HELP please, re cervical CIN3 cells and breast feeding, long

[puffylovett]

hi all, i really hope u can help me !! am desperate 4 words of advice.

my situation is this - about 2 yrs ago i had a smear with abnormal cells and was referred for colposcopy. Cells were found to be level 3 (which is just before pre cancerous i think).There is only a very tiny number of cells that are abnormal at te mo. I was advised to have the cells looped (chicken wired) off. However for various reasons, mainly because i love to bury my head in the sand, i didn't get it done.

A couple of months later i then found out i was pregnant by accident. same consultant and she got me back for a repeat colposcopy during the pregnancy to keep an eye on things, and for another repeat when baba was 4 months.

I have just had the 4 mth repeat today and have been advised the following -

There is a 1-2% chance that the cells could turn cancerous over the next 15 yrs. Her advice is i should have them removed.

However, because i am breastfeeding, the cells on the cervix are apparently v fragile and she can't tell for sure how much she would need to remove. Consequently, I have been told to stop breast feeding and wean ds straight away so she can get rid of the cells.

TO cut a long story short, i feel very pressured to stop bfing him on the off chance that these cells could turn cancerous. There is also supposedly a chance that if i had the loop that i could prematurely deliver my next baby, which we want quite soon. Yet I was told previously tat looops do not cause problems with pregnancy !

Their attitude is, i have bf for 6 months and thats all baby needs, i have done my bit and there is no reason to continue. To which i quoted the WHO recommendations and that i wated to continue till he self weans, but was told there was no need.

anyway i am posting here because i feel at a loss - the hosp make me feel stupid and ridiculous for wanting to put my bfing ds over the slight possibility that these cells may turn cancerous and i'm also under pressure from my family to stop now as well. i want more than anything to continue as i feel it's the best thing i can do for him and we both really love it and i am devastated at the thought of having 2 stop.

not really sure if anyone can help ! guess i have 2 wait for biopsy results and weigh up pros and cons..

[tiktok]

Oh, what a really difficult situation....I don't know anything about the medical side of this, but can you ask questions:

1. what if you wait a year or two years? Do the odds change in any significant way? Or even five years (time to have another baby and breastfeed him/her as well)
   
   
2. is the doctor aware that weaning will not instantly zoom your body back into a non-lactating state?
   
   If you decide to stop, you can do it gradually and lovingly, and you can become used to the idea of not breastfeeding over this time - it doesn't have to be a massive wrench.
   
   I think you need a second, medical opinion on whether weaning is needed, anyway - and someone here is bound to have some personal experience to help you.

[PinkChick]

the main issue here is that you have cin 3 and need to have them removed before they prgress and possibly turn in cancer.
i understand you want to feed your little one yourself but this is your health we're talking about and i have had the loop biopsy/laser and the only thing they said to me was to wait until i had had 2-3 clear cervical smears before i fell pregnant..i went on to ahve my dd with no problems and waters broke dead on due date with dd arriving two days later.
you really need to have this done.good luck.

[determination]

puffy,

my heart goes out to you you are in such a sticky situation here.. and really need to decide for the benefit of your baby.

• breastfeed for 2years and possibly not have a mum or possibly have a sick mum?
  
  or
  
  
• stop breastfeeding and have a fit and healthy mum?
  
  You have done extremely well bfing as long as this and you should be very proud of your self. But in reality you need to be healthy and well to look after your baby.
  
  Big hugs, i understand how difficult this must be for you.

[Pannacotta]

I cant comment on the breastfeeding advice sorry, but I did have treatment some years ago pre having babies, even though my smear result was only CIN1.
I was told afterwards that I was a very borderline case for needing treatment and that it was a management decision to recommend I have it.
However, I found the treatment pretty stressful and unpleasant and I felt quite under the weather for about 5-6 weeks afterwards with heavy bleeding and clots. I also wonder if it had an impact on giving birth as both times I managed really well during labour but found the second stage almost unbearable due to huge cervival pain (though I obviously dont know if this was any different from any other woman giving birth).
There are nutritional things you can do and supplements you can take which help protect against cancerous growth. Am not an expert so cant give you specific advice but if I were to have an abnormal result again I would def see a nutritionist rather than repeat the treatment (like you I'd want to continue breastfeeding). HTH and good luck.

