[Question #1933] hpv cin 1 petrified

46 months ago
For my 50th bday I had an abnormal pap acsus hpv e6/e7 !  Had colpo showed cin 1 size of 1/3 of a dime.  For last few years vaginally I burn & get red biopsy shows dermatitis .  Pap done 3 mths  later negative for hpv normal pap and another 3 mths still normal .  I have OCD of health issues always scared .  I feel like I am a sitting duck waiting for vulval cancer especially cause I get red and burn  .  Not sure how suddenly I got hpv as I have been married 22 years we are faithful & I have had the DNA test years ago and was negative   .  Since I was cin 1 before am I likely to get cancer ?  I am petrified that it's just a matter of time 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question.

First and most important, CIN 1 is to be ignored as a health threat. The numbers seem to imply that infection can progress from CIN 1 to 2 to 3 and ultimately cancer. That's what was once thought. But in the past 20-30 years, science has learned that CIN1 almost never progresses. If an HPV infection is prone to progress to pre-cancer or cancer, it presents from the beginning as CIN 2 or 3. You should follow your doctor's advice if she recommends treatment. However, even without treatment, you can expect CIN1 to clear up without ever progressing. Most likely your doctor will agree, and I expect she will simply want to follow repeat paps or perhaps colposcopies to observe it, without actual treatment. (Unless she senses your anxities and concludes the treating the infected area, clearing it up more rapidly, would help you deal with the problem.)

I will also add that nobody dies of cervical cancer, if the disease is detected before it becomes invasive and the patient is offered, and complies with, standard treatment and follow-up. Even when CIN2/3 progresses to actual cancer, it is typically another 5 years before it starts to invade and becomes dangerous. So even if your CIN1 was misdiagnosed and is really CIN2/3, you really are not at serious risk. (I almost hate to raise this, given your self-professed OCD. I'm not implying such misdiagnosis is likely. It is not.)

As for the source of your infection, there is nothing unusual here. HPV is a tricky, sneaking virus. We don't understand why it sometimes reappears years after it was acquired. It means nothing about your general health or the status of your immune system. It just happens and appears to be random.

Bottom line:  Follow your doctor's advice about follow-up. If you doubt anything I've said about it, discuss it with your doctor. (You could print out this thread as a framework for discussion.) I'm betting s/he will agree with all I have said.

I hope these comments have been helpful. Let me know if anything isn't clear.

HHH, MD

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46 months ago
thank you for your response.  What I am very concerned with is vulval cancer from the HPV. Also, when I was first diagnosed with  an abnormal pap hpv + it didn't say what strain just said 16,18/45 & that  it test for 15or so strains.  I was e6/e7 positive but on  colposcopy only e6 not e 7.  this was in August.  Retest pap and colposcopy 11/16 showed normal pap so couldn't say what strain and  pap and colpo again on 2/23/17 again completely normal. I am  scared I am going to wake up with vulval cancer. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
I'm sorry you didn't tell me initially that your pap had become normal, twice. As my answer suggested, that's exactly what usually happens. You're in the clear with respect to your cervix, although of course you should follow your doctor's advice about possible additional follow-up paps and/or HPV tests.

Vulvar cancer is rare, even in women infected with the highest risk HPV types. And it's rarely dangerous anyway. Given your anxieties about it, I'm sure you'll notice any abnormality early. And even then, there is little hurry. Vulvar cancer usually is entirely curable within a few years of onset, with minor surgery or chemical treatment. This really isn't something that should worry you.

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46 months ago
thank you , yes I mentioned my normal  pap first if you notice it says pap done 3 mths late normaland another 3 mths stlll normal.  I am more worried about cancer  from HPV on vulva, vaginally or orally than on cervix.   My therapist is trying to help  since I do have diagnosed severe OCD  of health issues.  I just don't understand how I have had myself tested DNA for hpv several years ago been in a faithful marriage for 25 years and now at 50 I get it?  I read my husband the riot act even though he in all the  years I have known him isn't the cheating type.   Took him to my therapist and am  positive he wasn't unfaithful.  This is confusing and scary. I know the CIN 1 can  come back and  I am leary it's gone as the 1st colpo was in  aug. but only the area of a third of a dime and 3 months later I was in the clear and the follow up 3 months after that was clear as well.  The transformation zone nevertested abnormal.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
I'm sorry to hear you're having such a difficult time dealing with this. You seem to understand that the main problem you have is with your OCD, not HPV -- but I understand how these issues are interacting. I can only recommend you continue to work with your therapist on this, and use his or her guidance to channel your energies -- especially in regard to your husband. He's just an innocent bystander in all this.

I'll close this thread with two straightforward facts:  1) For the reasons discussed above (re-read my prior replies), the chance you will develop any cancer due to HPV is extremely low; and if you do, almost certainly it will be detected at an easily curable stage. 2) HPV does this -- i.e. goes dormant with the potential to reappear years later. There is no known cause; it appears to be random. There is nothing you could have done to prevent it, and this has no implications for your overall health or your immune system.

That completes the two follow-up comments and replies included with each question and so concludes this thread. I suggest you consider printing out the entire thread and using it as a framework for discussion during your next visit with your OCD therapist. In the meantime, do your best to put HPV aside and stop worrying about it.

I do hope the disucssion has been helpful. Best wishes.

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