Do ovaries really have to go?

I'm having robotic davinci Tuesday at Sloan-Kettering. My diagnosis is complex atypia with hyperplasia bordering on well-differentiated adenocarcinoma.

I'm a figurative sculptor and it's been difficult for me to accept my cervix which I'm rather fond of will be gone but I finally can face it. Now I'm working on losing my ovaries. Do they really have to go?

I'm 56, feel, act and look quite young. I never married though have had a fairly decent love life here and there, alas no family and related goodness.

The next few paragraphs are my personal and medical history. I get back to the questions at the end.
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Over the years I've had three surgeries for fibroids, only one which I requested due to heavy bleeding, in 2006. The others were done by doctors who said, "you need this," (I had no complaints before that) and I didn't question. Hysteroscopic D&C 1991, laparoscopy 1999 and finally abdominal myomectomy in 2006. I feel something of a victim of over-intervention. I could have done without the two unprompted surgeries.

The 2006 myomectomy turned up a single polyp with well-differentiated adenocarcinoma. It took several weeks for the pathology and I was in no frame to undergo another surgery, especially without a D&C to see if there was anything else. I found another doctor. He put me on Medroxyprogesterone after a D&C showed hyperplasia with simple atypia. I stayed on that and it cleared up. Then it came back complex atypia. J, the "love of my life," who I'd been seeing again since 2006, the one who I "let get away" back in 1989, had just killed himself April 2009. I had started seeing someone else just before that (it wasn't working with J for the third time) and everything was unbalanced in my life. My 87 year old father was very ill and we're a close-knit family. Surgery at that time would have thrown me out completely--tipped me back into a familiar but distant dark, hard-to-reach psychological state--so I begged and was put back on Megace. When the atypia didn't resolve again, the oncologist said I needed an hysterectomy. That was November 2009.

Waiting for an appointment with the surgeon, I stayed on the Megace and the next biopsy showed no atypia so I had a D&C which was also clear. The Megace had finally worked. Then I was put back on it just "to be sure." I'm not sure if that final course threw things off but it was very unpleasant for me. I still had a cycle but also sweats, weight gain, weird discharge-bleeding, all ascribed as side effects of the progesterone. Also joint aches and eye troubles. My next D&C showed complex atypia was back, December 2010.

Meantime my father, needing dialysis, went into a nursing home. My mom and I and the rest of the family visited him regularly. It was a challenging time but also rewarding. There was a terrace we'd sit on and my dad would draw. So much came out in that last year. It was a loving time but very sad and stressful too. I needed to be there for my mother and didn't want to burden her with also taking care of me though she would have managed. Finances were also precarious and I had a lot of work that was essential to complete. I also broke up with that fellow I was seeing, an old childhood friend. He recently married a woman fifteen years younger and she's pregnant, due in February.

Though second cousins on one side have had breast cancer, my closer family does not have cancer. Maybe they do now though.... I wasn't particularly frightened of a few stray cells though reading this board has put fear in my mind. A doctor friend had described cancer cells as pirates. One or two stray pirates are okay, it's when they start grouping together that problems arise.

So it's been a long journey for me fighting this diagnosis. My father died August 1. I finished two years of delayed tax prep for me, my parents and a business. I'm seeing a wonderful man and though there are limitations he's been very supportive. I'm ready for the surgery. I have normal cycles, still, and no symptoms or pain, except on my descending colon where there's a patch from the myomectomy/prior adhesions--or maybe it's something else?
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Heart, kidney disease and diabetes do run in my family. My doctor explained they don't just yank the ovaries but there's a tradeoff--removing the structures provides more benefits than the longterm more amorphous benefits of keeping the ovaries. He says I can take estrogen afterwards. But maybe I'll be staged and then won't be able to? I don't understand how I can take estrogen but can't keep my ovaries. I'm trying to work through this today as I can still sign a paper tomorrow saying I understand the risks of keeping my ovaries. I signed the one saying to give them up.

After so many years of accepting risk I'm inclined to say "remove it all," now that it's finally being done. Is that really the best choice I have?

I realize this is a forum of women who've had massive intervention and insult to their bodies and support each other with hearts and minds--we are not just our physical selves--and I'm here complaining about step one. Somehow I feel if I take that step, there will be more steps. If I avoid it, I will be fine. Yet I'm ready to do something now as I'm finally convinced it's necessary. I'm just having trouble getting my head around it. Any kind of insight will be welcome. I'm scared of waking up and feeling completely empty. I know that's in my head and I won't be alone or abandoned but that's what it comes down to for me.

Thank you and blessings for health and well-being,
Kathy