[aloha]

What does the doctor say is the link between breastfeeding and cervical cancer? I can't see why you can't have the treatment AND breastfeed. Ask some more questions.

[Pannacotta]

Agree with Aloha, def ask more questions. That is what I was trying to say in my long winded post, ie dont take what the docs say for granted. Am sure you can breastfeed and haved the treatment.

[3madboys]

why does bfeeding make the cells on your cervix more fragile? i am sure there must be more info available to you, lots of women have treatment for illness and carry on bfeeding, maybe la leche league may have some more information for you?

can you get a second opinion? its always worth checking these things out

ultimately your child needs a healthy mummy tho, so althought that 1-2% risk sounds very small you may not want to risk it, if you can carry on bfeeding and have it removed that would be fab, if not i think you need to see if the risk would increase if you fed him to one yr? etc would you be happier to wean him then?

what does your dh think?

sending you love and strength and i hope you find some answers. xxxx

[aloha]

I remember some poor woman on MN who was told she had to stop breastfeeding before she could have an ingrowing toenail treated! FFS!

[puffylovett]

basically, the breast feeding causes low oestrogen, which makes the cells on cervix v fragile & altered and consequently she can't see what she would need to remove.

pannacotta - i was told by my midwife that it's a good job i hadn't had the loop as it can cause problems with cervix dilating... and am training to be naturopath so am already taking all supps that can help...i do feel a bit like i'm a conveyor belt case, i had to fight really hard with the same consultant to let me go into natural labour at 18 days overdue.

they've said that i would be stupid to do this, but if i continue bfing then they would check me every 6 mths. my gut instinct is continue as am for the forseeable future and just have regular checks - but then i just don't like anyone firkling with me bits !!

how long does it take to get back into a non lactating state tiktok ?

also i am a bit of a militant lactator and can't help but weigh up all the pros of bfing ie protection against other forms of cancer against the slim chance of developing this one !!! argh !!

[puffylovett]

it's the 'ypou've done your bit, he doesn't need it anymore' that's wound me up more than anything i think !!!

will do research and wait for the results i think, and get a second opinion, although how i do that i have no idea

[Blu]

Agree with Aloha.

I can see that bf could well affect the cells in your cervix....but break your questions down into v clear chunks - write them down.

Such as
'what is the risk in having the procedure done while you are bf?'
'what is the likely increase in risk of developing cancer if you wait 6 months or a year before having the cells removed?'
'is there any particular reason why you would be at risk of premature labour in future pg?'
'what IS the risk of premature labour in women who have had CIN cells removed?'
(so many women, me included, have had this treatment even before they have thought of having a baby - it can't be that high!)

Then get clear answers when you get the boipsy results. Take your list of written questions with you. Actually, ask how they can get an accurate biopsy result when you are bf-ing, if they can't do accurate treatment when bf-ing.

But don't panic yet - be strong in your mind that you WILL get this done, but with all the information clear in your mind that enables you to make a calm decision about what YOU want to do about it. And no more burying your head in the sand!

[tiktok]

Non-lactating state you ask....it is hard to say, but it is not instant. Women retain milk for some time after stopping, and this varies hugely, but they may not be actually producing milk all that time. I really don't know how quickly or slowly you would be at getting back to normal oestrogen levels, sorry - and have your periods come back? If so, your oestrogen levels may be raised anyway....it's all technical stuff and not within my knowledge. It's yet more stuff to ask the doc, I think.

[Blu]

Sorry - x-posted.

If they carry on checking with regular smears, then carry on bf-ing - and look at the bigger picture - bf-ing and possible serious disease - rather than the little picture of bit-firkling!!

To get a second opinion, ask to be referred by your GP - or you should be able to ask your consultant to refer you for a second opinion. Some make that easier than others - the consultant who looks after Ds's leg pro-actively offered to arrange a second opinion for us...others act as if you are threatening to set the mafia on them if you mention it.

[puffylovett]

tiktok no they haven't, not yet - best go armed with a list, thank you all so much for suggestions ! am prob panicking, didn't realise till today how much bfing truly meant to me - or am i just hormonal !!!

