Hysterectomy or Not??

I have a prolapse and am scheduled for operation this coming Monday 3/19. Thebladder is protruding but not my uterus. I don't have any incontinence (never once even) which evidently many do have with the bladder coming into the vagina. I had breast cancer 1993 and had two mastectomies but have been cancer free since then, thank God! Now, the question is, my doctor asked me if I wanted to have a total hysterectomy when he was working in this "area" as many women choose to do so, he said. I had no plans before to have this hyst. but I started to think that maybe it would be a good idea because of my earlier cancer. I have tried to get opinions as to this from other doctors but it is 50/50 so far and I am still confused what to do this Monday! My oncologist said he would do it if in my shoes, another doctor said that sounds like a good idea, and a female gynecologist just said that most women choose to do it. Some other opinions have been against it. Iam 66 years old (young) and very active with my own business. This prolapse is stopping me from feeling really good. - But would anybody know if there is a connection between breast cancer and later ovary cancer development? My doctor said it is fairly easy to detect cancer of the uterus, but not around the ovaries. My uterus has dropped about an inch so it seems to me that it chould stay where it is for some time if not removed. I have started to read some books about all this and it says that 50% of women who have hysterectomies get problems of different sorts afterwards. Is that right?? Also, I have read that the ovaries continue to give out good hormones even after menopause. And it seems that even if you take out the ovaries you can still get cancer in the nearby areas,so I am not sure about the preventive reason in all this. I had decided about 80% to have this total hysterectomy, butthe more I write here and read in books today, it seems that it might not be such a super idea as I first thought it might be!??? i would very, very much appreciate any comments on all this - I know this is not a doctor visit, but still very wise comments, I am sure. Sign me uncertain what to do - Hillevi

Hillevi,

I did read your other post to me, thanks. You first, but I can't address all the points.

I think that both breast cancer and gynecological cancers are or can be fed by hormones. This might put you at higher risk for cancer in this area, but I would do a search on say. ovarian cancer and endometrial or uterine cancer. There should be some risk factors listed along with information on these cancers. Read many different articles even if you find information addressing this point on one, as opinions can vary.

Are you on hormone replacement now? Based on your age, I am going to make a guess that you have been through menopause. If you are on HRT already, you already know what it will be like, and I personally would stick to the same regimen unless you start to experience problems. If you're not on HRT (maybe because of your previous cancer?), you might be able to take very smal amounts, or maybe even some supplements to make up for the small amount of hormones your ovaries are still supplying, though you will probably have many less noticeable effects than if you were pre-menopausal now. Ask some more questions on the hormone jungle page. I've done some reading there myself since ovary removal became an issue.

The choice is always yours, but especially since your oncologist thinks it may be a good thing, I would personally be inclined to do it if I were you. I am assuming you have a good relationship with your oncologist. If mine got me through breast cancer and 2 mastectomies, I think I would be. WOW, that is fantastic, by the way!! Yes, ovarian cancer is sneaky. I have heard quotes that it "whispers," but HIGHLY unlikely that you will get it after ovary removal, though it is technically possible as there may be a few cells left behind. Only the REMOTEST possiblity, so you would be able to relax and live your life without worry in this area. Even if not for that, it may make your life better if having your uterus is in any way contributing to your prolapse problems.

In any event, I know that there will be other ladies along to answer these questions better than me, but I want to wish you well, and maybe put your mind a little at ease. I am so glad you are doing so well after beating cancer!! Good luck to you.

Karri

Hi Hillevi

I tend to be conservative about these things and wouldn't do any unnecessary surgery. It is true that your ovaries and uterus continue to be useful even after menopause. I just had both out three years after menopause and started having hot flashes again and now am on HRT.

Maybe 50% of women who have hysterectomies have problems if you count pain as being one of them! I don't know, but it is major surgery that you only do if it's necessary.

I have also read that you can get ovarian cancer if your ovaries are removed. My doctor insists that this is not so, at least in my case, because, she claims, that all the ovarian tissue has been removed. She says it it had been cancerous I could then get a recurrence.

Yes, it is true that ovarian cancer is difficult to detect. Whether or not you are more likely to get ovarian cancer because of your breast cancer could depend on the type of cancer you had. Not sure.

If you are having frequent follow-ups because of your previous surgery, and they include ultrasounds, it seems to me it would be likely that you would catch any ovarian cancer early, since any increase in size in your ovary would be suspect.

Many, many doctors would suggest that you have a total hysterectomy just because you don't 'need' your organs anymore and they COULD become malignant. On the other hand, like I said, I found out that even my diseased ovaries were doing some good for me and we do't know what our chances are of getting cancer, although the risk is higher the older we get.

You sure do have a few things to think about! Also, I'm wondering what your recovery time is estimated to be if you do not have the hysterectomy. It will be significant if you have the hysterectomy, and you and I are no spring chickens like some of the othere on this board. It makes a difference!

I'll be thinking of you on Monday and watching to see what your decision is.

Hi Hillevi,

I know this is a difficult decision and it will be YOUR decision but I'll share my own personal experience.

I had a significant family history of breast cancer, lost both my mother and aunt to it many years ago. This was way before they have some of the preventative measures they do now. I have known since that time I needed to be screened regularly and had a higher risk of getting breast cancer. What I didn't know was that it also increased my risk of developing ovarian cancer. It is a hard cancer to diagnose as many of its symptoms are vague and can be confused with other conditions.

At this time, I am unable to take any HRT due to my cancer being estrogen receptive but have not really experienced any problems that are unmanageble.

I wish you the best in your research and do hope you'll be able to come to a decision that you are comfortable with. BTW, have you tried posting on the Cancer board? There might be some ladies that have dealt with similiar issues that might be able to shed some further light.

Take care and please keep us posted on how you're doing.

Vicki