Aggressive management of low-risk endometrial cancer in infertile patients of low socioeconomic status

Aggressive management of endometrial cancer often involves hysterectomy, a procedure where a part of the uterus is taken out to eliminate the cancer. This procedure results in secondary infertility and this may cause significant morbidity, especially in patients who wishes to have children. A 29- year-old woman presented with a chief complaint of vaginal bleeding. Curettage and hysteroscopy revealed a low-risk endometrial cancer. The patient was first given conservative therapy to preserve the uterus. After 1 year of treatment, her condition did not improve. The patient was of low socioeconomic status and was unable to afford in vitro fertilization. She decided to undergo hysterectomy, even though she was of childbearing age. Secondary infertility due to medical procedures significantly impacts the patient’s biology, psychology, and social factors. This patient’s decision to undergo aggressive treatment for endometrial cancer is influenced by her disadvantaged background. A patient’s socioeconomic status influences her decision making and affects her quality of life. This case illustrates how a patient’s socioeconomic status influences clinical decision making and progression of the disease. The clinician must appreciate socioeconomic factors that may influence a patient’s preference in managing endometrial cancer.