[Pannacotta]

Am sure its not that you're hormonal, rather that you want to feel empowered into making the right decusions for you and yor baby rather than being bullied into it.
I would do waht you are thinking of, ie carry on breastfeeding and have checks every 6 months as sometimes the cell changes disappear, mien certainly didnt get any worse, I had a few checks before the loop treatment.
Good luck with it all and do keep taking the supplememts, I know some are very effective in relation to this condition - think selenium, vits A, C & E among others, but am sure you know more than I do about this....

[aloha]

I have googled and googled and googled (should be working!) and cannot find one single reference ANYWHERE to problems with smears or treatments for cervical abnormalities while breastfeeding.
Low oestrogen is very good news with dysplasias anyway, as oestrogen is linked with the development of cervical cancer.
I would honestly ask again, and ask for a second opinion.
I can't help but feel that if treatment was routinely contra-indicated in treatment for abnormal cells or for smears, then it would be somewhere in the literature.

[Lorayn]

I had my loop done two months ago, and wasn't told anything about getting pregnant (have now found out I'm 6weeks gone) so it's kinda scared me a bit!!
I can't give any info on whether you should do it or not, but what I can say is although it is an invasive procedure, it doesn't last long, and I was more nauseas though the anaesthetic than the procedure, I bled for a while afterward, and had HORRID black discharge for ages, which scared the pants off me!!!
All I can suggest is you ask as much as possible, and when you do get it done make sure they tell you everything!!!
Good Luck

[Pannacotta]

Thinking about it, agree with Aloha that breastfeeding is supposed to be helpful in protecting against female cancers (breast and ovarian) so would have thought it would help (rather than hinder) in this case too??
Did the consultant eplain WHY she wants you to stop breastfeeding? What effect is it supposed to have on your cervial cells?

[Slacker]

I had cells removed for CIN III while I was breastfeeding a 6 month old - my consultant's only concern was that I might bleed more than average which is why it wasn't done at 3 months postpartum when it was discovered. I carried on breastfeeding for a further 2 years. I suggest you put your foot down with this doctor, or get a second opinion.

Oh, and there is a small risk of your cervix being weakened for subsequent pregnancy but this can be monitored etc, it's not a reason to delay treatment until you're finished having babies.

[majormoo]

Puffy, I have had a LEEP (Loop Excision), also for CIN3, and it caused no problems whatsoever in my pregnancy or labour with DS. I had the treatment in Mar 05 and DS was born Oct 06.

I do know that I had to wait three months for my follow up smear after giving birth, as pregnancy hormones can have an effect on the cervical cells, but no one was worried about the fact that I was breastfeeding.

I believe it is relatively recently (since I gave birth in October-I would remember if it was earlier as would have worried about it!)that research came to light that suggested LEEP can lead to premature labour.

It is obviously your decision but it is obviously not ideal to delay the treatment. I believe that there is no way of knowing who will develop cervical cancer from a CIN3 smear and who won't.

There is a website-Jo's Trust-which you can look at where there may be able to give you more advice. it is for women with Cervical cancer and also pre-cancerous cells

[Pannacotta]

BTW didnt mean to scaremonger with my first post, was just trying to say that I didnt get on too well with the treatment and wished that I had asked more questions and done more research before having it done (wish I had known about MN then).

[Meglet]

sorry, haven't had time to read whole thread. I had CIN3 too and know how bloody scary it is. The main thing is to get those cells out your cervix as soon as possible. You have done a fab job at BF and if the hospital insist you have to stop BF (goodness knows why?!) then I'd just stop and get the op done. I can understand how much this must be upsetting you but you have to make sure you are healthy now you are a mum. best of luck.

I've had 2 ops on my cervix and ended up with a emergency c-section as its got so much scar tissue in it it wouldn't dilate. But at least I am well and baby is fine.

[cmotdibbler]

I'd ask to see someone else and get their opinion on doing the LEEP when bf, as I've checked PubMed and other resources and can't find anything that says it would be harder to do when bf. Also, if she can see the cells on colposcopy, then she can remove them as its the same process.
Go with your questions and points written down so that you are really clear on what you want to know, and maybe take someone else with you for some support ?

[puffylovett]

thank you all again for your support and suggestions, i am compiling a list of questions and going to gp to see if can get a 2nd opinion... determined to continue bfing if poss, had set my heart on letting him self wean when he's ready.

[vole3]

I had loop excision for CIN3 8 years ago
My obstetrician did tell me about the risk of premature labour, but that it is at the 34 weeks plus stage rather than earlier.