Hysterectomy to diagnose endometrial cancer – Cynthia’s Story

I am 50 and had an endometrial ablation 4 years ago for very heavy periods. The specialist removed some uterine polyps at the same time but left a fibroid. The polyps were benign. The ablation stopped all bleeding with my periods so I only knew I was menopausal when I started getting hot flushes 18 months ago and had my hormone levels tested. I started on HRT about 4 months after that (combined estrogen and progesterone).

I spotted several weeks ago and went to the Dr even though it was very minor spotting. He did a pelvic exam and took a smear test. Both were fine. He sent me for an ultrasound which found a thickened endometrium and fluid in the endometrial cavity. He then referred me to a gynecologist who said a hysterectomy is the only way to rule out endometrial cancer as the scarring caused by an ablation can mask cancer. He assessed my risk level as 5% which is twice the average for women in NZ.

I am getting a second opinion next week but the literature I’ve read is consistent with his advice. I have no other symptoms and feel very well. The spotting has occurred a few times since I first spotted but lasts only a a day or so and is very light (hard to see even on a panty liner) and I have no pain, problems with urination etc. I do not recall understanding the risk of failure to diagnose cancer when I was considering the ablation.

However I am a lawyer and expect it would have been mentioned to me and must have been in the fine print at least of the written material I was provided. I understand now that I would have been at very low risk of endometrial cancer (risk is higher now because I’m possibly post-menopausal but we can’t be sure if my periods have stopped for over a year as there has been no bleeding since the ablation) at that time so am unsure whether in hindsight I would have made a different decision. I am prepared to have a hysterectomy if that’s what the second opinion recommends and I would be surprised if it didn’t. My GP also thinks I should have it done. I would be keen to know if other women have been in this situation and if cancer was found when the uterus was removed.

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