Trying to decide what to do.. *sigh* (a bit of a rant)

I'm 33...no kids (cept a neurotic, cat with an oral fixation)...new hubby (married July 4th). I was dx with complexthyperplasia w/ atypical cells last October. My gyn put me on progesterone 30mg a day...and retested with hysteroscopy in Feb. ...she said there was nothing there on the retest.

So, since Feb. I've still been on 30mg progesterone a day, as hubby and I had hoped by now we'd be in a position to try for kids. We aren't...in fact the earliest we would be able to consider it would be 2-3 years away as we want to move the US and would need to get sorted with new jobs, health insurance, etc.... We don't want a baby when we are barely keeping our own heads above water.

I went back to the gyn last Friday and she is strongly suggesting I have the hysterectomy. She is concerned that I can't stay on this dose of progesterone indefinitely and that when it is reduced or if I go off of it, the CHA will return.

Now, being a university academic, I've been pouring through our medical databases and all it has done is add more confusion. On the one hand, the lack of a conclusive/standardised classification system for hyperplasia is a concern, as pathologists looking at the same samples differ over what it 'is' ...other studies suggest that hysteroscopy and biopsies may miss cancer that is already present...and yet others suggest that in young women who have the CHA regress with progestin therapy, they generally have a recurrance with/or without cancer within 5 years (the mean was 4.5)...but most of these studies were looking at small samples of people. *sigh* All of those *seem* like they would be good reasons to go ahead with the surgery....

But I just can't committ either way....to trying to stay on the progestin therapy longer, running the risk that there may have been cancer already present and with no clue what the rogue cells have been up to since February....OR to saying 'rip it all out'.

In amongst me trying to decide, I get the news that my sister in law is pregnant again. *sigh* I just don't know how to make this decision. My hubby (bless his lil cotton socks!) is wonderful...listening to me one minute say "that's it...surgery it is"...and the next minute going "no! Budget be D$%#NED! Let's go for a bub"...but then again, his fear is that something is already lurking in there. This is compounded by the fact that I am at great risk for gestational diabetes (I'm already insulin resistant), I've got high blood pressure, high cholesteral, etc....

How do you decide if the 'risk' is worth it. I mean, the studies suggest that untreated CHA (most people conveniently ignore the 'untreated' bit of this statistic) converts to cancer in 30% of cases. Now, if you consider that 30 people in 100...that is 70 who didn't get it which doesn't seem too bad. But if you consider it from the 'glass half empty' point of view...it's pretty darn close to 1 in 3 women.

ARGGGGGGGHHHHHH!!! I so wish someone could just tell me..DO X... *sigh*

Oh boy you've got a lot to think about. I really don't have any advice, just some I hope you can somehow figure this out. One thing I can say is that statistics are numbers, not real people. You and your hubby need to listen to your Dr's, and listen to your heart, and your own gut feeling about what is the right thing to do. Sorry I can't be more helpful, but maybe someone else will come along with a similar experience.

I've got a big for you. so much to think about! Can you at least get a couple of opinions to sort of feel out your options? I would strongly suggestion seeing a gyn/oncologist if you have not already. They are the ones that are really on the up & Up with these things.

good luck, I know this period of being unsure of the best path to take is very, very draining and confusing.

in there,
xoxo
k9

Hi Dani,
In the end the decision is ultimately yours to make. I would suggest writing down the pros and cons and see which one outweighs the other. Then discuss it with your docotor.
Good luck to you.
Rosalie

Hi Dani,
I am so sorry you are facing this at a young age and newly married. If at all possible please try to get the opinion of a gyn/onc. Speaking with an expert may help you consider any alternatives, timing, etc.
I did discuss using progesterone and/or megace with two gyn/oncs to treat CHA and both said they only considered this when a woman wanted to try to conceive soonest and if these hormonal treatments were used then testing needed to be frequent to watch for recurrence.
I'm wishing you the very best and please let us know how you are doing.
s,
peggiesue