Woman with no history of cancer should not risk hysterectomy

DEAR DR. ROACH: A friend who is a breast cancer survivor recently had another friend who survived uterine cancer, but learned she had bone cancer after five years of being cancer- free. I am 76, and my friend insists I’m crazy if I don’t have a hysterectomy to avoid getting cancer in that area. I have no history of cancer or concerns with the health of my reproductive body parts. Please share your thoughts on this topic. – R.D.

ANSWER: Endometrial cancer, cancer of the uterus, is a common cancer (about 3 percent of women will get it) and is increasing in frequency; fortunately, it is curable in most. Unfortunately, there are women who do present in later stages, when the prognosis is not as good. I would be very surprised if the friend’s bone cancer came from the uterus. Unlike breast cancer, which can show up frequently in bones years after an apparently successful treatment, uterine cancer is found locally in the vagina and pelvis, even spreading to the abdomen or lungs, but bone spread would be very unusual.

The most common form of endometrial cancer is often related to an excess amount of estrogen, either taken as a prescription or produced by the body (such as with polycystic ovarian syndrome or obesity). Women at highest risk (such as those with a genetic syndrome, like Lynch syndrome, that predisposes them to endometrial cancer) should consider medication or surgery when childbearing is complete.

For a woman like you with no increased risk for endometrial cancer, I do not advise either medicine or surgery to reduce your risk. Regular exercise and a normal weight reduce risk of endometrial cancer. The risk of surgery outweighs the benefit if only used for prevention of uterine cancer in a woman with average risk.

DEAR DR. ROACH: I have been researching studies of erectile dysfunction linked to motorcycle riding. My “gentleman” is 58 and has been riding for about six years. He has no health problems, except for rheumatoid arthritis that only affects his eyes. He does not take any daily medications.

During the warmer months when he rides at least 100 miles per week, he experiences ED (for which Viagra has been helpful). When it’s cold and his riding is less frequent, he has no issues getting or maintaining an erection, so it certainly appears – at least for him – that there is a link between ED and riding his motorcycle.

I’m just wondering if you’ve seen this to be true or have any verified data on the subject. I’m sure your readers who are motorcyclists would be interested in finding out. – A.C.W.

ANSWER: Although there is controversy, my reading of the literature shows that it is likely that both motorcycle and bicycle riding can cause erectile dysfunction in some men. The problem is usually not severe and, like with your gentleman friend, normally goes away after being off the bike for a while. The problem is direct pressure from the bike saddle onto the pudendal nerve. In addition, motorcyclists have the engine vibration, which can also affect the ability of the nerve to carry information.

Bicyclists and motorcyclists both may benefit from differently shaped (and perhaps better-padded) saddles as well as avoiding riding for long periods of time.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@ med. cornell. edu or send mail to 628 Virginia Dr., Orlando, FL 32803. ( c) 2023 North America Syndicate Inc. All Rights Reserved