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Ovaries or not?

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rufus
Ovaries or not?

Hi All!

I was wondering if people had any advice/thoughts on keeping ovaries with a radical hysterectomy.  My surgeon has given me some choices.

Keyhole or open surgery: I've opted for open and I think that is right for me.

Ovaries/removal:  Instinctively I want to say keep them. I am 46 so the menopause is not far away but an instant menopause/ hrt seems an unnecessary challenge right now. 

Does anyone have any ideas about this?

Thank you in advance

Stay safe. Xx

Lletz under GA on 19/3/20, mri on 21/3, Results cc: stage 1b no sign of lymph involvement. 18/4/20 Radical hysterectomy with lymph node removal 6/5/20 Histology shows microscopic Involvement 2 nodes. Moved to stage 3. Chemo rads planned. 

Pleasehelp

Hi rufus ;) 

i think it's a big decision and an individual one I think I would opt for ovaries removed otherwise me being me would worry about the possibility of ovarian cancer , 

its a hard choice it really is maybe ask for a phone call from your nurse specialist I'm sure she will be glad to chat about it 

best wishes xx

Jazza
Jazza's picture

Might be worth asking your doctor/GP if there are there some tests that can be done to assess when your natural menopause might be due?  If it looks as though you are set for menopause in the near future then maybe removing the ovaries would be a way to go as then they won't be there to potentially cause problems in the future. Some women don't have a natural menopause until they are in their mid fifties so if you are one of those it might be a shame to lose out on the best part of a decade of natural hormones.

x

  • Feb 04:  (age 47y) Smear test normal
  • Stopped going for smears!
  • Summer 16: persistent watery yellow vaginal discharge
  • Dec 16: post menopausal vaginal bleed
  • Jan 17: Hysteroscopy under GA for ?fibroids - abnormal cervix observed -multiple biopsies taken, 1B1  squamous  cell cc diagnosed - confirmed by MRI/PET scans
  • Feb 17: pelvic lymphadenectomy - nodes negative, Da Vinci radical hysterectomy- close anterior margin/LVSI/PNI, restaged to 2A
  • Apr/May 17: 6x chemo, 25x external radio, 2x brachy
  • May 20:  NED.  Various side effects notably hypotonic bladder since hysterectomy - ongoing ISC, unilateral lymphoedema lower abdo/groin/leg/ankle/foot
Izzzy76

If I were to make this decision I would have them taken out.

28-8-2019 diagnosed grade 2 squamous 2B 4 cm tumor Mri suspect lymphe nodes but pet scan Shows no lymph nodes 25 radio extended field, 6 chemo and 4 brachy finished October 29 2019
rufus

Thank you, Pleasehelp and Jazza,

I wasn't expecting to get a choice so now I have, I guess you are right that I need to talk to professionals about it. I know that I have at least two weeks before I have the op because the surgeon says the swelling from lletz makes the operation more tricky.  

Hope you are both safe and well.

much love

Lletz under GA on 19/3/20, mri on 21/3, Results cc: stage 1b no sign of lymph involvement. 18/4/20 Radical hysterectomy with lymph node removal 6/5/20 Histology shows microscopic Involvement 2 nodes. Moved to stage 3. Chemo rads planned. 

rufus

Thank you, Izzzy76,

I'm really torn so I am really interested in what other people think. In the scheme of things, I guess it's not going to make much difference to the recovery from the op if they come out as well. I wasn't aware that you could have hrt as a tablet until yesterday (I have sensitive skin and would suffer with patches) and that makes a difference too. 
thank you

stay safe 

big hugs xx

 

Lletz under GA on 19/3/20, mri on 21/3, Results cc: stage 1b no sign of lymph involvement. 18/4/20 Radical hysterectomy with lymph node removal 6/5/20 Histology shows microscopic Involvement 2 nodes. Moved to stage 3. Chemo rads planned. 

LaurieBeth

I am late to weigh in here, but I am 43 and my surgeon is going to to do ovarian transposition in case I need to have radiation after my RH. He said it is for my heart and bone health and quality of life overall. I personally want to keep them, but I don't think there is a right answer here. It is all a lot to take in. Or it sure is for me. When is your RH?

LBA 

11/18Abnormal Pap CINIII

12/18Colpo confirmsCINIII-horrible experience with cruel doctor

12/18Cold Knife cone biopsy confirms CiNIII, clear margins-doctor says we should just take it all out

1/19 second opinion-close monitoring appropriate

5/19, 8/19 paps and colpos CIN I

2/20 Pap reveals CIN III

3/17/20 Lietz under GA

3/20/20 Cervical Cancer, no clear margins- doctor calls my situation rare and shocking as my cone had clear margins

  1. 4/1/20-scan shows no evidence of spread Radical Hysterectomy, Lymph node dissection, and ovarian transposition May 12-pathhology staged cancer at 1a1. 

 

rufus

Hi LaurieBeth,

Thank you for your reply. I am thinking that I want to keep my ovaries atm. It's overall health but also I read that loosing them effects your sex drive.  I don't think my surgeon would say I can keep them if he thought it was risky. He hasn't given me a choice over my lymph glands despite saying the mri shows them as clear. 
At the moment I am not sure when my RH will be, other than that it will not be in the next two weeks (to allow swelling from lletz to go down- surgeon says it makes op more difficult). He said I might not get much notice and need to be ready to go when the hospital calls. Covid has sent everything into a spin here and he has got less theatre time. 
Like you, I am a teacher and I want this done asap, so I can get back to work.  
stay safe

big hugs. Xx

Lletz under GA on 19/3/20, mri on 21/3, Results cc: stage 1b no sign of lymph involvement. 18/4/20 Radical hysterectomy with lymph node removal 6/5/20 Histology shows microscopic Involvement 2 nodes. Moved to stage 3. Chemo rads planned. 

