Path to Vulvar Cancer (high grade squamous intraepithelial lesion)

@mdr3 Can you please explain what HSIL stands for? Do you have that diagnosis? Also, what is AI? I'm asking the second question but I have vaginal atrophy and dryness and I use a moisturizer that works well for me.

Thank you and when is your next appointment with your doctor? Is the excision scheduled yet?

It is a pre-cancerous condition of the skin (High grade squamous intraepithelial lesion). An AI is an aromatase inhibitor I have taken for a year and a half after surgery, chemo and radiation for breast cancer. The vaginal dryness that these estrogen stoppers cause can be extreme, so that's what I thought it was. I pushed my primary care for a gynecological consult where I was taken seriously and received a biopsy; recently got the results. I'll see the doc Monday to discuss next steps. They'll want to remove the lesion I'm quite sure. This whole thing of no gyn and/or pap smears after age 65 is crazy. Had I been examined regularly this never would have happened (p.s. Estrogren creams wouldn't be an option because I had ER positive breast cancer).

Can you provide an update on your findings? Was it due to AI?

No it was not. They did one surgery, thinking they were removing the VIN3 skin condition. Pathology came back positive for SCC (Squamous cell carcinoma of the vulva). Second surgery: pathology was clean. The connection to the AI was my random thinking at the beginning of all this (in March or April) because initially I thought the symptom I was experiencing (itching) was due to vaginal dryness. No. It was due to the presence of a 1B cancerous lesion. Had I been getting yearly gyn exams (which now Medicare says is not indicated after age 65) we would have picked it up. Luckily, they did "catch it early" but it took 2 surgeries to get rid of this. I guess I would say never assume vaginal dryness and its symptoms are the result of taking AIs which tends to cause dryness in general

@brighterdays

Medicare did us a huge disservice with their age 65 coverage cutbacks. I am convinced that if I had an exam my aggressive endometrial cancer would have been caught earlier. Do prostate exams cease to be covered for men at age 65?! 😡

@nanang, welcome. Have you been diagnosed with vulvar cancer? How are you doing?

@mdr3
Hello. I just got the same results from a punch biopsy. Are you willing to share your surgery experiences? I am sure that will be the next step for me. I also take a AI for Stage 4 Breast Cancer.

@ffr I am not aware of any Medicare cutbacks. I have Traditional Medicare and a Supplement (G). I'm wondering what kind of exams for women you are referring to?

Do you have Traditional Medicare or a Medicare Advantage Plan through a private insurance company such as Aetna, United or something similar? I am aware that Medicare Advantage Plans require preauthorizations and sometimes turn down medical care for imaging, for instance, that Traditional Medicare covers. For instance, when I had a recurrence of endometrial cancer my medical provider ordered a PET/MR. Traditional Medicare covered the entire cost.

@sherrymcqueen Hi. Haven't been on here in a really long time. Had to re-up my user name and password. I tried sending you a private message, and maybe I have forgotten how to do that, but I'd be happy to share all the details that I think would be helpful if I could do it that way.