Hysterectomy? Are reasons good enough?

At my last routine gynecologist visit in June my doctor told me I need a hysterectomy because my largest fibroid grew from 4 to 6 cm. and my uterus grew from 3 month preg. equivalent to almost 5 month preg. equivalent. This growth occurred over a 21 month period.

I have about 3 or 4 heavy period days with "flooding", followed by a week of spotting. Spotting varies from 'tarry' to 'mucousy' to 'blood tinged watery'. (sorry for being so gross in the description). Periods seem to have gotten closer...22 to 26 days apart.

I am a few weeks shy of my 49th birthday. My mother developed breast cancer at age 39, had a mastectomy and ovaries removed(it was routine back then)....then developed a new breast cancer on the other side 16 years later and succumbed to it within a 4 1/2 year period. My mother's mother also died of breast cancer at age 54 after receiving some quack treatment prior to seeking proper medical treatment. My father's birth mother died of some sort of cancer in her abdomen at age 33. Cause of death is given as "carcinoma of entire abdominal cavitiy".

I have sought two other medical opinions at two major hospitals in the city. Based on my history, they say hysterectomy.

my problem is that my symptoms are not bad enough to make me want to go through with a complete hysterectomy.

no paps or endometrial tests have been abnormal. estrogen levels are fine.

if i were "suffering" and had pain this would be easier to accept I cry all the time oer this decision.

Hello, I'm sorry that I don't have any answers for you. A hysterectomy is major surgery and even when people are in a lot of pain and bleeding heavily, they still doubt whether or not they should go through with a hyst. I bled non-stop for 11 months, and in the last few weeks before my surgery, even I wondered if I was doing the right thing.



From what you said, it seems that all your doctors seem to be in agreement that you should have a hyst. Now you must be convinced of it yourself before you can go forward with surgery. No one can make that decision for you. How nervous are you about developing cancer given your family history? How much do you suffer on the days of your period when you are flooding? Do you have a doctor who will sit down with you and discuss your feelings? If so, tell him/her exactly what you have written in your post here. This may help you to feel more comfortable with your decision.

Good luck,

Laura

I'm sorry about your mom and grandmothers! That must be pretty scary - worrying about any ol' hyst is bad enough without that family history.

I would look at your situation from two directions:

First, go only by what you know to be true for you now - how many days of bleeding, your level of discomfort, side effects from any drugs you have to take, how much it interferes with your life (sports, work, sex, vacations, social life, etc.), and how long until you expect to hit menopause. Make up a pros/cons list with everthing you can think of on both sides.

Next, consider all the "what ifs". Fibroids in general are very unlikely to become cancerous, but you have some special circumstances going on. I would set up a consultation with an oncologist and get answers to all your questions. Some ideas:

- Is the change in the size of my fiboids considered "rapid growth"?

- How accurate is the method used in detecting size? (That is, could they have actually not grown much, or at all, just been measured by different technicians on different days?)

- Given what we know about their size and growth rate, what is the likelihood that they could be cancerous?

- Are there any other tests that could help determine if they are cancerous, or are likely to become cancerous?

- If my mother and grandmother had breast cancer, does that have any relationship to this problem? (That is, am I more likely to develop uterine, cervical, or ovarian cancer because they had breast cancer?)

- Assuming the "abdominal cancer" my paternal grandmother had was uterine, cervical, or ovarian in origin, does that increase my chances of developing one of those? (Do those run in families?)


If the answers are that there is A) no link between a family history of breast cancer and your chances of developing uterine, cervical, or ovarian cancer, and B) your paternal grandmother's case doesn't change your odds a bit, then you are back to just your pros/cons list, and whether it's worth it to you to make your current problems go away.

Start writing your lists - maybe even some thoughts on "how I feel now", "what I'm scared of", "how I expect the next 10 years to turn out *with* a hyst, and *without* one". I'll bet with all that, you'll hit on some insights that will help you decide with more certainty one way or the other.

Best of luck!

Hi,

The ladies have brought up some very good points to consider. I can see how this would be a hard decision to make and can also see with your family history why the Dr's would recommend the surgery.

One thing, I would also recommend consulting a Oncologist but a Gyn Oncologist would be even better as this is their specialty. I also had a pretty extensive family history of cancer - Mother, Aunt - breast cancer and Father - Colon and Lung. I had my surgery for Ovarian cancer after which I found that while I knew my risk was high for breast there can be a link to ovarian (this does not apply to all ovarian cancers).

There are some tests available that you might check into. Some physicians are doing gene testing to see if you carry the gene that would greatly increase your chances of getting breast and this includes the ovarian cancers linked to it.

In addition, although its really not meant for a screening, there is a CA125 blood test available which picks up on a protein that elevates with some (not all) ovarian cancers. The bad thing of this test and why its not reliable for screening is that it can also pick up on other conditions such as endometriosis. This is really meant as more of a tracking tool to monitor an existing cancer not for screening. In addition, a vaginal or trans vaginal ultrasound might be a good test to have done if you haven't already.

I wish you the best in your search and decision. I do hope you'll get a consult with an oncologist as this may ease your mind significantly and help you make a decision you are comfortable with.

Take care,

Vicki

I just wanted to tell you I felt the same way about not having to many symptoms and am I doing the right thing. I also had fibroids. I must of had them for years and I never said anything about the pain I had in my right side until this years visit. After doing some research on fibroids I found out that the back pain, the bloating, maybe even the indegestion was all related to fibroids. (besides horrible cramps for 3 or 4 days, then the heavy bleeding) Well, I had my surgery on 6/11 and it was definelty my own decision. I will tell you I haven't had any indegestion, or back pain. I do get swelly belly but it is different than the bloating. I use to look 6 months pregnant by the time I got home from work. I started wearing elastic waist pants. Even after my surgery I still don't know if I made the right decision. I think I did. You have to do all the research you can and feel comforable with your choice. Don't rush into it. It took me a good 3 months to decide. This web side was a blessing for me. Take care Betty Ann