Saturday, June 03, 2006

question for BBCTCHR

or anyone else with the requisite knowledge....

why bother doing colposcopy on someone who has squamous cell or adenocarcinoma diagnosed from a pap? why wouldn't you skip straight to a biopsy?

thanks in advance for sharing your wisdom,


Anonymous Anonymous said...

I wish I knew MRPRTP (wow, that's a lot of initials). Maybe to confirm a false positive?

Today has been one of those extremes of emotions day. Caught a baby who's dad I went to high school with. And who's grandpa was my history teacher. The family took pictures of us all together, it was glee.

Then, I did a cervical exam on a young mom at 22 weeks... and saw huge bulging membranes. Which is bad news for the expecting mom, who has to cross her fingers, legs, toes, hoping to make it a whole month more to give her little guy a chance.

Sometimes, when I look at gestational age in weeks, I don't realize how long it actually is. 22 weeks is almost 6 months of coddling this growth inside; 6 months of hopes, dreams, plans for the future... crazy how it change so drastically in the time it takes to complete a speculum exam.

happy studies friend,

8:59 PM  
Blogger telltale tabby said...

Dear Tool,

Very happy to see you posting. It would be better if you didn't use any identifying information though, even my initials. There are a lot of people out there trying to track me down these days. Some for good. Some for bad. That's the life of the Tabster. I like to fly below the radar though.

Sounds like you've had quite a day. Medicine really is a career filled with highs and lows isn’t it? Sometimes it's easy to academically skim over a situation without giving much thought to the implications for the lives of those involved. I had a similar experience on Friday. I got so caught up in the insanity of what I was seeing, that it wasn't until much later in the day that I was able to process the reality of my patient’s prognosis. I guess in part surgeons (and all Drs. for that matter) need to put up those kinds of walls in order to do their job effectively, but I think you also need to know when it’s time for a gut check.

Obs/Gyne is a really good rotation for that because it is so emotion-laden and has the potential to be totally wonderful or absolutely catastrophic. Not much in the middle is there? Also, people’s expectations are so high…

Re: Colposcopy for squamous or andenocarcinoma of the cervix. Good point, maybe it is to rule out a false positive before proceeding to some invasive and nastoid cone biopsy. Also, particularly for squamous, I guess it would be necessary for identifying the size, and exact location of the lesion, as well as, its potential for ressectability with cone biopsy. But to be honest, I still have no clue what the hell is going on. Studying for 2 exams at once always makes me crazy and I am also not going to lose any sleep over the philosophy of colposcopy. I am going to lose sleep over other things instead.

Hope to see you here again,
Tabby T - XO

9:34 PM  
Blogger The One and Only said...

Tabs...I can't answer your question either.

However, I will ask whether I am here as one of the good guys or bad guys who is trying to track you down. So, which one am I??

Saw Pesto in Downtown Kitchener last night. It was nice to see her again.

Painted the baby's room today...I was bothered by reading Tools post - I guess I won't be satisfied with anything until our little one is caught by one of you Dr's and we are told that he is healthy.

That is all for now.

10:20 PM  
Blogger telltale tabby said...


You are one of the good guys. I'm so glad you were able to hook up with Pesto. She's a real gem.

You have to assume that your baby is going to be fine. You have no information to the contrary. I know it would make you feel better to have me there running the show, but I'm sure the doctors out there know a thing or two.

xxx ooo T

11:07 PM  
Blogger The One and Only said...

They may know a thing or two, but they are not YOU.

11:13 PM  
Blogger bbctchr,M.D. said...

Sorry for my late reply, I usually check up on you more often! The answer lies in the difference between "cytology" and "histology" - you can suspect cancer on a Pap (cells), but you need tissue to make a diagnosis - a colposcopic directed biopsy.

Re: 22 weeker - not a good situation, but still pregnant when I left this morning...

11:40 PM  

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