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derycksan71 t1_ivj9jil wrote

Reply to comment by OhtareEldarian in Researchers have found that having more babies reduces the risk of endometrial cancer. by IMBatUQ

Nobody is forcing childbearing. However, I do highly encourage you do some research on hysterectomy before being nonchalant about the procedure. Early menopause and cardiovascular disease risks alone should be enough to realize, hysterectomies are a last resort option, not a default or preventative care.

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Mercuryblade18 t1_ivms72q wrote

A hysterectomy can (and often is) performed without an oophorectomy (removing the ovaries) and therefore cardiac affects and menopause aren'ta factor.

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derycksan71 t1_ivmwx9r wrote

Sure but we're talking about endometrial cancer prevention/treatment which the most effective treatment is a full hysterectomy. Even if an partial hysterectomy is performed it still does not prevent ovarian cancer which, while less common, is far more deadly.

The whole point of this study is the hormones introduced from pregnancy, particularly progesterone, are what have the benefit for cancer production. Hysterectomies are not typically performed for preventative care.

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Mercuryblade18 t1_ivmyfw6 wrote

To prevent cancer? In a patient with abnormal endometrial tissue - a hysterectomy without oophorectomy is reasonable, oophorectomy is only recommended if you have actual cancer or atypical hyperplasia on biopsy (since the risk of an occult malignancy is high).

No need to take out the ovaries on a 40 year old with abnormal bleeding and risk factors but no actual cancer. Endometrial cancer is slow growing and acts locally until its advanced stages.

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derycksan71 t1_ivn4l4e wrote

Prophylactic hysterectomy are typically only performed on women with high risk gene mutations. Three of the top mutations for endometrial cancer are also indicators for ovarian cancer, because of this, removal of ovaries and tubes are recommended when those genes are present.

We're getting into pretty individualized situations, not general prevention as this article is discussing.

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Mercuryblade18 t1_ivn6xl5 wrote

Yes, in a genetic cancer like Lynch you would take out ovaries.

In a patient with an abnormal biopsy that doesn't want to take progesterone to see if it regresses a hysterectomy is a form of prophylaxis

Endometrial hyperplasia with or without atypia is fairly common especially in obese women.

As far as general prevention? No, we don't just cut out uteruses, and now we're in the weeds, but you didn't talk about hysterectomy with or without oophorectomy because I think it's clear you didn't know the actual difference or you would've specified in your original comment. It's okay to admit you were wrong rather than trying to Google answers that make you technically correct. What's your background in this?

If a patient asked one of the gynecologists at my hospital for a prophylactic hysterectomy 1) they wouldn't likely do it but also wouldn't take out the ovaries unless that had some other risk factors.

Most hysterectomies under the age of 50 are performed without an oophorectomy.

We don't use terms like "partial" or "complete" anymore, those are outdated and not uniform.

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