42. The C Word

from an email received March 23th:

"I have an appt. for the 15th of April - but I have to say - I think it's crazy you have to wait so long for an appt. when its something potentially as serious as this is. I'm having a hard time concentrating on anything else. My father was recently diagnosed with cancer so this is making me crazy. I think three weeks can make a huge difference in whether or not someone beats a disease... or not!"

Two possible replies:

1. Explain that an abnormal Pap smear usually diagnoses "precancer," (dysplasia) not cancer, and that the progression from dysplasia to cancer takes years, so a three week delay really is acceptible. Three months would be okay. Three years not okay.

2. Offer an appointment tomorrow, my call day so it may mean some extra shuffling back and forth from the hospital to the clinic, but usually doable.

Number two of course. The time to talk about the difference between dysplasia and cancer or about the natural progression of the disease is BEFORE not after the results are known. But I'm not the one who obtained the Pap smear.

p.s., biopsy obtained during the appointment; she has moderate dysplasia (maybe 10% chance of become cancer over a few years). She accepted a procedure that will remove a button-size segment of the cervix, almost always including all of the dysplasia)