Ovaries: To Keep or Not to Keep...That is the Question

I'm 40 and have been diagnosed with complex hyperplasia with atypia. Had a biopsy and D&C and they did not see cancer but based on the MRI/CT Scan, my doctors feel fairly certain they will find cancer when they perform the hysterectomy. The MRI showed potential invasion into the uterine muscle and (in my layman's terms) the atypia is at an advanced architectural stage which would make them think it has/will move from pre-cancerous to cancerous. The gyn/onc says if he finds cancer during the surgery he'd remove the ovaries, of course. But if not he's still recommending removal to get my levels of estrogen down as much as possible. He says if we feel differently, though, we can certainly tell him our wishes. Had to think through the fertility question as my husband and I hadn't had kids yet, but I don't think we'll be looking to freeze the ovaries to harvest the eggs. So that leaves whether I keep them to prevent the immediate menopause, etc. I've been told it will be difficult to be thrown right into menopause and that they won't be able to use the normal treatments because the hormones would be contraindicated because of needing to reduce my estrogen...I just don't know if that outweighs removing them and being certain there wasn't cancer left behind in them. The other piece I'm thinking about is that a lot of woman on my mom's side of the family went into early menopause by their mid-forties so if I'm keeping them to prevent menopause, that might not really stave it off for long. I'm just pondering it all and if anyone has any helpful thoughts or insights they learned or thought of as they were dealing with this, I'd appreciate hearing about them.
Thanks!
Nora

Hi Nora
I don't have any useful insights. But I can recommend you find the cancer threads - there would be plenty of sisters there that can share their thoughts and experiences with you.

It is a tough dilemna isn't it?

I had a benign ovarian cyst, so I got to keep one and a half ovaries. And I am glad. But my instructions to my surgeon were take them if you are concerned or they look like they might be impacted.

take care

I had to make the decision and I still don't know if I made the right one. (Too late now anyway). For me, one GYN onc told me it was standard of care and I'd never know the extent of the cancer without removing the ovaries. A 2nd GYN onc verified that but said I had about 10% chance of the cancer having spread to the ovaries. 10% seemed high to me considering I wouldn't have any early warning if cancer was already there. So I had them out, in a separate surgery in fact. Since the cancer hadn't spread there, it makes me wonder if I should have kept them. But its a done deal and all I can do is share my experience. I have peace of mind that I don't have cancer lurking within and that worry is what made my decision. One thing is, you may consider a 2nd opinion on ovaries and nodes. But if need be you can have a 2nd surgery if the cancer is more extensive than expected. Not preferable but possible. Really I have no good advice, just my experience. Best wishes finding the right decision for you.

It's definitely a hard decision, and I wish you nothing but best wishes and peace of mind as you figure out what makes the most sense for YOU!

But, just to hit on what you said about your family going through menopause at an early age -- Your ovaries don't become completely useless after menopause. They actually continue to "dribble" smaller amounts of hormones which can help with your overall health. Not trying to make your choice even harder or more confusing, but I just thought I'd mention that as something else to keep in mind.

I guess I'd just suggest really weighing all the pros and cons, on your own, and with your doctor, and see which way things lean. Whatever you do decide, I hope it all works out for the best!