Breast Cancer/Ovarian Cancer Options

TylersMom1

I finished treatment for Stage II breast cancer in February 2003. A recent ultrasound has found a mass on my left ovary. When speaking with my gynocologist, she recommends laproscopic surgery to remove just the ovary and if malignant, perform a hysterectomy. My oncologist suggested considering performing a hysterectomy as the first action since I am on tamoxifen and ER receptor positive such that reducing hormone output is beneficial in preventing breast cancer recurrence. I am 45 years old and in chemically induced menopause from the chemo and tamoxifen. Has anyone ever received advice either pro or con for either course of treatment?

DeeNY711

My choice would be to remove both ovaries along with the hysterectomy. Pathology can figure it all out later. Part of my reasoning is that I elected to have both breasts removed, and everyone except me was surprised that pathology found microscopic spots of cancer in the "unaffected breast." Why have two surgeries and why leave that door open to chance? Hope this helps some. Hugs, Denise

jeancmici

DeeNY711 said:

My choice would be to remove both ovaries along with the hysterectomy. Pathology can figure it all out later. Part of my reasoning is that I elected to have both breasts removed, and everyone except me was surprised that pathology found microscopic spots of cancer in the "unaffected breast." Why have two surgeries and why leave that door open to chance? Hope this helps some. Hugs, Denise

I'd second Denise's suggestion - go with the oncologist's opinion. Once you have the full hysterectomy, you won't need the gynecologist anymore. Always decisions! Good Luck, Jean

24242

I think when looking at options given one has to take in to consideration the best odds at prolonging life, simple. I could of had a lumpectomy as so many have but because of lymphnodes positive more of risk for reoccurance. Everything I did there after finding out how aggressive the cancer was turned out to be giving me more time, as much time as I can get out of this. I wanted to have a double mastectomy from the start to minimize my risks even more. My mother was the one who convinced me not to be so drastic. Deal with cancer side then if I still felt the same get the other taken off. Maybe I should of listened to her more over the coarse of my life. I had one at a time since the trauma to my body turned out to be drastic with only the one, thank God I didn't have to go through both at same time. I had very rare nerve pain at nerve endings. Interesting how the old body kicks back.
Having a hyster will minimize your risks and that is all we can do.
Be good to yourself along the way.
Tara

hummingbyrd

Pros for Hys:
If the ovaries and uterus are gone you never have to worry about cancer there.
No ovaries, you've just reduced your main source of estrogen production.
No more periods, no more break through bleeding, which can happen even in chemo menopause.
No more Pap Smears! Need I say more? Well, you are suppossed to still get a pap, but only every 5 years.

Remove one ovary: no pros in my opinion! Unless you want to be able to get pregnant.

Cons:
If ovary is malignant then you gotta go back in and have everything removed.
If leave other ovary then you've got estrogen production, have to worry about developing cystic mass, possible periods, have to see Gyn every year for pap...

No doubt I'd opt for hys, had one myself 10/01, one of the best things I've ever done. My only other suggestion is think twice about the laparoscopy. Lotta people have it no problem, but lot of people have lots of pain. In order to see through scope they fill your belly with gas. Patients look about 9 months pregnant. They try to get most of it out before they close, but rest has to be absorbed by gut, then passed. Can be painfull! Hope this helps. Best of luck. hummingbyrd

OH, OH, this reminds me of a joke...
83 year old lady goes to see doctor. She see's the new associate as regular doc is booked. After new MD is in room with her 5 minutes she comes running out and goes SCREAMING down the hallway. Runs right into regular doctor, he calms her down and asks 'what on earth is wrong?' She says, "I'm pregnant!" MD assures her, at 83, she's NOT pregnant, storms into exam room demanding explanation from new associate....who by the way is calmly charting office notes. Slowly he looks up and says, 'she doesn't have the hiccups anymore now does she?' LOLOLOL I thought it was funny. :-)

Snookums

hummingbyrd said:

Pros for Hys:
If the ovaries and uterus are gone you never have to worry about cancer there.
No ovaries, you've just reduced your main source of estrogen production.
No more periods, no more break through bleeding, which can happen even in chemo menopause.
No more Pap Smears! Need I say more? Well, you are suppossed to still get a pap, but only every 5 years.

Remove one ovary: no pros in my opinion! Unless you want to be able to get pregnant.

Cons:
If ovary is malignant then you gotta go back in and have everything removed.
If leave other ovary then you've got estrogen production, have to worry about developing cystic mass, possible periods, have to see Gyn every year for pap...

