen because the biopsy is much more accurate, while the pap might not be as accurate. My dr had me wait and see, with a followup 6 months later. Last month I had it done and he could still visually see the abnormal cells when he stained my cervix, so I was nervous about it having upgraded, but once again it was level 1, and he said we can continue to watch it since it didn't get worse. If it had gotten worse, he would have done the laser procedure to remove it, and we'd have had to put TTC on hold.

On my own I had done some reading online because I was very concerned, and from what I found, it appears that cervical cancer generally takes a significant amount of time to progress from CN2/3 to actual cancer cells. I think I read somewhere around if you left it untreated for 10 years after your initial abnormal pap. So I don't think it's the type of thing, in most cases, that progresses so quickly. That said, I'm not a doctor, this was just what I had found out. Also, the first thing my GP told me when I had my initial result was "you do not have cancer, this isn't cancer cells," which I appreciated her explicitly saying.

I understand feeling nervous, and for me the few hundred dollars was worth it to be seen by a great gynae within the week, and just have it resolved right away. That being said, if you need the LEEP/laser procedure, I'm sure the gynae can write a referral to the public system, since that might be more expensive. Good luck, and try not to stress too much if you can help it.
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Jellybean 3's Photo Jellybean 3 03 Feb 2019

Tthanks so much everyone- i feel much better - love you EBers.. xx
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*Ker*'s Photo *Ker* 03 Feb 2019

I had CIN III 20 years ago, high grade. Had colposcopy and biopsy private, but so long ago I can't remember costs!

My Gynae was really concerned and said I needed it treated sooner rather than later and estimated a month waiting for the public system. The next day I got a call from the local hospital to attend in 2 days time to have it treated. I've no idea what my gynae said or did, but it freaked me out! I had mine cauterised as it was extensive.

I was pretty unconcerned until it took only 2 days to get in!
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Dani_R's Photo Dani_R 03 Feb 2019

 Kaylaballerina, on 03 February 2019 - 10:23 AM, said:

Would it be possible to go private for colposcopy to speed diagnosis but have removal/ treatment through public system?

It feels so long ago I can barely remember what I did now!  I think I saw a gyno privately for the colposcopy but went to a public hospital for the laser treatment- I remember getting the call for my day surgery admisson and I was going interstate for a wedding so had to reschedule!

As you can see here it's pretty common and usually nothing to stress about.
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lunariviera's Photo lunariviera 03 Feb 2019

 Kaylaballerina, on 03 February 2019 - 12:23 PM, said:

Thanks Harry Hoo - so LLETZ seems to be treatment of choice?

They like LLETZ more than laser because they can take the piece of cervix and test the margins. But its something to discuss with your gyno.
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Veritas Vinum Arte's Photo Veritas Vinum Arte 03 Feb 2019

My mum had CIN 3 as she turned 50. She had the cone biopsy done then went on holiday for her 50th before returning to get the cells lasered out. Like others more regular pap tests for a few years. She is 71 now and has never needed anything more done.

My SIL had similar (possibly worse) 10 years ago and is perfectly fine today.

Goodluck
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Soontobegran's Photo Soontobegran 03 Feb 2019

 Kaylaballerina, on 03 February 2019 - 09:54 AM, said:

Thanks for your reply- I didn’t realise I’d need an anaesthetic for a colposcopy/ biopsy. Or if you mean the next step ie actual removal?

Sorry I was looking ahead if it was necessary.
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Jellybean 3's Photo Jellybean 3 05 Feb 2019

So I can’t get into private gynaecologist until mid April... can anyone recommend a good gynaecologist in Melbourne? Thx
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nom_de_plume's Photo nom_de_plume 06 Feb 2019

View PostKaylaballerina, on 05 February 2019 - 07:05 AM, said:

So I can’t get into private gynaecologist until mid April... can anyone recommend a good gynaecologist in Melbourne? Thx

Which area of Melbourne? Have you told them what it is for? They will probably fit you in earlier if they know.

I had CIN 3 discovered at the end of 2012. I had a colposcopy and punch biopsy at the gynecologist. No anaesthetic required, it’s a similar (only slightly more uncomfortable) procedure to a Pap smear. Paid just under $500 and got about $200 back from Medicare.

The gynaecologist booked me in on his public list (he operates both public/private) the next week. I had LLETZ under a light general anaesthetic. I had it done on a Friday and was back at work on the Monday. Totally covered by Medicare.
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