You might still have some questions after reading the section on DO'S AND DON'TS FOR YOUR SURGERY
How soon will I be seen and have my definitive surgery?
As a general rule, we do not have a long wait list in our practice, as Dr Tan personally triages every referral and only sees patients with a malignancy or complex benign gynaecology. Priority will be given to patients with a diagnosis of cancer, whom we aim to see and treat within 1 week of referral being received. Often certain tests may need to be performed, or pathology results to be reviewed in the WA GynaeOncology Tumour Board Meeting prior to your appointment. This may delay appointment times, but is necessary to ensure all information is at hand prior to your consultation.
After consultation, if surgery is deemed necessary and suspicious of malignancy, we will endavour to book the procedure within a week on one of the six sessions that Dr Tan operates a week.
After consultation, if surgery is deemed necessary and suspicious of malignancy, we will endavour to book the procedure within a week on one of the six sessions that Dr Tan operates a week.
Whats happens to the space inside my abdomen after the uterus, cervix or ovary is removed? What happens to the vagina?
Funnily enough, this is one of the most frequently asked question by patients undergoing a hysterectomy. The abdominal cavity is a dynamic space occupied by other organs including the bowels, bladder, omentum, blood vessels, etc. When the uterus is removed, the other organs in the abdomen have more space to move around to fill "space". Usually it is the bowels that fill the space. In certain circumstances, when the uterus is abnormally enlarged or if there is a big ovarian tumor, other organs can be compressed by the large pathology, so removal of it will resolve the symptoms of compression once the space is freed up. Once the uterus/cervix is detached from the vagina, the top of the vagina will be closed by sutures to enable it to heal without problems. Sexual intercourse is usually possible after 6 weeks.
Will I be menopausal after a hysterectomy?
This depends whether the ovaries are removed or not. A hysterectomy can be performed with or without removal of the ovaries at the same time. In certain condition, especially cancers, the ovaries are often advised to be removed to achieve a better cure rate. The ovaries sometimes can be preserved even in cancerous conditions, and other fertility sparing options are available if you are still young and desire to have more children: these special cases will need to be discussed with Dr Tan.
Naturally, women have 2 ovaries, and removal of 1 of them will not cause menopause as the other ovary is able to compensate. Studies shows that overall, your time of natural menopause may be accelerated by 6-12months if 1 ovary is removed.
If you are already menopausal (average age of menopause onset in Australia is 51yo) prior to the surgery then removal of both ovaries will usually have minimal side-effects of hot flushes, though if you are peri-menopausal (still in process of going through menopause with some hot flushes) then your symptoms of hot flushes may worsen.
Naturally, women have 2 ovaries, and removal of 1 of them will not cause menopause as the other ovary is able to compensate. Studies shows that overall, your time of natural menopause may be accelerated by 6-12months if 1 ovary is removed.
If you are already menopausal (average age of menopause onset in Australia is 51yo) prior to the surgery then removal of both ovaries will usually have minimal side-effects of hot flushes, though if you are peri-menopausal (still in process of going through menopause with some hot flushes) then your symptoms of hot flushes may worsen.
Is hormone replacement therapy (HRT) bad for me?
This is an intensely complex field and there have been numerous media releases that unfairly created negative connotations to hormone replacement out of context.
In summary, it depends on whether naturally you should be menopausal, or if your menopause is a consequence of surgery. If you naturally should not be menopausal but have been rendered menopausal after surgery, then HRT is a benefit in most cases. There are certain rare gynaecological cancers (Endometrial Stromal Sarcomas) that may exclude the use of HRT, but as a general rule, most gynaecological cancers after treatment, recurrence is not affected by whether HRT is used.
We will discuss in detail your specific clinical scenario and advise whether HRT should be prescribed. Necessary referrals will also be made to the "Menopausal Service after Cancer Care" at King Edward hospital or to Dr Paul Cohen who subspecialises in this area.
In summary, it depends on whether naturally you should be menopausal, or if your menopause is a consequence of surgery. If you naturally should not be menopausal but have been rendered menopausal after surgery, then HRT is a benefit in most cases. There are certain rare gynaecological cancers (Endometrial Stromal Sarcomas) that may exclude the use of HRT, but as a general rule, most gynaecological cancers after treatment, recurrence is not affected by whether HRT is used.
We will discuss in detail your specific clinical scenario and advise whether HRT should be prescribed. Necessary referrals will also be made to the "Menopausal Service after Cancer Care" at King Edward hospital or to Dr Paul Cohen who subspecialises in this area.
Is my cancer curable?
Up to 70% of gynaecological cancers are curable with either surgery alone or a combination or surgery with adjuvant chemotherapy and or radiation.
Bear in mind that less than 5% of medical conditions have a cure. There is no cure for asthma, diabetes, hypertension, skin allergies, etc. In these situations the disease is controlled, and every time if becomes a problem, aggressive management is employed. This is the mindset Dr Tan uses when treating ovarian cancer. Although less than 20% of ovarian cancer is cured, the condition should be treated like a chronic disease rather than a death sentence just like the way we treat asthma and diabetes. Each recurrence if and when they occur is retreated either with surgery and/or chemo therapy, just like a chronic disease which keeps being a problem occasionally and treated before becoming better again. The combination of radical surgery and tailored chemotherapy have enabled us to maintain long term survivors with a normal quality of life.
Bear in mind that less than 5% of medical conditions have a cure. There is no cure for asthma, diabetes, hypertension, skin allergies, etc. In these situations the disease is controlled, and every time if becomes a problem, aggressive management is employed. This is the mindset Dr Tan uses when treating ovarian cancer. Although less than 20% of ovarian cancer is cured, the condition should be treated like a chronic disease rather than a death sentence just like the way we treat asthma and diabetes. Each recurrence if and when they occur is retreated either with surgery and/or chemo therapy, just like a chronic disease which keeps being a problem occasionally and treated before becoming better again. The combination of radical surgery and tailored chemotherapy have enabled us to maintain long term survivors with a normal quality of life.