What to do?

Hi everyone. and wanted to get some advice.

My GYN has recommended a complete OPEN hysterectomy due to a dermoid cyst on my left ovary that measures 9x6x6cm. I had a abdominal and transvag ultrasound on 4/6/10. I recently saw him due to heavy periods for the past 5 or 6 months which have become extremely painful. His nurse called my a few days ago with the results and said he wanted to do the surgery asap. She also said the the cyst was complex and that my left ovary was enlarged. The ultrasound revealed my uterus to be 8x4x4cm which I think is normal size. She also said that if I really didn't want a complete that he could just remove the left ovary and tube but wanted to stress the fact that with my weight I would have a higher risk of endometrial cancer and with my heavy bleeding and painful periods it is possible that I would have to have another surgery in the next few years so he is really recommending the complete hyst. The results of CA 125 test were 8.

I had a CT scan done in July 09 due to abdominal pain and it revealed the cyst which at that time measured 7.9x5.8cm and also 2 kidney stones in each kidney. In Aug 09 I saw a GYN/ONC who recommended removing the left ovary/cyst and then said I needed to decide if I wanted everything removed. He advised me because of my weight I "will" get uterine cancer (not that I am a higher risk for it just that I "will" get it). I am about 340lbs and there is NO history of female cancers in my family. At that time he did a a pap test and 2 biopsies and all came back clean. I was supposed to have the transvag ultrasound done for him but the next week I ended up in the ER with a kidney stone blocking my ureteral opening so I was dealing with numerous kidney stone issues including 7 surgeries to blast the stones or have stents inserted in my ureter up until Dec 09.

I lost my mom in Feb 15, 2009 due to what they believed to be pancreatic cancer (official diag. adenocarcinoma of unknown primary). She was diagnosed Dec 1, 2008 with a large mass in her abdomen and the cancer had metastasized to her bones and several tissue areas. They tested her for all female cancers and nothing was found.

I am currently searching for a doc for a second opinion as well as to find out my surgical options. My current GYN will only perform open hyst and I don't want to be cut open if I can avoid it. I am looking for a doc in another town or different practice that has performed laparoscopic surgeries and/or the da vinci surgery. I am also curious if it can be done vaginally.

I don't know what to do. Should I get the complete or just have the ovary and tube removed. I am 41 (42 in Sept) and have no children due to fertility issues with myself and husband. I don't want to have to have surgery again in a few years if the periods get worse but the fact of really not being able to have children scares me. I guess I have kept a little hope that someday it could happen but this would take away that forever.
I would appreciate any advice or input you have to offer.
It's times like this I really miss talking to my mom.

Thanks for listening and I'm sorry this is so long.

I would agree you need a 2nd and probably 3rd opinion. Certainly they can't say you for sure will get ca due to your wt, but there are other factors beside wt to consider. Taking an organ out because you might get ca later doesn't make sense for everyone. I do know Drs can have a big attitude about large women that is not always totally fact based which is why I'd suggest a 3rd opinion maybe, although yes there may be limitations as to type of surgery. Its not a decision to take lightly and doing your research in advance can help you sort thru info a bit. If you really wonder about the ca link maybe have a consult with a GYN oncologist directly since that would give you more accurate info. I certainly don't think you have enough, or accurate enough, info to make a decision yet, from what you say. (PS some ladies opt for a panniculectomy with the hyst so if you do opt for a hyst and have thought of the other, just be aware they can be done in the same surgery. Just an FYI since its been discussed here recently by other ladies. Not suggesting one). Good luck with your decision.

Precious,

Definately get another opinion. I don't know where you are, but check the ob/gyn's in the nearest large city.

I'm also zaftig. I'm 5'8" and weighed 288 when I started all this. I had a TLH 3/10 to remove fibroids (in Dec I found I had 2 the size of oranges). No complications to surgery due to my size (my Dr never mentioned it as a problem). Also, with the surgery, I've lost 20 lbs. (officially making this the most expensive diet I've ever been on )