the Next Steps After a Stage 1 Cervical Pre-Cancer Diagnosis

The diagnosis of stage 1 cervical precancerous lesions has been made. What is the correct follow-up process?

Hello, Doctor.
I have been getting Pap smears at the Cathay Clinic in Neihu every year.
Until the end of last year, my results came back abnormal.
I subsequently arranged for a cervical biopsy and HPV testing.
Fortunately, I tested negative for HPV, and the doctor only advised me to have a Pap smear every three months for regular follow-up.
She did not explain the causes or preventive measures, which I found unsatisfactory, so I switched to another doctor.

During my first visit with the second doctor, my Pap smear report indicated inflammation.
After three months, I had another Pap smear, which again returned abnormal results.
Yesterday, when I went to discuss the results, the doctor informed me that I have stage 1 cervical pre-cancer.
She asked if I wanted to undergo cryotherapy or continue monitoring for another three months.
She mentioned that improving my immune system might help my condition.
I decided to opt for the three-month follow-up, and if the Pap smear results are still abnormal, I will proceed with cryotherapy.
Is this treatment plan appropriate? I am worried that I might have other options that the Cathay doctors did not inform me about.
I also plan to get the nine-valent HPV vaccine next year, regardless of whether I undergo cryotherapy, as I am very concerned about the possibility of developing cancer.
Additionally, I would like to ask about royal jelly.
I usually take it for its anti-aging benefits, but I found information stating that individuals with a history of breast cancer and uterine fibroids should avoid it.
Given my cervical pre-cancer diagnosis, should I also avoid royal jelly? I have a lot left that I haven't consumed yet, and I'm worried.
Would taking one capsule a day have any impact?
Thank you very much for your assistance!

Double, 30~39 year old female. Ask Date: 2022/10/19

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, for stage one cervical intraepithelial neoplasia (CIN), both electrosurgical excision and cone biopsy are options.
If subsequent follow-ups show no abnormalities, considering the HPV vaccine is also an option.
As for royal jelly, it is likely unrelated to cervical lesions.
Wishing you good health!

Reply Date: 2022/10/19

More Info

Understanding the next steps after a diagnosis of cervical pre-cancer, particularly Stage 1, is crucial for managing your health and reducing anxiety about potential progression to cervical cancer. It sounds like you have been proactive in seeking medical advice and follow-up care, which is commendable.
When you receive a diagnosis of cervical intraepithelial neoplasia (CIN), particularly CIN1 or CIN2, the management often involves careful monitoring. CIN1 is generally considered a low-grade lesion that may regress on its own, while CIN2 and CIN3 are higher-grade lesions that may require more intervention. The fact that your doctor has recommended a follow-up Pap smear every three months is a standard approach, especially if you are not HPV positive. This allows for close monitoring of any changes in your cervical cells.

The decision between undergoing a procedure like cryotherapy (commonly referred to as "electrosurgery" or "LEEP") and continuing with observation depends on several factors, including your age, overall health, and personal preferences. If your follow-up Pap smears continue to show abnormal results, then proceeding with a treatment option may be warranted to prevent progression to cancer.
Regarding your concern about other options, it’s always beneficial to seek a second opinion if you feel uncertain about your treatment plan. You might also want to discuss the potential benefits of the HPV vaccine, especially since you are considering the nine-valent vaccine. This vaccine can help protect against the strains of HPV that are most commonly associated with cervical cancer and may provide additional peace of mind.

As for your question about royal jelly, while it is often marketed for its health benefits, there is limited scientific evidence regarding its effects on cervical pre-cancer or cancer. Generally, dietary supplements should be approached with caution, especially if you have a history of hormone-sensitive conditions. It would be wise to consult with your healthcare provider about the safety of consuming royal jelly in your specific situation, particularly since you have concerns about its effects given your medical history.

In summary, your current plan of monitoring with Pap smears every three months is a reasonable approach for managing Stage 1 cervical pre-cancer. If abnormalities persist, further intervention may be necessary. Additionally, discussing the HPV vaccine and the use of royal jelly with your healthcare provider will help you make informed decisions about your health. Remember, open communication with your healthcare team is key to navigating your treatment options effectively.

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