Dear OncoLink "Ask The Experts,"
I have recently been diagnosed with HNPCC after a resection of the transverse colon, at age 48. The genetic counselor has pulled quite a bit of information, and I see [that] the recommendation is to possibly have a hysterectomy to avoid uterine cancer. My doctor. feels [that] this would be the only way to avoid having to go through biospies every 6 months. Are there any other alternatives?
Jill Stopfer, MS, CGC, Certified Genetic Counselor, responds:
In women who have a clear cut diagnosis of Lynch syndrome, the lifetime risk to develop uterine (endometrial) cancer in some studies approaches 60%. In addition, there is about a 10% chance of developing ovarian cancer. For this reason, women do sometimes consider prophylactic hysterectomies, usually after childbearing decisions are completed. Some of these decisions may be due to the pedigree (meaning the rest of the family history).
If a woman is post-menopausal, then the hysterectomy may be less of an agonizing decision than for a woman who is pre-menopausal, especially for one who would still like to have a child / more children. It is a reasonable and frequently offered alternative to management of uterine and ovarian cancer prevention in women who have Lynch syndrome. Recommended screening for women with an intact uterus includes annual endometrial biopsy and transvaginal ultrasound.