Understanding Your Treatment Options for Uterine Health

My Journey Navigating Uterine Cancer Part Three: The Treatment Options + The Decision

Kat Sanford | Wellness Coach

July 22, 2024

Today’s blog is part three of My Journey Navigating Uterine Cancer series. If you have been following my journey, you know that I had a hysterectomy in July 2023 after receiving a diagnosis of endometrial intraepithelial neoplasia or EIN. It’s hard to believe that it has taken me almost a year to write about the reasons that I chose to have a hysterectomy as my treatment option.

The Diagnosis

In April 2023, I received an abnormal endometrial biopsy diagnosis of endometrial intraepithelial neoplasia, abbreviated as EIN. When I received the biopsy results, I was completely unfamiliar with those three words. All I could think about was, "Is this cancer?"

Being someone who doesn't like to wait, I decided to search for information (thank you, Google). According to the American College of Obstetricians and Gynecologists, EIN, or endometrial intraepithelial neoplasia, is a precancerous condition of the uterine lining that often precedes endometrial adenocarcinoma. Learning that it was likely not cancer provided a little peace of mind. Nevertheless, biopsies are not perfect, so I was still worried about my treatment options.

Treatment Options

Following the diagnosis, I was referred to Gwyn Richardson, a gynecologic oncologist with MD Anderson/UTMB, to discuss the treatment options. During my consultation with Dr. Richardson, I learned there are three recommended treatment options for endometrial intraepithelial neoplasia (EIN), including:

Surgical intervention. A hysterectomy is the most recommended treatment option due to the high risk of an EIN lesion becoming cancerous.

Progesterone therapy. This option is for women who still want to have children and can be given as oral, intrauterine, or combination therapy. Progestin treatment can shrink the lesions or cancer or even temporarily disappear. For more information on this treatment option, visit the American Cancer Society or www.cancer.org.

Close Surveillance. This option is usually only recommended for patients who may not be a good candidate for surgery due to certain medical conditions or age. In this case, patients need a repeat endometrial biopsy and physical exam every 3-6 months.

Dr. Richardson thoroughly explained all the treatment options, including their advantages and disadvantages. Leaving the appointment, I felt better educated and confident in my ability to make an informed decision. Considering my diagnosis, age, and hormone levels (which suggested postmenopausal levels despite regular periods), she advised a hysterectomy.

This recommendation during my oncology consultation came as no surprise, as I had previously researched and discovered that a hysterectomy is a definitive treatment for endometrial intraepithelial neoplasia. I am glad I knew this in advance. Knowing that surgery was a possibility allowed me to be prepared to go into the consult with a list of questions regarding surgery and what to expect afterward. For me, knowledge is power, and having the facts has always been a way for me to navigate my feelings when dealing with circumstances beyond my control. Being informed helped me cope with the emotions of fear, worry, and sadness.

The Decision

After much consideration and a lot of additional questions for my doctor and her team, I chose to have a hysterectomy at the age of 53. Even though I didn’t have a definitive cancer diagnosis, the risk of the abnormal lesion developing into cancer was not a chance I was willing to take. As scary as undergoing surgery can be, I didn’t want to live in fear daily and worry about “What if I have cancer?” I can honestly say once I had all my questions answered and weighed the pros and cons of having surgery; I was at peace with my decision.

Reflecting on it now, one year later, I believe I would still make the same choice. In hindsight, I suppose I could have initially attempted one of the non-invasive treatments and adopted a more cautious approach. However, I would likely have only prolonged the unavoidable decision of undergoing a hysterectomy and endured unnecessary stress and worry.

If you or someone you love is experiencing abnormal gynecological issues, I encourage you to visit your doctor as soon as possible. Early detection and diagnosis make a difference.

Keep an eye out for my upcoming post, where I will discuss my preparations for surgery and talk about the various types of surgical procedures for a hysterectomy. Until then...

XOXO,

Kat

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Kat Sanford, a certified Revelation Wellness fitness instructor and versatile entrepreneur, marked her 54th birthday just a week after undergoing a hysterectomy in 2023. She is also a Hashimoto's warrior, committed to living her second chapter to the fullest and empowering other midlife women to do the same.