Surgical Options for Endometrial Cancer
Dear OncoLink "Ask The Experts,"
I am 31 years old. I went to the doctor because I had a positive pregnancy test, but I was not pregnant. My doctor did an endometrial biopsy and those results showed I had hyperplasia. I had a hysterectomy. I was diagnosed with endometrial cancer. When he did the hysterectomy he just removed the endometrial. Now after he has talked to a Tumor Board in my small town they say that it was not in the muscle wall and I am cured. I read that for level one endometrial cancer they should remove my ovaries and fallopian tubes I feel I should get a second opinion from an oncologist or at least someone that deals with this on a more often basis.
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
Most patients with endometrial cancer do have their ovaries removed at the time of surgery. Sometimes microscopic cancer cells may spread to the ovaries, and spread cannot be detected without removal of the ovaries. In a situation such as this the surgeon typically does not remove the ovaries when a patient is young, and because a diagnosis of cancer was unexpected. While having the ovaries removed after the diagnosis of cancer is one option, if the cancer is grade 1 (well-differentiated) without any growth into the wall of the uterus, typically it is recommended the ovaries are left in place. It is always reasonable to get a second opinion, preferably at an academic medical center that has a certified gynecologic oncologist available for consultation.