Dr. Mazumdar.... I went to the gyn/oncologist this morning and

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Dr. Mazumdar.... I went to the gyn/oncologist this morning and I walked out of there feeling like I just wasted my time. He's going to do ANOTHER colposcopy next week and he mentioned laser and some type of cream for treatment. My gynecologist and another oncologist has already said that the best answer is an upper vaginectomy but this dr. didn't even consider it and I feel confused. I know you can't answer with a concrete answer, but in your opinion, do you think another laser would work if the previous one did not? Why do you think he's doing the same tests that were already performed within the last 3 weeks? Thanks.

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Female , Age: 46

Already Tried:
hysterectomy, laser, biopsy, colposcopy

Customer (name blocked for privacy)

Status: Closed Value: $10

Hello rhonda,

I doubt if a laser would work now after a previous attempt has already failed. And I do not know why he is not doing the vaginectomy. I agree with your previous gynecologist that in your case (repeated pap smear positive for severe dysplasia), a complete removal of the affected tissue by upper vaginectomy is the ideal treatment.

The 5-Fluorouracil ointment (which is the standard anticancer ointment usually used) is more a deterrent to future development of cancer rather than an actual treatment procedure. You would have to use it even after the upper vaginectomy.

I have no idea why he wants to repeat the same test again. Some doctors do prefer to repeat the tests but more because they want to plan out how much tissue to remove, the site of incision etc. But since he is not planning a vaginectomy, I do not see what he hopes to gain from it.

Personally, I feel that getting another colposcopy, and then a laser, and then repeating pap smear after a few months is simply a wastage of time. If the pap smear shows severe dysplasia then, will he do a vaginectomy? Why not do it right away - considering you have had severe dysplasia for quite a long time now?

Did you ask him about the vaginectomy? Did he mention why he does not want to do it?

Experienced in the management of Pregnancy,Infertility,Menopause and all problems in Pregnancy and Gynecology

Reply to Dr.M.D.Mazumdar, MD(O's Post: I did ask him about it and told him that was the treatment recommended and although he did say it was a possibility, he quickly went back to the laser/ointment treatment again. He brushed over the vaginectomy and I really felt intimidated about the situation so I guess I wasn't as forceful in finding answers like I should have... but I guess I wanted to see what you thought as well since I've come to trust your opinion, even though I know it takes an actual examination to get an answer. I don't look forward to waiting another week to have another colposcopy but it looks as if I have no choice.

Rhonda,

Perhaps he thinks that the laser will be enough to dry out the dysplastic cells and that it was not properly or adequately used the last time - and if he is very experienced with the laser, he may well be right.

Laser is, of course, one of the standard treatments for your condition - the only problem is that it has failed once previously. Since you do not have a choice but to go along with the plan of treatment, hopefully it will succeed this time.

Thankfully, severe dysplasia is not a problem that spreads or develops very fast and you have time on your hands.

Looking on the bright side of the situation, if the laser and the 5-Fluorouracil does succeed, you have been spared an operation.

I hope things go well for you.

Experienced in the management of Pregnancy,Infertility,Menopause and all problems in Pregnancy and Gynecology

Reply to Dr.M.D.Mazumdar, MD(O's Post: Since, I had my ovaries out when they did the laser last time, I don't know if it's an outpatient or inpatient procedure. Can you tell me and how long it normally takes?

Hello,

It is usually an outdoor therapy. But in your case, since it will be used over an extensive area of tissue and you will also be given the 5 Fluorouracil, perhaps you will need to be in the hospital for a day or two. The 5-Fluorouracil is very toxic and will need to be applied first either by the doctor himself or by the nursing staff. You will be taught how to use it before you are sent home.

Experienced in the management of Pregnancy,Infertility,Menopause and all problems in Pregnancy and Gynecology

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Dr. Mazumdar.... I went to the gyn/oncologist this morning ...

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