Rethinking hysterectomy options -help

Hi,

I am scheduled to have a hysterectomy on Jan 11th. I am beginning to rethink my options because of all the info on this site and others. I am 50 years old, never had children, never had an abnormal PAP in my life, I was diagnosed with lobular carcinoma insitu (LCIS)10 years ago (no changes or abnormal mamms since) --- I have fibroids; according to my surgeon they are the size of grapefruits.
At 1st glance I was going to have a total hys. With all the info on this site I am now going to tell my surgeon this Tuesday that I want to keep my cervix! The other option I am reconcidering is keeping my ovaries (if not both at least 1). I have not had any premenopausal sympytoms to date but I am sure due to my age I will very soon. The question I have is due to LCIS and nearing menopause should I remove my ovaries or keep them? I would appreciate all input. Thanks.

Hi!

Well, my response is.....have a very serious chat with your doctor about your concerns.

I had an LSH. I kept both ovaries and my cervix. I have not regretted my decision...in fact....it was one of the best things I have ever done, health-wise. I feel so much better now, no horrid periods, no periods that will not stop....I am able to travel and not worry how I will get through the trip, etc.

I feel good...the only odd thing is feeling "out of it" once in a while and realizing that it is PMS! LOL!!!

In my opinion, and that is all it is MY opinion....I would keep the ovaries if given a choice. The reason is that you can then go through "natural" menopause. I am not sure if I am going through it or not. Sometimes I think I am having a hot flash...but then I do not feel that way for months. Go figure.

Best of luck to you!

The hardest part of the pre-op for me was the decision about the ovaries. I had to have a hysterectomy (large fibroid), but the doctor told me the ovaries were up to me. These are the things I thought about:

Age: I am 46. My doctor told me that 45 is a somewhat arbitrary cutoff age in terms of having ovaries removed--that if you are younger you might consider leaving them; if you are older you might consider removing them. Clearly this is because of the length of time between surgery & going through natural menopause.

Ovarian Cancer: This is a small risk, but it is there AND I was told that it is very difficult (or impossible) to detect in advance. Thus, when doctors find it they often find it too late. This is unlike cervical cancer or breast cancer than you can be tested for at early stages.

No kids: I also have never had kids. In my reading on the subject the more kids you have (and thus the fewer times you ovulate) the less likelihood of ovarian cancer. Thus no kids meant a higher likelihood of the cancer (albeit, still fairly low).

Family members with ovarian, breast, colon: It seemed that having relatives with these cancers meant that there was a higher likelihood of ovarian cancer. I don't have any family members with these cancers.

Ovaries continuing to produce hormones: It is true that at age 46 I still had functioning ovaries, but I decided that their functioning was going to end relatively soon and bring with it the menopausal symptoms.

As you can probably tell from reading this, in the end I decided to have my ovaries removed, but not without a lot of discussion with my friends, doctors & doing a bunch of research on line. The issue that really made me finalize my decision was my age. Unfortunately, I didn't find a lot of advice that didn't take age into consideration. I think that advice either to keep them or remove them without taking age into consideration doesn't make much sense.

Good luck with this decision--it is a tough one. I don't regret my decision at all.

I'm 52. I kept my cervix on the advice of my doc (my main complaint was prolapse.) I did a lot of researching as breast cancer runs in my family trying to decide if I should have my ovaries taken. I ultimately decided to keep them but told my surgeon to remove them if they looked diseased.

My doc sent me 3 very informative study summary papers from the ACOG on whether to keep ovaries or not and that information was extremely helpful. Part of your decision might be based on if the LCIS was estrogen postitive or negative.

Thanks for all your replies....

I am going to see one of my surgeons tomorrow morning. Thanks to all of your input (and reading other messages) I now have a whole list of questions I am going to ask. Also this morning I made an appointment with a da Vinci surgeon at the Cleveland Clinic for a consult next week Dec. 31st -- I have continued researching this and it may be the way to go since I only have fibroids; it is my body and I want the least invasive, quickest possible recovery with the least amount of pain. I did leave out one bit of info about myself -- my mom is 75 and she has 4 sisters (the youngest one is 65) and there is not one bit of cancer in the family; so I will also use this info also as part of my decision making (I used this when it came to decide if I was to go on tamoxifin 10 years when diagnosed with LCIS - and I didn't go on it and I have not had any changes in my breasts for 10 years)

All of you, I can't thank you enough for your input and this entire site -- I won't be making any decisions from this point on without asking a lot of questions and making "informed" decisions. thanks.