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Crohn's Disease Forum » Treatment » Imuran/Azathioprine/6-MP » One for the ladies....smear tests!


05-10-2013, 01:50 AM   #1
starsparkle
 
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One for the ladies....smear tests!

Hello!

I am due to start Azathioprine asap to help manage the Crohns - been flaring on & off for a good few months now and after discussion with specialist IBD Nurse, it seems its time to start getting treatment (Ive gone unmedicated since diagnosis in 2010).

The nurse advised me that aswell as various vaccinations, I should make sure my smear tests were upto date before starting the Aza.....I didnt think anything of this as I have always had normal smears & never missed any (Im 29). So, I had my smear done and turns out there are 'minor changes' and Ive to go discuss with my GP next week.

My understanding is that 'minor changes' arent usually much to worry about and are certainly doesnt suggest pre-cancerous cells at this stage - however my worry is that if I have changes/HPV virus (likely cause of the changes) that being on immunosuppressant medication like Aza is going to make me less likely to be able to fight off these abnormal cells/HPV and they'll eventually develop into something more serious!

Does anyone have experience with this or know if being on meds like Aza makes us more likely to develop pre-cancerous cells/cervical cancer (esp if already have 'changes' in cells)??
05-10-2013, 02:41 AM   #2
Jennifer
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I had an abnormal pap 10 years ago and was told that I had high risk HPV. I was on 6MP at the time and took it for close to 10 years after that abnormal pap. They did a biopsy right after the abnormal pap and no cancerous cells were found. I had a pap done each year after and they all came back normal. Keep getting them done as usual to make sure.

Here's info I've found regarding cervical cancer:
"They concluded that AZA use does not substantially increase the risk of colorectal, other gastrointestinal or extra-intestinal cancers in IBD. However, there was a slight, but non-significant, increase in cervical cancer, which has also been reported in the immunosuppressed transplant population.[33,34]" http://www.medscape.com/viewarticle/507462_3
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Diagnosis: Crohn's in 1991 at age 9
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Currently in: REMISSION Thought it was a flare but it's just scar tissue from my resection. Dealing with a stricture. Remission from my resection, 17 years and counting.
05-10-2013, 07:28 AM   #3
LindaS
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Hmm. I never heard that. As I'm now in my mid-40s, and don't plan to have kids and have never had an abnormal pap, I was told to move to every 5 years for a pap smear. I guess that is something to ask, as I'm due for my next one in a few months.
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05-10-2013, 08:26 AM   #4
starsparkle
 
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I had an abnormal pap 10 years ago and was told that I had high risk HPV. I was on 6MP at the time and took it for close to 10 years after that abnormal pap. They did a biopsy right after the abnormal pap and no cancerous cells were found. I had a pap done each year after and they all came back normal. Keep getting them done as usual to make sure.

Here's info I've found regarding cervical cancer:
"They concluded that AZA use does not substantially increase the risk of colorectal, other gastrointestinal or extra-intestinal cancers in IBD. However, there was a slight, but non-significant, increase in cervical cancer, which has also been reported in the immunosuppressed transplant population.[33,34]" http://www.medscape.com/viewarticle/507462_3
Thanks for this - puts my mind at rest a bit. Hopefully they'll just want to do more regular smear tests for me & thats what my GP wants to discuss (usual is every 3 years here in the UK so Im hoping for a yearly check at least).

Let you all know if I get any more info on this kind of thing at my appointment.
05-10-2013, 09:46 AM   #5
lizbeth
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Good luck at your appointment. Think I might be starting Aza soon so was very interested to read your post. I've been having vaccinations in preparation, including the HPV one (I'm 44 and even my IBD nurse was surprised I was getting it?) I don't know the answer to your question, sorry, just wanted to let you know I was thinking about you, take care.
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05-11-2013, 08:39 PM   #6
CrohnsChicago
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Im 29 as well and never heard of that and I asked my GI of all the possible risks associated with 6MP and Imuran and other meds. I'm due for a pap in a few months so I will make sure to ask them as well as check with my GI on this.

Hope your tests are clear now and in the future. Good luck on aza!
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Crohn's-Colitis May 2012
Current Meds:
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Prednisone/ Entocort / Flagyl
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B12 Shot (1cc/mo) / Multivitamin / Vitamin D (1000iu) / Calcium (1200mg) / Omega 3 Fish Oil (4800mg)
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Anemia/Borderline Anemia - whole life
Generalized Anxiety Disorder - 2009 (Cognitive Behavioral Therapy, mindfulness meditation)

05-16-2013, 10:31 AM   #7
starsparkle
 
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I spoke with the IBD nurse about this and she's advised that yes, Aza can increase the risk of ALL cancers but as long as we get regular smears done they can keep an eye on things - actually hoping I get them more often now so I will always be sure what position Im in. Will let you all know what the doctor says about this though!
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