Harmful Hysterectomies: What Your Doctor's Not Telling You
Finding Other Choices
The primary reason that some gynecologists aren't telling women about hysterectomy alternatives is because they're not trained in new, less-invasive therapies, Dr. Parker admits. "Doctors may not want to tell their patients, 'This procedure is available but I don't know how to do it, so I'm going to send you down the street to my competitor.'" The other reason doctors are quick to recommend this surgery is cancer prevention. "It's drilled into us in our training," says Lauri Romanzi, MD, clinical associate professor of gynecology at New York-Presbyterian Hospital/Weill Cornell Medical Center. "After 40 -- when preserving childbearing is no longer the goal -- taking out the uterus, cervix, and ovaries prevents gynecological cancers, including ovarian cancer, which is relatively rare but very aggressive and deadly. Preventing cancer is a noble goal, but the fact is, hysterectomy's not the only solution out there now. And we also need to start thinking about lifetime survival rates and quality-of-life issues such as sexual functioning."
The chilling reality is that even patients who do need a hysterectomy have options that could lessen the procedure's impact on the body, such as saving one or both ovaries (which may ease or prevent premature menopause). And depending on the type of tumor and its location, there's even a less-extensive surgery for early-stage uterine cancer that preserves fertility.
The best a woman can do right now is to become educated. When hysterectomy is recommended to treat a benign condition, the decision should be made only after consulting more than one gynecologist -- and not under duress. "When you don't have cancer, you have all the time in the world," says Barbara Levy, MD, medical director of the Women's Health and Breast Center at the Franciscan Health System, in Federal Way, Washington. And if the doctor does find cancer, your next step should be to consult a gynecologic oncologist about the most-advanced, least-invasive treatments for your particular situation (see www.wcn.org, the Web site of the Women's Cancer Network, for names near you). Use the following pages to explore your choices.