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Obesity & hysterectomy

Bagatha
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Hello, I have recently had a uterine ultrasound which revealed endometrial thickness of 60mm with ulcerated appearance followed by an hysteroscopy which revealed irregularity to the distal endocervix and proximal endometrium. (I am now waiting for biopsy results and an MRI on Monday.)

The gynecologist told me that this could be an unusual type of cervical cancer & that the normal treatment would be hysterectomy but I will not be offered this due to my weight.

I was very shocked and have since done lots of googling and found alternatives to the standard operation, such as laparoscopic hysterectomy with regional anesthetic, which has better outcomes for women with obesity. 

Can you please advise regarding his decision to simply not offer an hysterectomy due to weight? Is this a decision based on funding or health outcomes? Is it possible to have the operation at a hospital that offers bariatric surgery? And what is the treatment process when someone has been excluded from surgery? 

Many thanks for your help, I look forward to hearing from you. 

  • Dear Bagatha

    Thank you so much for seeking information and support from us here at Macmillan Cancer Support.  My name is Rae, and I am a Cancer Information Nurse Specialist.

    Undergoing a biopsy of the womb can be a worrying time, please do feel that you can speak to our nurses on the Support Line regarding any further questions that you have.

    Turning to google for answers is a common response to being told that you may have cancer, but that can cause further anxiety.  It is always better to speak to a professional as it can be difficult to interpret information in light of your own circumstances, and not all information is peer reviewed and to a high standard.

    When the lining of the womb is thickened it is called endometrial hyperplasia.  Atypical hyperplasia is when the cells are abnormal and can become cancerous over time if not treated.  Atypical endometrial hyperplasia may develop into an endometrial cancer in more than 8 out of 100 women, therefore they will normally be advised to have a hysterectomy. 

    The decision from the gynaecologist should always be based on health outcomes, rather than funding.  Looking at information about recovering from an abdominal hysterectomy, if a person is overweight at the time of surgery it can take longer to recover from the effects of the anaesthetic and there is a high risk of complications such as infection and thrombosis (blood clot).  The same information is given for a vaginal hysterectomy.

    Any decision about whether you are fit for surgery should be made after a comprehensive evaluation and a preoperative assessment is essential, including an anaesthesia consultation.  We have information about preparing for surgery.

    You will be able to have a second opinion, but this may delay treatment.

    We suggest attending the meeting for results on Monday and see what options the gynaecologist offers. Then contact us again regarding the information given to you, and we can explore the further questions that you have asked in relation to the results you have been given.

    Best wishes

     

    Rae, Cancer Information Nurse Specialist

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

     

    Ref/RH/SH

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