No doubt I'd opt for hys, had one myself 10/01, one of the best things I've ever done. My only other suggestion is think twice about the laparoscopy. Lotta people have it no problem, but lot of people have lots of pain. In order to see through scope they fill your belly with gas. Patients look about 9 months pregnant. They try to get most of it out before they close, but rest has to be absorbed by gut, then passed. Can be painfull! Hope this helps. Best of luck. hummingbyrd

OH, OH, this reminds me of a joke...
83 year old lady goes to see doctor. She see's the new associate as regular doc is booked. After new MD is in room with her 5 minutes she comes running out and goes SCREAMING down the hallway. Runs right into regular doctor, he calms her down and asks 'what on earth is wrong?' She says, "I'm pregnant!" MD assures her, at 83, she's NOT pregnant, storms into exam room demanding explanation from new associate....who by the way is calmly charting office notes. Slowly he looks up and says, 'she doesn't have the hiccups anymore now does she?' LOLOLOL I thought it was funny. :-)

I agree with Hummingbird- why play the wait and see game thinking maybe it won't happen? I, personally, would always wonder what was growing inside me, what is that pain is it cramps or cancer, am I bleeding heavy or is it a sympton of cancer- the "what if's" would rule my thoughts. Life IS too short- have the hysterectomy and go on with some fun and happy times. I chose a bi lateral masectomy and removed a healthy right breast for two reasons. 1. All I seem to keep reading is people that had lumpectomies or one breast removed have reocurring cancer and 2. my physical flesh does not define who I am. It is a body, a shell not my soul. Good Luck with your treatment.

inkblot

Hi:

I'd opt for the more conservative, laproscopic procedure first. Reason: What if the "mass" isn't even cancerous? Would you mind a total hysterectomy on a "maybe"? Many women find that they have numerous, chronic difficulties following hysterectomies and I'd want to try to reduce such (unnecessary) risks with an "if it's healthy, don't even touch it" attitude. After all, we don't see every woman on Tamox. electing to have her cervix removed.

Good luck, whatever you decide and wishing you a speedy and uncomplicated recovery with a good news path report!

Love, light and laughter,
Ink

Unknown

HI
I too have considered having "prophylactic"(sp?) surgeries. Not sure yet where I stand, but I have heard storied of many women who go through a more severe onset of menopausal symptoms. I'm in chemical menopause since end of chemo (2/03_) and not having many symptoms yet. I'm 35 yrs. old and not sure I would want to live without a small ammount of natural hormones. I was estrogen negative, though, and not a candidate for tamoxifen. But the onc. says a new cancer could still be estrogen pos. and wants me to avoid all other sources of estrogen. I would recommend reading "Sudden Menopause" ( I'm not sure if I got the Title quite right.) by Debbie DeAngelo. We've seen stuff on her book here before.... I'd just want to be aware of the possibilities, then if you do opt for the surgery, you'll be prepared and can also do the vitamins etc. that will be helpful to combat any new symptoms you'll have to deal with. Good Luck!!!

TylersMom1

Hi everyone,
Thanks for all the great words of advise. You have some good points that I hadn't thought about. I also will check that book out "sudden menopause" (thanks getupandgo)! I will be setting up a meeting with both my gynocologist and oncologist tomorrow to talk more about this. I am so confused; one minute I am having the hysterectomy no question about it, then the next minute I think maybe I should just have the laproscopic surgery. I don't want to have more surgery then necessary but at the same time, I want peace of mind and I don't know if I will have that if I only remove the one ovary.

This decision has been harder for me than any of my decisions when I was first diagnosed with BC. I know that God is with me and will help me make the right decision. Thank you for all your support; it means a lot to me. Will keep you posted on my decision. Cheryl

jmears

I finished surgery, chemo, and radiation for stage II BC two years ago. I too am on Tamoxifen. I too went into chemical menapause from the Chemo and once again I too am 45. Last year I had some abdominal pains and the ultrasound found cysts on the right ovary. Both my Gyn and Oncologist said it was not to be a concern. Evidently some types of masses can be identified visually as OK. However .... I wanted to have a hysterectomy. But neither Dr. recommended it. Said it wasn't necessary. They know when something is suspicious and when something isn't dangerous and I have found that with a history of Breast Cancer all the Drs. and labs are super thorough. I guess we are marked high risk. I think if I were you I'd have the hysterectomy and be done with it. But I didn't have that option. Good luck.