Complete hysterectomy, should I? after est.+ BC
My oncologist wants me to have a hysterectomy, and I have been putting it off now for a year. Had stage 3 cancer, with mas., chemo, rads. I really don't want to do this, worried about quality of life after. I am 42. I am currently taking Tamoxifen and haven't had a period since my chemo in Sept. -Dec. of 2008. I scheduled the hyst. but am having second and third thoughts. Really what is the percentage its gonna decrease my reoccurence rate? Any women have it done? I have no problems with my female organs, all look good, had internal ultrasound and pap, came back clear.... I don't know what to do, op scheduled for March 25. Scared!!!
Comments
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I finished up my treatment this past Nov, Lumpectomy, chemo, and rads. I had a total hysterectomy in Dec. I am not sure how much that decreased my chances of recurrence but for me it was an easy decision. My thoughts were that if it was estrogen positive I wanted to do whatever I could to get rid of it. I figured it had to improve my chances. The surgery itself was very easy and I havent felt any different since having it. I do not have any side effects from having it done and was put on Arimidex. I hope you will find peace in making that decision.
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Why does your onc want you to have a hysterectomy as opposed to just having your ovaries taken out? As far as I know having an intact uterus poses no risk for recurrence--it is the ovaries that are the issue. The recovery from just an oopherectomy (ovaries only) is a piece of cake and it is usually done as an outpatient procedure. If the uterus is healthy--why take it out and have more complicated surgery if you don't need to?
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I absolutely agree with Cindy - why the full hysterectomy? I had my ovaries and tubes removed (bilateral salpingo-oopherectomy) and it was a very simple day procedure. Tamoxifen can increase risk of developing uterine cancer - but the risk is very small and certainly no reason to remove your uterus! I would definitely not go down the hyst route - especially as you have no other problems down there.
Good luck.
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HI,
I don't have a BC DX and am still at the "want to get a biopsy" stage, but, I did have a total hysterectomy 5 yrs ago, when I was 50. It was easy for me since I had ovarian cysts and some uterine fibroids. The whole procedure went well for me. I think I took pain meds for a couple of days. Vaginal laproscopic surgery, no scars, just a plug of glue in my belly button!:) I was tired for a few mos afterwards, couldn't drive or do any normal housework, etc for several wks, but I tried to milk that while I could! I'm sure you have already experienced much worse. I had one emotional moment when me and my (now ex) hubby were out of town in a hotel and trying to go to sleep-I suddenly out of the blue missed my uterus, the thought of it carrying my babies,etc. and cried for a few minutes. My hubby was very understanding and I got over it pretty fast. I think that was 2 or 3 mos after surgery. I surprised myself....I thought I would have to go thru a big grieving process, but it never really happened. I haven't missed any part of it since and am glad it's done and one less thing to worry about. Doc put me on HRT patch immediately, but I had a skin reaction and then put me on BCP's , which I stopped quickly, worried about the estrogen and BC; I did have a few post menopausal issues, but nothing severe enough to take meds for...mild hot flashes, insomnia, vaginal dryness, moodiness... They went away within 6-8 mos of surgery. I feel fine now. I hope that helps! Hugs:)
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The only thing that may help with reducing your BC recurrence is to remove the ovaries. Also, reduce any ovarian cancer risk.
Unless you have some family history of uterine cancer,cervix ect or fibroids/cysts that are causing problems....why do a hysterectomy?
It kinda scares me that woman start trying to remove every organ out of their bodies because of some "risk". We are human...we have cells in our bodies. We are exposed daily to carcinogens through out food and the air....everyone is at some risk of cancer(s). Cancer or no cancer....
Sorry, for ranting...but I just dont get it.
Good luck with your decision.
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Here is my experience - my Onc wanted to give me the Lupron shots to shut off my Ovaries. As I am done having children, and I really didn't want to be tied up every month getting a shot, I suggested an ooph. She agreed that it would be a good idea, and would also allow me to go on an AI. So, last year after I finished Rads, I had the surgery. It was same day surgery, not very painful, and the recovery was quick. I am 100% ER+, so in my mind it was absolutely the right thing to do. i am now taking Arimidex, and it is going OK.
I asked about getting a full hysterectomy, and was told they wouldn't do it. I would ask why that is what is being recommended for you - as far as I know, your uterus doesn't produce Hormones. As for a survival advantage, well, I don't think they know. For me, it "feels" right, (makes me feel like I am doing everything I can) but I don't think there are and completed studies. It is all still unknown. As are the long term effects of early menopause.
So, what my advice to you would be - if you have any doubts whatsoever, do not do it. There is no going back once it is done. You can always reschedule later on if you change your mind. Are you currently getting the Lupron shots? If not, maybe try them for a while to see how you feel. I think they would have the same estrogen lowering benefit.
Good luck with your decision.
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Kerry when did you start the shots-while on chemo?
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No, I never had them. I started tamoxifen before having my ooph, and my Onc said as long as my period didn't come back I would be OK. I was only on it for about three months. She would not give me an AI while I still had ovaries.
