endometriosis and ovarian cancer

[manthri]

I was recently diagnosed with stage 4 endometriosis. I've been offered a choice of treatments: either an hysterectomy/bilateral oopherectomy or hormonal therapy (Lupron for a few months, add-back therapy and then the pill). I'm nearly 47 and fertility is not an issue, but the surgical option still strikes me as a bit drastic for a number of reasons, among them sudden menopause, possible complications from the surgery, and the long recovery time (I also have fibroids and LAVH may not be possible if my uterus is too large).  There is, however, one thing that makes me willing to seriously consider surgery, and that is the increased risk of ovarian cancer  in  women with endometriosis. And according to a recent European study, endometriosis increases the risk of some other cancers as well.
I have also read that endometriosis increases the risk of certain autoimmune conditions (though that connection doesn't seem to be one that's made as often). I have a family history of RA, so that is a concern too.  Given these risks, would you advise surgery (hysterectomy/bilateral oopherectomy) over hormonal therapy as a treatment strategy? I'd really appreciate your help as I try to arrive at  a decision.

[Luvs2Bike]

I think it's important to remember that, unless all the endo is removed by surgery then, presumably the increased risk of cancer remains.  I was faced with a similar choice, and I could not accept such dramatic surgery either.  Is there a chance that you could try continuous use birth control?  By not ovulating for an extended period of time, your risk of ovarian cancer can be reduced.  Maybe consider discussing that option with your doctor?  Best wishes.

[thinknpositive]

I believe Lupron is the same as Zoladex (implant by your waistline, once a month for 3 months or more) I had severe symptoms with this...major hot flashes, insomnia, weight gain. It was not fun. The worst was definitely the hot flashes, they were multiple times and hour, I changed clothes throughout the night and was miserable. I couldn't stand myself. Not sure how long you'd be on Lupron for but you should know it was a long 3 months. Its been nearly 2 months since my last implant and I'm still having symptoms although they seem to be subsiding.

Best of luck to you!

[staceyann73]

Don't do what I did.  I did nothing.  I just lived with the pain.  Now they tell me that my endo is too severe for a hyst.  That I have a 50% chance of ending up with a gastric bag if they perform surgery.  I have a lrg complex cyst on my ovary that they don't even want to biopsy at this time as its another surgery, more scaring, worse its gets.

Good luck and god bless.

[silver&gold]

Hi,

I had severe Endometriosis and ended up with Ovarian cancer, I was assured that this is a rare outcome of the disease but I suffered terrible pain, heavy bleeding etc every month. I also had 16 Fibroids and 10cm+ cysts on both Ovaries so you can imagine that it was a relief for me to have a Hysterectomy.
Only you  along with your doctor can decide whats best for you ,I will say though that looking back and remembering how Endo ruled my life aside from the having to have the Hysterectomy because of the cancer I  don,t regret it to be free of all of the horrible symptoms. Best of luck to you and I wish you well.

Angie