My Doctor Wants Me to Have a Hysterectomy

Miscellaneous and Personal Stuff I Must Share
1

Possible TMI warning. Not seeking medical advice, although if you’d like to share your experiences I’d be happy to listen.
Late 40s, eight year breast cancer survivor. The chemo put me into early menopause.

Fast forward to about four years ago. I suddenly start bleeding, which is odd, since I haven’t had a period since the middle of my chemo. I go to my primary, who says my Tamoxifen may need adjusting, so I go to my oncologist.

Og bless him, I tell him what’s going on, he whips out his iPhone and calls a gynecologist and says, “I’m sending her over there now.”

I meet a lovely young doctor, friendly, outgoing, personable. I think we could be good friends in another setting. In any event, she says the Tamoxifen, which is great for keeping cancer out of the girls, isn’t so great for keeping it out of the uterus.

I’ve had a few D&Cs because the endometrium lining keeps growing and I had my right ovary removed because it was growing a cyst (benign, thank goodness.)

Today, Left Ovary has a cyst, although it’s shrunk a bit since December. Dr. T wants to yank my whole works now, just to be safe. She says this is going to keep happening as long as I’m on the Tamoxifen. I do have an appointment with my oncologist next week (follow up, nothing to worry about) and I’ll ask him what he thinks as well.

It would be robotic surgery, I would spend the night in the hospital, miss two weeks of work, and not be able to do any of my normal exercise for six weeks.

I’m going to talk it over further with my husband. I have some out of town trips scheduled and I told Dr. T the soonest I could do it is mid to late April, and she said that’s fine.

I think the thing I’m most balking at is the No Exercise for Six Weeks. I go four times a week for at least an hour at a time, and I’ve learned from past experience that missing a week is enough to set me way back.

This goes back to my breast cancer, in that I don’t feel sick and I’m not having any symptoms. So part of me wants to wait and see, and the other part wants me to get this over with.

TL;DR: Doc wants me to have a hysterectomy, I’m worried about missing my workouts.

2

At times like these, I like to think percentages.
Yes, you miss a lot of workouts. You’ll miss the endorphins and it’ll be difficult to get your fitness back. But over the course of your lifetime, it’s not a great percentage of your total life spent sedentary.

Do the recurring issues cause you to miss workouts? I wonder if you’d end up missing more workouts having smaller procedures more frequently?

3

Well, there’s no exercise and there’s No Exercise. You’ll still be able to walk - in fact, I was encouraged to do that after my surgery. It was lifting that was a big no-no (and oddly, vacuuming, which I don’t think of as being particularly strenuous, but it does in fact put a strain on the abdominal muscles).

So maybe make yourself a list of what’s OK to do and not, and just stick with the list until you get the all-clear?

4

I agree with L-SD. It’s a small amount of time really. Not sure what you are setting back - weight loss? Muscle gain? The momentum of going to the gym?

If it’s momentum, since **romansperson **says you could walk, you could just make sure you are physically going to the gym on schedule but just walking. If it’s muscle loss, perhaps you could do some simple non-ab-affecting arm and leg movements, like in a chair, with weights. If it’s weight loss well…yeah that sucks. Maybe you will just have to do more work in the kitchen while you’re not in the gym.

Just six weeks of setbacks seems like a good trade-off for less cancer risk, maybe?

5

I’m not worried about losing my momentum. I’m worried about losing my progress thus far. I can do cardio but the strength training is out.

It just seems like such a major surgery for a little cyst.

6

I have a friend who teaches dance, and she had a hysterectomy last July. She too was bummed about not being able to be active for 6 weeks, and complained regularly to me that her doctor told her to take it easy. I visited her the week after the procedure, and we walked for several hours one day (like from 8am - 5pm, I thought she was nuts), so it’s not like you won’t be able to do anything. You’ll just need to take it easy and not do high-impact exercises or lifting more than about 8 lbs for that six weeks, in order to give the internal stitches time to heal.

7

Maybe get a second opinion?

8

I will, when I see my oncologist next week.

9

Correct me if I’m wrong, you wouldn’t be getting the surgery because of the cyst, you’d be getting it to reduce your chance of endometrial (uterine) cancer.

10

Losing progress can be disheartening…but…you did it once already, you could do it again.
Best wishes to you - hope the second opinion gives you some more to reflect on.

11

I guess that’s why Dr. T is so concerned. She keeps mentioning my history, and she can keep doing the D&C procedures, but do I just want to pull the plug now? I mean, so far everything been’s benign. But I guess it’s just a matter of time.

It’s just a big bunch of “But I Don’t Wanna!” going on, I think.

12

I don’t have much advice–I haven’t been down that road–but good luck. I think the long-term peace of mind would be worth it, for me. I think.

13

I would ask questions about whether/how they’d be using a morcellator, since it’s had concerns related to its use in hysterectomies.

(I’m not a doctor and I’m not saying that may not be what’s right for you. It’s just something I’d read about within the last year and assume it’s something you’d want to ask about and what the related risks are in your specific case.)

14

Endometrial cancer has a terrible prognosis. Have the hysterectomy.

15

She mentioned robotic surgery, where they go in through my navel. That’s what they did when Right Ovary was yanked. I woke up feeling like I’d done a month long ab challenge in three hours.

16

How much longer are you going to be on the Tamoxifen? Is it a lifetime thing or just for, say, 10 years after the breast cancer?

If lifetime, I’d be inclined to let the girly bits go now. If it’s “just” another 2 years or whatever, that might affect your decision.

17

My surgeon says the studies show it’s a lifetime thing, although Dr. T says I may be able to switch to another medicine after the procedure.

18

I’m a guy, so I won’t weigh in on what you should do, but yeah, I’d go stir crazy not working out for six weeks so I’ll just say I feel the pain in your decision.

19

Just about a year ago, my wife was in a very similar position.

She was diagnosed with a small malignant breast cancer at age 47. She had a lumpectomy, and six weeks of radiation. No chemo, though. She then began a five-year course of Tamoxifen, and the whole thing also put her into menopause.

About a year after the surgery, they found a large fibroid cyst on her uterus. They watched it for a year, but by late 2014, it had grown to 10cm, and was starting to become uncomfortable. They were also concerned about the possibility for ovarian cancer.

She got a few opinions, but in the end had the whole lot out: uterus, ovaries, fallopian tubes, even the cervix.

Her whole procedure was pretty much what you’ve described. She had robotic surgery, and while they initially said it would probably only going to be one night in hospital, they ended up keeping her for three. The cynic in me wonders whether it was because they had empty beds, and figured they could get a few more grand out of our insurance company.

She was nice and sore, and pretty much housebound, for a couple of weeks. After that, she was able to go on short walks and stuff, but it was a good 6-8 weeks before she was back doing yoga and other strenuous physical activity. One longer-term consequence has been fatigue. she needs more sleep than she used to, and finds it harder to get out of bed. They said this could last for up to a year.

After her surgery, they biopsied the ovaries and the big cyst they took out, and while they were not cancerous yet, they did find some signs of possible pre-cancerous cells.

Anyway, she doesn’t regret doing it. Best of luck with whatever you decide.

20

Yeah, my wife was initially told that her Tamoxifen regimen would be for five years, but since then her oncologist has told her that new studies suggest greater benefits from a longer-term treatment.