Surgery to lower endometrial cancer risk
This section covers the following topics:
- Expert guidelines
- Removal of the ovaries and tubes during risk-reducing hysterectomy
- Hysterectomy during risk-reducing salpingo-oophorectomy
- Vaginal or open surgery
- Surgical risks
Note that when we use "women" we are referring to the sex you were assigned at birth.
Hysterectomy is surgery to remove the uterus to treat or prevent disease. "Risk-reducing hysterectomy" refers to the removal of the healthy uterus to reduce a person's risk of developing cancer. Often the cervix is also removed during this surgery. Research on hysterectomy in high-risk women has shown that:
- hysterectomy is an effective way to lower the risk for endometrial cancer
- hysterectomy does not increase how long women survive
Surgery can have risks and side effects. It's important for people to speak with experts in order to learn as much as possible about their endometrial cancer risk and to make an informed decision about the best option for lowering their risk.
The National Comprehensive Cancer Network (NCCN), is an organization of cancer experts that creates guidelines on cancer care and updates them yearly. NCCN's guidelines discuss the benefits and limitations for risk-reducing hysterectomy in women with an linked to endometrial cancer and which women are most likely to benefit from the surgery. The NCCN guidelines include "consider risk-reducing hysterectomy" for women who have completed their childbearing and who have an inherited mutations in the following genes:
In addition to their increased risk for endometrial cancer, women with mutations in the following genes are also at increased risk for ovarian cancer:
Experts recommend that people with mutations in these genes have a conversation with their surgeon about the benefits and risks of risk-reducing removal of their ovaries and (also known as salpingo-oophorectomy) after childbearing is complete and at the time of risk-reducing hysterectomy.
Some people who have increased risk for ovarian cancer may choose to remove their uterus at the same time that they undergo risk-reducing removal of their ovaries and . This includes people with mutations in the following genes:
You can read more about the benefits and risks of this decision in our section on surgery to lower and ovarian cancer risk.
Hysterectomy may be performed using an incision through the vagina (known as vaginal hysterectomy) or through an incision in the lower abdomen (known as laparotomy).
- Open surgery (also known as a laparotomy) involves one incision in the lower abdomen to remove the uterus.
- vaginal surgery involves an incision from the vagina into the pelvic area to remove the uterus. This surgery requires a shorter recovery time than open surgery. Most risk-reducing surgeries can be performed vaginally.
Every surgery has potential risks; some are more serious than others. Some hysterectomy risks can affect recovery.
- Delayed healing
- Blood loss
- Blood clots
- Pain (post-operative and long term pain syndromes)
- Injury to internal organs
- Bladder incontinence
- Sexual side effects
It is important for people to discuss possible surgical risks with a surgeon to understand the seriousness and likelihood of these risks before making the decision to have risk-reducing surgery.
Average recovery time after hysterectomy is about 1-2 weeks.
The following resources can help you locate an expert near you.
Finding gynecologists with expertise in cancer risk and treatment
- The Foundation for Women's Cancer has a search tool to help you find a gynecologic oncologist.
Some symptoms and conditions related to female reproduction may be managed by other experts.
- The Oncofertility Consortium maintains a national database of healthcare providers with expertise in fertility preservation and treatment of people who are diagnosed with cancer or have a high risk for cancer due to an .
- Livestrong has a listing of 450 sites that offer fertility preservation options for people diagnosed with cancer.
Financial assistance may be available to make the cost of fertility preservation affordable for more patients. Patients are referred to those programs as needed.
- The North American Menopause Society has a tool to help you find a qualified menopause expert in your area.
Sexual health experts
- The Sexual Medicine Society of North America (SMSNA) has a search tool to find experts in your area who provide sexual health care services.
- The American Association of Sexuality Educators, Counselors and Therapists (AASECT) maintains a tool to help people find a sexual health expert near them.
Other ways to find experts
- The National Cancer Institute (NCI)-designated comprehensive cancer centers deliver cutting-edge cancer care to patients in communities across the United States. Most centers have specialized screening and prevention centers for high-risk people. Find a center near you and learn about its specific research capabilities, programs, and initiatives.
- Register for the FORCE Message Boards to get referrals from other members. Once you register, you can post on the Find a Specialist board to connect with other people who share your situation.
FORCE offers many peer support programs for people with inherited mutations.
- Our Message Boards allow people to connect with others who share their situation. Once registered, you can post on the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Our Peer Navigation Program will match you with a volunteer who shares your mutation and situation.
- Our moderated, private Facebook group allows you to connect with other community members 24/7.
- Check out our virtual and in-person support meeting calendar.
- Join one of our Zoom community group meetings.