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Thank you all for responding. I should have made myself more clear, but I was in a hurry to post since I have such limited time to get on the computer. My onc. told me I should think about having my ovaries removed, and when I spoke to my gyno. she suggested I have everything removed, since I'm having the ovaries removed. She said they can do it laproscopicaly. sp?? small incisions in belly and removal through vagina. She made it sound like it wasn't a big deal to do it all at once. I don't take anasthesia sp? well ( I was in recovery 10 hours after masectomy of left breast) , so I don't want to have another operation in the future, so I thought okay, but now I'm having second thoughts. I figured why leave anything if theres any chance of future issues. I'm soo tired of operations, and want this to be done with. Am I wrong for thinking this?? The dr.'s told me my cancer was very aggressive, rapidly spreading, when I was diagnosed at 40. I don't have children and didn't want any, so they are like whats the big deal?
As for the Lupron shots, my onc. never mentioned anything like that to me. I just take my good ol Tamoxifen, some days I'm a grouch, somedays I'm not. Always slightly depressed, just don't want it to get worse after surgery.
Thankyou again everyone, but I am still soo undecided......
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I take the lupron shots every month- I was pre-menopausal at dx. I think you can also get them every 3 months---I have been doing it since last June.... it shuts down the estrogen production and I take femara in addition. No one thought I should take my ovaries out---at the time I was certain I would do it as soon as my lumpectomy was over, but I just have never done it.
One onc gave me great advice- he advised the lupron--- and said you can always take out your ovaries--- but there is no need to right now. Even at that point, I was convinced that I would be taking them out before 2009 was over. But, I still have not done it.... I think I would like to hang on to as many of my parts as possible. Going for the shot takes me all of 30 minutes (that is the driving, waiting and getting the shot). I may opt for the every 3 month one next year.
You have to do what is right for you- but I think there are lots of people who were stage 3 who kept their ovaries....
good luck
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I don't know if there is a right or wrong choice as far as total hyster or just the ooph...just a personal choice. I did it all. I came back a poor metabolizer for Tamox and I made what I consider to be the best decision I could make with the information I had at the time. The ooph was going to put me into early meno, I am 37, and I knew that with bilateral hormone + BC I would never go through the meds it would take to support an assisted pregnancy so I had it all out. The hormones go with the ovaries and I thought that if I was not going to use the uterus or tubes then they could go as well. I did not want to worry about uterine cancer down the road and looking back this decision may have been made in haste but I don't regret it. I have had times where I mourn. I had been trying to get pregnant for about 3 years prior to my BC diagnosis and hubby and I tested completely, frustratingly normal as far as fertility was concerned. It just did not happen. I mourn that I will not carry a baby and that without a uterus I can not change my mind down the road about an assisted pregnancy but we are in the middle of our adoption process so parents we will be. Anyway I did do Lupron shots during chemo, to protect my ovaries (what irony now!), and I just wanted to be done with this mess so I decided on the surgery. I have had little to no side effects, sometimes I pray for a hot flash because it is so freakin cold in my office at work. For me, I decided I had had enough of the female organ cancers and the uterus could go so I would not have to worry down the road. That does not mean I will not get cancer again I know but I will not get uterine or cervical or ovarian. They are off the list. I am comfortable with that. One thing I do know is that we are all so different and everyone makes the right decision for them. Good luck with your decision and know that whatever it is you made the best one you could with the information you had at the time. That is all you can do. There is always great advice on these boards so I know the ladies here, even if they don't agree with my choice, will be a great help to you. Best wishes.
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nene...
Was your gyn able to remove the uterus laproscopically?
My gyn gave me the option of removing my uterus at the same time as my tubes and ovaries but said that she would have to do an incision along my c - section scar. A bigger surgery, with more healing time.
I would like to do as little as possible. Im so sick of surgeries and decisions!
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Hi Lexis! Yes it was all done laproscopically and taken out vaginally. I have a little scar in my belly button and one that looks like a paper cut in the pubic area. I don't know why she would need to cut you open again unless she wants to leave the cervix which I think is impossible if you have the uterus removed vaginally. I think that is true but am not 100% certain. I was in the hospital one night and went back to work in two weeks. I should have stayed out one more week but that was just because I was tired which may have been more because I had just had chemo and a bilateral mx in the same year. The worst part was the air they blow into you during the surgery. It takes a few days to dissolve and it set up shop in my right shoulder and hurt like a really tight muscle. I agree with you on the surgeries and decisions. Right or wrong I did not give myself much time. I felt it best to make the decision and move forward. Put this crap behind me if I can. PM me any time if you have any questions. Good luck girl.
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Hey
I didn't have a hysterectomy or ooph. Was in chemo pause and my onc felt I'd had enuf surgery. I did end up having a d&c likely caused by tamoxifen. On Aromasin now. No issues in two years.
Annie
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Hi there,
I just saw your post tonight. Sorry to hear about the recent turn of event. I too may be headed down that path myself soon. I do understand your concerns but if the onc thinks it will lessen the chance of reccurance it might be a good thing to do, although I would ask again about why the whole shabang and not just the ovaries. In reference to the anesthesia thing I can relate to that. I had a bad experience once coming out from a procedure, but ever since then I've told them ahead of time and have had no problems recently. They can usually try different meds as a precaution if they know ahead of time.
