Fibroids, Options

Hello,

I'm new to this site. I have been seeking information about pros & cons of having a total hysterectomy, uterus only or none at all.

I am 46 years old with a very large uterine fibroid (grapefruit sized) that causes me a great deal of menstrual bleeding. I also have a cist on one ovary. My sister passed away at age 53 from Peritoneal Cancer which is very similar to Ovarian Cancer and my grandmother died from cervical cancer in the 70's.

My OB/GYN is recommending that I have everything removed because, she feels, I will worry about cancer and want the ovaries removed eventually. Because my fibroid is so large there are no other options for its removal that I am aware of. The bleeding is terrible and I'm severely anemic because of it (hemo 7).

I'm done having babies but I really don't want to throw myself into menopause yet. Not to mention the ovaries, I've read, continue to produce hormones all of your life.

I really would like to know what the benefits (pros and cons) of leaving the ovaries vs. taking everything or if I should just wait for menopause and see if the fibroid goes away completely.

Any advice is appreciated.

There are other options than abdominal even for large fibroids. My uterus is the size of a 22 week pregnancy and I am scheduled for a Davinci Robot assisted total hysterectomy in April. I am 51 and not yet in menopause and am not going to wait for them to shrink. It may be 10 years before I hit menopause, and I'm already anemic from the bleeding. It seems to me from my research that a hysterectomy is warranted in this situation even if there are other medical ways to shrink them, but if you are done bearing children, is there really a use to go a less radical way'? Especially if you have a family history of cancer.

I am also struggling with whether or not to keep my ovaries. Haven't decided yet.

(((Jan Mc)))

It definitely is a big decision to make, that's for certain. If your primary reason for taking the ovaries is the cancer risk, perhaps you could consult a gyn/onc (gynecological oncologist). They are the experts for gyn cancer/pre-cancer and could probably advise you more accurately on risk factors, etc., than a regular ob/gyn. Besides, it's always a good idea to get a second opinion.

FWIW, I was 37 when I experienced surgical menopause, and although it was no walk in the park, it is do-able. My hyst was due to cancer, and since I had a history of melanoma as well, we did take the ovaries. Obviously, the fear of OVCA would be gone if you go that route, but you might want to be cautious about getting rid of perfectly healthy organs if there's no real increased risk.


monami

It always amazes me that doctors are so quick to remove women's healthy organs but so reluctant to remove men's diseased organs. (I have a friend with prostate cancer whose doctor didn't want to operate because he said it might make him impotent and/or incontinent.) Hysterectomy can also make women incontinent and have sexual dysfunction but that doesn't seem to matter.
Are you worried about getting cancer? Cervical cancer isn't hereditary.
I have done research on fibroids and I know doctors out there that believe that no fibriod is too large to remove.
I have read some studies on keeping ovaries verses taking them out and they are unanimous that keeping them in far outweighs the benefits of taking them out. There are such benefits as reducing your risk of heart attack which is the number one killer of women. Bear in mind doctors always have a conflict of interest when they recommend surgery.

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It always amazes me that doctors are so quick to remove women's healthy organs but so reluctant to remove men's diseased organs.

In my case what was even more interesting was that my GP (a woman dr, in her 50s) recommended a total hysterectomy including the ovaries, while the surgeon I consulted later (male, in his mid 40s) recommended saving the ovaries if at all possible.

The GP (woman) had had a TAH earlier herself, maybe that colored her perception, she also didn't think I'd be a good candidate for the DaVinci, which the Davinci surgeon and another GYN both agreed I was a good candidate.

I got the feeling that for her the only hysterectomy worth doing was a TAH and that if I left the ovaries in I'd be heading for ovarian cancer. I don't have a genetic risk for any female cancer so I'm kind of turned off by her attitude. and all tests have come back normal. I think I'll be gone looking for another GP soon.