surgery

After a good, honest conversation with my consultant (Weds 16th July), with ultrasound and CT scan reports in hand, I decided to go ahead with surgery the following day (Thursday 17th July).  This would include a total abdominal hysterectomy (TAH), removal of both ovaries (bilateral salpingo-oopherectomy – BSO) and removal of the omentum (omentectomy).  The omentum (which I’d never heard of) is an apron of fatty tissue that lies in the upper abdomen near the stomach. It helps support the organs nearby, but it’s not essential to us. The omentum is a common place for gynaecological cancer to spread to, particularly ovarian cancer.

I decided NOT to go for what is called fertility-sparing surgery.  In my case this would mean removal of my left ovary ONLY.  The scans indicated that the right ovary was potentially problematic (at least a cyst) and that EVEN IF surgery indicated only the left ovary was in trouble, the consultant indicated I would need to have “completion surgery” (i.e. a total hysterectomy) by the age of 40 or so. 

Some challenging questions from my consultant about my fertility led to me clearly indicating that I wanted all tumour and all possibility for spread and growth removed ASAP.  Remember, with ovarian cancers, it is not possible to do a biopsy.  I did not want to undergo more surgeries than necessary and I wanted – first and foremost – the best possibility of being cured as possible.  Fertility sparing (conservative) surgery can be associated with poorer prognosis.

More on all this fertility-sparing soon.

As it turns out, I’d made absolutely the right decision.  Surgery indicated that there was some spread of disease.  Fortunately, all of the disease was removed but this required a slightly more aggressive surgery, a radical hysterectomy  – also called a Wertheim’s hysterectomy – in addition to the omentectomy and BSO.

A Wertheim includes removal of the womb, cervix, tissue around the cervix (parametrium), fallopian tubes, pelvic lymph nodes, the upper part of the vagina and sometimes the ovaries.

[If you’re interested, you can find out all about the history of how the development of radical hysterectomy surgical techniques here – In 1898, Wertheim, a Viennese physician, developed the radical total hysterectomy with removal of the pelvic lymph nodes and the parametrium. In 1905, Wertheim reported the outcomes of his first 270 patients.]