Two Stories

After a routine Pap smear, Judy, 35, was told that she had cervical cancer that had not spread past the cervix. Her doctor recommended a hysterectomy. The word cancer threw her into a panic state. Although she had three kids, she was still thinking about having a fourth. The stress of thinking about cancer, plus the recent death of her father, made her feel confused and uncertain. Her gynecologist was putting a lot of pressure on her to have the hysterectomy. He said it would also cure her endometriosis, which had been severely painful for so long. When Judy came to her senses, she had lost her uterus for no good reason, and within two weeks her endometriosis pain came back, worse than before.

On the other hand, Deborah, 45, felt that "something funny was happening inside of her." She visited her gynecologist and he ordered a pelvic ultrasound. Visibly alarmed, her doctor told her there was a large black shadow over one ovary which he thought could be cancer. He suggested an immediate hysterectomy.

Deborah went into a state of shock. She thought she was going to die. After she recovered from the shock, she went straight to the library to read about hysterectomies and cancer. She asked her family doctor to arrange for a second opinion. She talked to other women about their experiences with hysterectomies.

The second gynecologist said he thought the shadow was probably a fibroid, but he would have to operate to find out for sure. Deborah agreed to surgery with one condition, that if it wasn't cancer she wanted her uterus and ovaries to be left in.

"I didn't want to have anything removed that's not diseased." she said.

Fortunately, the shadow turned out to be a single large fibroid, which her doctor was able to remove while leaving her uterus intact.

"Medical doctors do not have the answer to everything," she told me, although, "they often act like they do."

Remember:

1. It is OK to panic but it is not OK to have major surgery done without getting all the facts and a second opinion.

2. Doctors do not know everything and even the most experienced one can still make mistakes.

3. Doctors have feelings and can get over concerned and fearful about missing cancer in their patients.

4. Most of the time you can take the extra few weeks, even months, to make a proper well informed decision that you can live with.

• If you are having a lot of bleeding or pain and are confused about whether to take medications for these symptoms, go ahead and take them for three to six months. This buys you enough time to read and explore the alternatives.

Resources:

Make sure that your library carries these books or order them through your local bookstore.

NO HYSTERECTOMY; YOUR BODY YOUR CHOICE, by Dr. Herbert Goldfarb and Judy Greif (Wiley and Sons, 1990). I highly recommend this book which is written by a sensitive and sympathetic gynecologist. It is clear and offers many options to women including well designed checklists for yourself and your doctor.

YOU DON'T NEED A HYSTERECTOMY: New and Effective Ways of Avoiding Major Surgery, by Dr. Ivan Strausz (Addison and Wesley, 1993). This is a new book which Janine O'Leary Cobb says is "both informative and enormously supportive to women," although he is too accepting of the practice of removing the ovaries of women over 45 or 50.

HOW TO AVOID A HYSTERECTOMY, by Lynn Payer (Pantheon Books, 1987). This book is subtitled. "An indispensable guide to exploring all your options before you consent to a hysterectomy," and is the official National Women's Health Network Guide. It has an excellent section on fibroids and myomectomies.