Jazza
Jazza's picture

Hi rufus

It's very commendable that your are keen to get back to work.  But this is a time to put yourself first, and possibly be a bit selfish, because you need to aim for best medical outcome possible. As far as possible, allow yourself the space and time you need,  be kind to yourself.

x

  • Feb 04:  (age 47y) Smear test normal
  • Stopped going for smears!
  • Summer 16: persistent watery yellow vaginal discharge
  • Dec 16: post menopausal vaginal bleed
  • Jan 17: Hysteroscopy under GA for ?fibroids - abnormal cervix observed -multiple biopsies taken, 1B1  squamous  cell cc diagnosed - confirmed by MRI/PET scans
  • Feb 17: pelvic lymphadenectomy - nodes negative, Da Vinci radical hysterectomy- close anterior margin/LVSI/PNI, restaged to 2A
  • Apr/May 17: 6x chemo, 25x external radio, 2x brachy
  • May 20:  NED.  Various side effects notably hypotonic bladder since hysterectomy - ongoing ISC, unilateral lymphoedema lower abdo/groin/leg/ankle/foot
Jeebers

Hi Rufus,

I didnt get a choice my consultant decided to remove my ovaries but myself and my OH had discussed it beforehand and we had decided that if I was given a choice I was going to have them removed. I'm 36 but I just want to be able to move on from this after I get the all clear and not worry about a recurrence, I had pre cancerous polyps removed from my colon a couple of years ago so in my head I've convinced myself that everything down there is a ticking time bomb so for me it was an easy decision just to have the peace of mind but it is a very personal decision to make, maybe do up a list of pros and cons, seeing it on paper can sometimes help cement a decision. 

5/2/20 sent to a&e with abnormal bleeding, mass found on cervix

12/2/20 colposcopy and biopsy taken

26/2/20 diagnosed with cc - Stage 1b2

03/03/20 colposcopy with lletz, hysteroscopy and cystoscopy performed under GA

10/03/20 - admitted to hospital with abnormal bleeding, MRI, CT and PET scans done. PET showed abnormalities in lymph nodes, laparoscopic surgery to take biopsy of lymph nodes 

31/03/2020 - radical hysterectomy with lymph node and ovary removal

20/05/20- started radiotherapy 

meraud

Hiya

I am 46 and I had my ovaries removed last year during my RH on the proviso that I could go straight on to HRT.

I slapped the 1st HRT patch on the day after my op and I can honestly say I don't feel any different than I did before. I feel great, both physically and emotionally.

Maybe I've been lucky? I don't know. But that's my experience. 

Could HRT be an option for you?

 

xx 

  • 09/08/18. Positive smear - High grade (severe) dyskaryosis
  • 22/08/18. Colposcopy - CIN3
  • 14/09/18. Lletz - CIN3 with unclear margins
  • 07/12/18 Lletz  - CIN3 with unclear margins and VAIN3 
  • 14/01/19 MRI 
  • 29/01/19 PET-CT 
  • 15/02/19 scans indicate 2cm tumour
  • 26/02/19 RH (postponed due to virus)
  • 05/03/19 RH
  • 08/04/19 No evidence of malignancy
55

Hi Rufus I haven't had a hysterectomy but my consultant has advised me to start HRT as he feels that the menopause may be a factor in the discrepancy in my results. I have come across a book called Menopause by Dr Louise Newson who is a GP specialising in the menopause, including early menopause brought on by surgery. I found that her book explains the pros & cons of different types of HRT really clearly. Like you I have very sensitive skin & so felt the patch was not for me. I have opted for transvagiinal tablets indefinitely as they are very low risk & have also started low dose progesterone tablets combined with oestrogen gel which I'm finding very easy to use - I plan to use these for a year to minimise the risk & help me to cope with further colposcopies/treatment but hope they will also help me with the fatigue & aches & pains which I have developed with the menopause which I have only entered last year. I can recommend the book as a manual to help with coping with the menopause generally including coping with relationships & your rights at work. Wishing you all the best with your decision.

Take care

A

1st ever abnormal smear hpv & severe high grade dyskaryosis August 2019 lletz September 2019 polyp & nabothian cyst found Results hpv & mild cell changes polyp innocent Repeat colposcopy Dec 2019 test of cure January 2020 results of test of cure; no high risk HPV present , check up colposcopy appointment in June because of the discrepancy between initial smear & lletz result
rufus

Hi 55

Thank you for your suggestion I will get hold of that book and have a read. Whichever way I jump it will be useful as I'm not far off natural menopause even if I keep my ovaries. I found out today that I am very unlikely to be called for my hysterectomy until May for medical reasons (healing of the cervix and accuracy of lab work afterwards) so I am able to take more time to make the decision.  
It is reassuring that there seem to be so many ways now to replace hormones. 
Stay safe

Big hugs

Xx

Lletz under GA on 19/3/20, mri on 21/3, Results cc: stage 1b no sign of lymph involvement. 18/4/20 Radical hysterectomy with lymph node removal 6/5/20 Histology shows microscopic Involvement 2 nodes. Moved to stage 3. Chemo rads planned. 

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