Why is a hysterectomy required for early endometrial cancer?

Question

Hello doctor,

I am 38 and have been diagnosed with early endometrial cancer. I never wanted children, and I am certain about that decision. Doctors insist that surgery is best, but I am scared of losing my uterus emotionally.

Why does a 38-year-old need a hysterectomy even if she never wants children at all?
Is a hysterectomy mainly about cancer control rather than fertility?
Could hormones or local treatment work instead?
Is this medically necessary for my specific case, or is it recommended out of caution?

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query and can understand your concern.

Not wanting children doesn't make this any easier. Losing your uterus is still a big deal, and feeling shaken by it is completely valid.

In endometrial cancer, the cancer starts in the uterine lining. Removing the uterus is the most reliable way to get rid of it and lower the chances of it coming back, so the hysterectomy recommendation is about cancer control, not fertility.

Progestin therapy [progesterone-based hormonal treatment] is an option in some low-grade cases, especially when fertility preservation matters. But it carries a real risk that the cancer can persist or come back. If surgery is appropriate for you, it's generally the safer route.

Your age, cancer stage, and risk level all factor into the ovary decision. Some younger women keep them to avoid sudden menopause. Others have them removed to lower the chance of spread or regrowth. It really comes down to your specific case.

Doctors often recommend surgery because it offers the highest chance of cure with the least uncertainty. You have every right to ask your doctor exactly what stage and grade the cancer is, whether your ovaries can be preserved, and whether a second opinion makes sense before you decide anything.

Please try to follow up if you find this answer helpful

And I hope you will feel better soon.

Thank you.