Let us know what you decide.
Take care,
Sharon
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Hi Horselover,
As a fellow horse lover I feel it is totally up to you and how you want to approach it.
For me I am triple positive with a grandmother who had stomache cancer back in the 50's so I have no history of what type of cancer she really had. I am on tomxifen and 3 month Lupron shots. The Lupron shots were at my request. Now with a new onc. she would like to see me havee my ovaries out at least. She recommends full hysterectomy due to me not knwing my real family history. I agree!!! So their is my choice. But if their is know family history that you know of then I think a overie removal is all you need if its your choice. Much easier procedure. I unfournatly am at the other end, no thanks to my od Onc. who was surprised when I brought up Lupron shots, then it was oh thats a great idea. Thanks for nothing. She is suppose to be top of the line in my state!!! Great!!!! Love my new Onc. even though my old is a advisor, oh well!!!
Good luck!!! love the horses!!!! I have Morgans!!!! They are my Heart and Soul!!! And I just Bought a Shelby Mustang cause you know what I have wanted one for ever and now its now or never!!!
HUGS!!!!
Bridget
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I have already had a hysterectomy with one ovary removed because of multiple cysts. My one lone ovary is still pumping away (no menapause) and is now enlarged. My OB/Gyn wants to remove it. It is a hard decision because of putting yourself into menapause but I kind of wish she had removed it during the surgery in 2002 so I didn't have to go through another surgery. I feel for you, I know its a hard decision {{hugs}} For myself, in hindsight I would have done the whole thing to avoid future issues, which is where I find myself now. You have to decide how comfortable you are with a complete hysterectomy, how you feel about a possible future surgery and what is best for you. {{hugs}}
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My first surgeon visit isn't till this week. But I'm planning on the ovaries and fallopian tubes coming out -- nothing more. BACR positive is the reason. I've never had any issues with my uterus so I'd like to keep it. I'm having enough things removed. So that's the route I'm going to take.
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I want to chop as many organs as possible off just so I don't get cancer in them. I don't care how crazy it sounds, it is true. I have been going back and forth of whether to get an ooph or hyst - today it's hyst. I am doing it for birth control purposes since I'm er/pr- because I can't be on birth control, I'm not going to have any more babies, and since the ovaries are going there's just no good reason to me to leave the uterus in. I am too d*** young for this crap and have a lot of different cancer in my family - no uterine, but I don't care I still want it out.
I thought I'd go through a mourning process when I had my bilateral mx but I didn't.
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Its funny - I had no mourning for my Breast, but did have some for my Ovaries. Totally unexpected. And we were done having kids, my husband had had the snip already. It is weird how these things can hit you from out of the blue.
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maybe some helpful reading for you.. you might have to copy and paste them into your browser
http://www.breastcancer.org/risk/everyone/question/hysterectomy.jsp
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I wasn't able to get the second link to connect.
I really enjoyed the link to Dr. O'Hanlan's website. I'm going to send this one to my daughter. She hasn't had her BRCA test yet but, at 30 and coming from a high risk family, she is trying to learn more about her options. This site does a very good job talking about HRT and separating some of the misunderstandings from what the studies actually found.
Thanks!!
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Right now, I am getting Zoladex shots every three months along with Femara. I have begged my onc and my family doctor to please take my ovaries. My FD has wrote several letters to the gyno and the cancer center and they have all come back saying no. I'm not giving up. Worse comes to worse, I will be asking to please refer me to the cancer center in Toronto and I will have them taken out there! I am so fid up with this issue, but everyone has to do what they think is best for them. I would have a full hystertomy done, but I know that will never happen!
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Does anyone get lupron shots when their periods have not returned? Mine stopped during chemo and chances are they won't return as I am almost 47. I saw a specialist regarding an ooph and he said he would not recommend it at this time to me. If my periods returned, that would be different. So, almost a year out and no return of the periods. But, some of the blood work I had done on my last appt indicated that I was in menopause and some indicated that I was not.
I am still agonizing over this decision. I am scared of dimentia. I feel that chemo has already taken some brain cells. There is debate over this I realize and we all have to weigh the pros & cons. We should not have to make these decisions that trade off one positive for a negative. And, it seems like the medical community cannot answer our questions. No one knows how our decisions can affect us down the road.
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I had an ooph (gyn took both ovaries and tubes)....it helps reduce the risk of ovarian cancer...could have done Lupron shots, but preferred this instead....old gyn was going to do TAH...but insurance didn't want to pay (they eventually agreed) but after talking to onc, he assured me that I didn't need the hysterectomy, that the ooph was all that was necessary....he said (as was insurance reason) that there is not the association with BC and uteran cancer as there is with ovarian cancer. Its the loss of ovaries that slams you into menopause. The ooph was done laprascopically, day surgery....was off work just over a week...fatigue was the biggest issue....good luck in making your decision..
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