Once I made the decision to have surgery because of my BRCA1 diagnosis, the next challenge was figuring which procedure to have. At the very least, my doctors urged, I should remove my ovaries. That much was clear. It would reduce my chances of getting ovarian cancer by at least 90%. The other choice was to also have a hysterectomy. Now, everything was not so clear.
This has been an agonizing decision. And, because my doctor wouldn’t tell me what to do, the choice has been even more wrenching. After all, all of these procedures are elective — I don’t have cancer and I’m not even sick – and it’s purely my decision.
I was confused for a long time because there are numerous long term consequences to consider. If I just remove my ovaries, which is called an oophorectomy, I not only decrease my chances significantly of getting ovarian cancer, which is what my mother died of, but I’d also be able to keep my uterus. Keeping my uterus has merit. It hasn’t caused me any trouble, it housed each of my two children, and by keeping it, my surgery would be shorter and less complicated. My doctor also told me that the uterus keeps other body parts in place and that by taking it out, other bits and pieces inside of me might move around and fall. The example he used was that, overtime, my bladder might drop and I might start leaking when I cough or sneeze.
If I keep my uterus, though, I’d have to commit to taking hormones to induce a menstrual cycle. Women have to shed the lining of their uterus – whether they do it naturally or not.
For me, that was the deal breaker. I’d have a hysterectomy too.
Since I already have two children, I don’t truly need my uterus anymore. I’ve downgraded its importance to something like my appendix – it’s insignificant and I really wouldn’t miss it if it were gone. And, to be honest, the idea of taking hormones just to support an organ for the organ’s sake, just seems wrong. For me.
I am, apparently, in the minority. A surgeon who does these operations all the time recently told me that 70% of women who test positive for BRCA1 or BRCA2 (and who choose to have pre-cancer surgery) – opt just to take out their ovaries.
I’m OK being in the 30% who decide to go the other way. Take it all out, I say. Reduce my chances of ovarian cancer – and at the same time – the possibility of getting uterine cancer too. Hey, if I’m going under — if I’m going this far — take it all out and wake me up when it’s over.