4/4 with Endometrial Cancer

[materfamilia]

I've been diagnoised with endometrial cancer, so I'm facing a complete hysterectory including ovaries, fallopian tubes, and sentinel lymph nodes. It will be done laproscopically under general anesthestia, and the oncologist seems to thing it's no big deal -- it's type I, grade 2, which he says is highly treatable. My concerns are with losing my ovaries. Even though I'm 55 (and 'don't need them' anymore), they've still been producing some estrogen (which is how I -- surprise -- got this condition), and I know estrogen protects a woman from heart and brain issues and helps your bones. As APOE 4/4, I'm all about protecting my brain. It's also very weird to feel completely normal and healthy, have a little spotting, and find your you have a type of cancer that is most common in older women who never had children (I have seven). I'm otherwise in good shape with the exception of high LDL and being overweight -- something I've struggled with my entire life. Anyway, has anyone gone through this, and how has the loss of ovaries effected you? Is there anything I can do to offset the effects of no ovaries? Am I silly to worry about this when facing a cancer diagnosis?

[NF52]

I've been diagnosed with endometrial cancer, so I'm facing a complete hysterectory including ovaries, fallopian tubes, and sentinel lymph nodes. It will be done laproscopically under general anesthestia, and the oncologist seems to thing it's no big deal -- it's type I, grade 2, which he says is highly treatable. My concerns are with losing my ovaries. Even though I'm 55 (and 'don't need them' anymore), they've still been producing some estrogen (which is how I -- surprise -- got this condition), and I know estrogen protects a woman from heart and brain issues and helps your bones. As APOE 4/4, I'm all about protecting my brain. Anyway, has anyone gone through this, and how has the loss of ovaries effected you? Is there anything I can do to offset the effects of no ovaries? Am I silly to worry about this when facing a cancer diagnosis?

Welcome again materfamilia!
I went back to read your first post from early this year, and was reminded of the kinship I felt with you dealing with children still at home at age 55, and thinking about going back to school, and dealing with the news of ApoE 4/4. Life has decided to throw you some curve balls this year! It's never "silly" to worry about the long-term consequences to your heart and brain; it shows both are still working well and that you are asking good questions. I didn't have a hysterectomy, but I did go through menopause at age 53 and because of the views 13 years ago about hormone replacement therapy (HRT) that was never even offered as an option. At 66, I am 4/4 and still doing fine in both heart and brain, in spite of strong family history of heart and vascular problems at young ages and dementia later on. So genes are not destiny--just part of the picture.
It might be helpful to talk with both the oncologist and your ob/gyn about what you could do to support both this unexpected loss of estrogen and any menopausal symptoms, as well as supporting your overall health and sense of being "normal".

I thought you'd appreciate the August 2018 post below from another user who had a somewhat similar experience and is going strong at age 78! She will get an email notifying her that she's been quoted, so may be able to offer some more advice. Please keep us posted about how you are doing. Hugs from a 4/4 "older sister".

For what it's worth...I had ovarian CA at age 41 and had a complete hysterectomy and was advised to go through everything cold turkey. I found vitamin E very helpful. Of course that was 37 years ago and my body has adjusted. I am 78, 4/4, and do fine with just a pea size shape of estradiol vaginal cream before bed. Medical advice is different now of course but I'm healthy and active in every way! Much luck to all!

[rrmolo]

I did have ovarian CA at age 41 and am now 78. Of course the initial cold turkey post surgery was a shocker but my doctor (at that time things might have been different) preferred I do it that way. The vitamin E really helped. Presently there should be more natural alternatives you might research. Looking back the CA was the shocker but the complete hysterectomy was worth it of course. Our bodies are very adaptable and the better we can mind to all the other things ie diet, exercise etc the better we will do. I had counseling after my surgery because I couldn't stop crying and found out I had never grieved my mother's death some 13 years previously and the counseling sessions were very helpful for me. I cried a river...that washed the inside of me! So a lot of attention on this site discusses physical issues but emotional issues are equally important. So however you can mentally prepare and deal with any emotional issues it pays off big time. Keep us posted and if I can assist in any way please reach out. You're in my prayers.

[Anna]

I went through surgical menopause at the age of 50. Although my surgeon prescribed 1 mg estradiol, beginning a couple days following my surgery, I had a rough time. I can’t recall when the crying began, but I do recall crying uncontrollably for no reason during at least the first couple weeks. I suspect that it was just too big of a change from the dose in oral contraceptives to the dose in estrogen replacement therapy. My surgeon said my crying was due to the surgery itself, rather than hormones. But previous surgeries did not produce this result. Not even close. It wasn’t until a six week followup appointment, when I complained about significant dizziness and brain fog, that he increased my estrogen, which provided significant relief.

Two years later, I told him I suspected low testosterone, and he confessed to not knowing how to balance hormones and referred me to a functional medicine doctor, who diagnosed and treated low testosterone. I think the lesson learned is that I should have seen a doctor who knew how to address the hormonal aspect of surgical menopause before I had the surgery. My biggest remaining issue is that very few doctors will prescribe progesterone unless there is a uterus. My concern, like yours, is protecting my 4/4 brain. Bredesen says that rapid withdrawal of hormones is bad for the brain. So my suggestion is to do everything in your power to prevent this type of withdrawal. Your bones may thank you too.

On the bright side, I never had to experience bothersome hot flashes

[Sara]

Greetings Materfamilia, This can be scary and overwhelming. Coming at this from a different perspective and if you have not already had this surgery, might I suggest that you take a deep breath, research this thoroughly (as I am sure you are already doing) and consider getting a second opinion... perhaps from an integrative or functional medicine perspective.