Path to Vulvar Cancer (high grade squamous intraepithelial lesion)

Posted by mdr3 @mdr3, Apr 20, 2023

Anyone have the diagnosis HSIL prior to vulvar cancer? Just wondering how to manage the pain of the lesion(s). Supposedly "not cancer" yet, but something that hurts this badly has to be something. Excision will tell the story. All I can say is, never assume you just have vaginal dryness from an AI

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@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?

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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).

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@mdr3

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).

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

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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

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