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Swollen Endometrium. D&C And Hysterectomy Advised. Cancer Chances?

Posted on Mon, 2 Jul 2012

Question: Hello, I'm 61 years old. My gynecologist found that I have a swollen endometrium. Last year I under went a D&C and she wanted me to take some hormones. I didn't take them because they affected my mood too much. This year she said that it is even more swollen. ( from 7.5 last year to now 9.0 now.) She now wants me to get another D&C and then a hysterectomy. I have absolutely no symptoms. I feel better than anyone I know. My last period was when I was fifty and I had an easy menopause. I'm thinking if the D&C doesn't show any cancer that it would be asking for trouble to undergo a hysterectomy, which I know can cause problems. If I were sick or in pain I would understand doing this but as long as I feel fine I don't want to rock the boat. Am I right to refuse a hysterectomy without a diagnosis of cancer?

Answered by Dr. Minoo Bhagia (10 hours later)

Hello,
Thanks for writing to us.
If you are asymptomatic and the endometrium is not showing any changes for cancer, you need not go for the hysterecomy

If your endometrium is 7-9 mm in thickness, then it is not hyperplastic.

As you have not mentioned the units, I would like to see the reports. Please attach them using the upload your reports section on the right.

There are other investigations for cancer like CT scan, MRI and tumour markers. As you have mentioned thyroid disease in your medical history, that can be the cause of an endometrial hyperplasia.
Think twice before undergoing a surgery.
Hope this helps. I will be available for follow ups.
Best wishes.
Take care

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Minoo Bhagia (16 hours later)

Thank you for the helpful advice.
I didn't know that the thyroid disease could cause endometrial hyperplasia and I think that is important to know.

You said there are other investigations for cancer. Do you think I even need to have the D&C done again? I had one last year. Should I consider asking for one of the other less invasive test that you mentioned?

I didn't understand what you meant about units.

Thanks again

Answered by Dr. Minoo Bhagia (7 hours later)

Hello and welcome again,

You mentioned that the endometrium is swollen from 7.5 to 9; did you mean 9 millimeter (mm) or centimeter (cm)? - Because if it is 7-9 mm then it is not "hyperplastic". I would not consider repeating dilatation and curettage (D&C) on my patients if there is no hyperplasia and they do not have history of postmenopausal bleeding. There is no need to repeat D&C in such cases.

CA -125 is the most reliable tumor marker for ovarian as well as adenocarcinoma of the uterus. Consider this blood test after discussing with your gynecologist.

Other non invasive tests are Computed Tomography (CT) and Magnetic Resonance Imaging (MRI); but ultrasound is sufficient to see your endometrial thickness.

Discuss about these options with your treating doctor. I wish you luck and good health.

Hope I have addressed all your concerns. Any further query is most welcome.

Thanks again for posting this query to me. Do not forget to close this discussion if you do not have any further queries.

Best wishes and Take care

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Prasad