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Suggest Treatment For Precancerous Overgrowth In The Lining Of Uterus

Posted on Fri, 20 Feb 2015

Question: I have had a hysteroscopy, removal of a large polyp, a tumor, & D&C that revealed the worst precancerous overgrowth in the lining of my uterus. My alternatives were Megestrol 40mg by mouth w/6 month check ups, IUD w/Megestrol or hysterectomy. I am 67 yrs old and have been on Estrogen. I messed up & didn't go back for my check ups I chose hysterectomy but now am having 2nd thoughts

Answered by Dr. Srilatha Myaka (59 minutes later)

Brief Answer:
Surgery might be the good option

Detailed Answer:
Hello dear,
Welcome to healthcare magic.

I understand your concern.

I am sorry for your condition.

In my opinion , since the D&C revealed a precancerous growth, surgery is the better option.

Megestrol is a progesterone hormone which is prescribed in cases of cancer, cachexia (severe weightloss), etc. It might have side effects like weight gain, indigestion, increase blood sugar levels,
,breakthrough bleeding etc.

And in between you might need to follow up with repeat D&C's, to check the status of the the precancerous growth.

Considering the age and basing on D&C report I would suggest surgery if a patient comes with similar complaints to me.

So I suggest you to take your doctor's decision because he might be the best one to assess your condition

Hope this satisfies your query.

Feel free to ask any more queries.

Best regards...Dr srilatha.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Srilatha Myaka (20 minutes later)

In your opinion would a small dose is estrogen after the hysterectomy be ok as long as I have yearly check ups

Answered by Dr. Srilatha Myaka (1 hour later)

Brief Answer:
Estrogen therapy has risks and benefits

Detailed Answer:
Hello dear,I got your query.I understand your concern.
In my opinion estrogen therapy helps to releive hot flushes and osteoporosis.
Estrogen therapy increases the risk for stroke ,blood clots,gallstones,dementia etc.
It has side effects like weight gain,,breast tenderness.

But as you are saying the low dose but sorry even the long term risk due to low dose is not known.

Theres always a controversy in between the risks and benefits of hormone replacement therapy.

But usually estrogen therapy is not given in cases with personal or family history of breast cancer or ovarian cancer or endometrial cancer.

So as the D&C revealed precancerous growth it might not be a good option .
And if I were the doctor in charge, I would not go for estrogen therapy post hysterectomy in a patient with similar complaints.
Kindly discuss with your treating doctor regarding this.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Srilatha Myaka (1 hour later)

Okay, this is my real concern many years ago my older sister had a hysterectomy in her 20's and was not given estrogen. She grew a beard. From that time on she has been depressed and does not feel like a woman. My mother went through a very difficult menapause with no estrogen therapy and among other things late in life she had a small beard. I have always been terrified of the side effects of not having estrogen I do have osteperosis & extreme hot flashes

Answered by Dr. Srilatha Myaka (11 hours later)

Brief Answer:
hysterectomy in early age need to take HRT

Detailed Answer:

Hello dear,

I got your query.

I understand your concern.

i am very sorry about condition of your sister.

In your sister case as she underwent hysterectomy in her 20's so she should have been given hormonal replacement therapy.

In your condition as you are in 60's we need to asses both advantages and disadvantages in considering hormonal replacement therapy.

There's always a controversy in between the risks and benefits of hormone replacement therapy.

I suggest you to meet an endocrinologist for proper assessment of your physical condition and suggestion on hormonal replacement therapy.

Hope this satisfies your query.

Feel free to ask any more queries.

Best regards...

Dr srilatha

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju