Cancer fear high among women having hysterectomy

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Many women who have their uterus removed for benign conditions may mistakenly believe that, unless they have the surgery, they’re likely to develop cancer, new research shows.

Researchers found that among more than 1,100 women who underwent hysterectomy for non-cancerous conditions, 29 percent said they had “a lot” of fear that they would develop cancer, without the surgery. The large majority, 80 percent, reported at least “a little” fear.

This was despite the fact that the conditions the women had - mostly fibroids, menstrual disorders or uterine prolapse - did not put them at high risk of uterine cancer or other gynecologic cancers.

The level of cancer anxiety in the study was surprising, according to lead study author Dr. Lisa Gallicchio of the Johns Hopkins University School of Public Health in Baltimore.

Given the benign nature of the women’s conditions, she told “Cancer fear should not have played a role in their decision to undergo hysterectomy - which is only one of several treatment options for the conditions the patients had”.

But the study, published in the journal Psychosomatic Medicine, did not look at whether concern about cancer was in fact a factor in the decision-making process.

“You could certainly suggest, due to the high levels of fear reported by some women in the study, that fear of cancer may have played a role in the decision to have a hysterectomy,” Gallicchio said.

Exactly why many women overestimated their cancer risk is unknown, but a lack of clear communication from their doctors is a possibility, according to Gallicchio.

For example, about 60 percent of the 1,142 study participants had uterine fibroids, benign growths in the uterus that rarely become cancerous. In medical language, however, fibroids are often called “tumors.” If a doctor uses that word, the study authors note in the report, a woman could mistakenly believe she has cancer or is at high risk of it.

“Physicians should make sure that women undergoing hysterectomy for benign conditions understand that they are not at higher risk of developing cancer if they do not undergo a hysterectomy," Gallicchio said.

She and her colleagues also found that certain hysterectomy patients - including younger women, black women and those who had less education or low incomes - had higher levels of cancer anxiety.

Women who are young or less educated, Gallicchio noted, may have relatively less understanding of their medical condition or its treatment options. It will be important, she said, to improve communication between women and their doctors so that patients can make a truly informed decision about treatment.

SOURCE: Psychosomatic Medicine, June 2005. 

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