Complex Hyperplasia with atypia.

[pitabella689]

Complex Hyperplasia with atypia.  

Wow now that is a mouthful.  I have had problems with my period for the past few years. I thought I was starting menopause as my periods were very irregular.  I am 54 years young and I have always gone yearly for my pap tests.  I have had three children.

Four years ago I even had a cone biopsy.  Everything always came back fine.

I went 3 months ago for a ultrasound and it showed a thick lining.  My period was late by a few weeks but the doctor thought it best that I have a biopsy to be on the safe side.  It came back as... complex hyperplasia with atypia.  

He said there are no pre cancer or cancer signs showing but he wants me to have a hysterectomy as I am 55 and said it is best safe then sorry.  He said that hormone theapy is an option but given my age would not be the best thing for me...wait is he saying I am old?

So here is my question.  Would taking a biopsy of a small sample of the uterus be enough to rule out cancer? If so what does it mean by abnormal cells.  My mind is just having such fun with me right now making me crazy with worry.  

Any advise would help as the doctor I have did not really explain this to me.

Thanks in advance.

[old_before_my_time]

I know what you mean about the fear. But at the same time, fear can drive us to make hasty or irrational decisions. So do your research and don't let fear take over. For me, trust in my long-time gynecologist and his fear tactics trumped my intuition and common sense. Also, convincing myself that the high rate of hysterectomies means it is a harmless surgery was also my downfall. Another mistake was seeing an oncologist recommended by my gynecologist versus one of my own choosing. My medical records showed they were "collaborated" to needlessly remove my organs. Good luck and keep us posted on how all this plays out.

[pitabella3]

Thank you so much for taking the time to talk to me.  I am so freaking out about all of this and I really am happy you sent me this information.  I am going to make an appt with my family doctor and have him make another appointment for me to visit another gyn.  

The thing that scared me was he said..."well if you dont...odds are you will be back here in a years time wishing you had done this"...GESSSSHHH.

Makes one so fearful...not that i am not afraid enough already.

[old_before_my_time]

I had a  hysterectomy 8 years ago and the problems / fall-out never seem to end. It does not make sense that hormone therapy would not be an option due to your age. It sounds like your gynecologist falls into the majority of gynecologists who treat the uterus solely as a baby bag. But it has many more functions which last a woman's entire life. The uterus and its ligaments are the structural supports for the pelvis. They maintain proper placement of organs (especially bladder and bowel) as well as an anatomically correct skeletal structure (spine, hips, rib cage alignment). Hysterectomy increases risk of bladder and bowel problems in the short- and long-term. It also changes the figure and leads to back, hip, and rib cage pain and mobility issues over time. Hysterectomy can also cause the ovaries to fail increasing risk for many health problems. An intact woman's ovaries produce hormones into her 80's for optimal health.

Hormone therapy is a first-line treatment for hyperplasia. So it would seem reasonable to try that first and then if it is not successful, you can proceed to the next step. Based on my experience, I wish I had sought out a doctor who used organ-sparing procedures when my long-time gynecologist recommended organ removal. I wish I would have known that only 2% of hysterectomies are done for a cancer diagnosis.  And that ACOG itself says 76% of hysterectomies do not meet their criteria. I also wish I had sought out  hysterectomy information from "non-medical" sites including forums that had a lot of activity from women who had hysterectomies.

There are medical studies that show regression and progression rates of endometrial hyperplasia with hormone therapy. So do your research and understand your treatment options as well as your diagnosis. As the one who has to live with the effects of treatment as well as the epidemic of over-treatment in Gynecology, it is always a good idea to be your own advocate.