So many questions

Hi. I am new here. I am 54 years old and still have my cycles regularly. I am a 10 year survivor of salivary gland cancer. I went to my gyn yesterday because of pelvic pain on my left side. He did an ultrasound and found that my left ovary is enlarged and has multiple cysts. I have had laproscopic surgery on this ovary already - 4 years ago - to drain a cyst. It was fine then. My dr was concerned due to the size of the ovary and ordered a CA 125 blood test. I got my results today. It is elevated, but not horribly so. My dr has given me two options. 1) He will do another laproscopic surgery to drain and test the cysts along with a peritoneal washing and a D&C ( I also have a very thick endometrium and multiple fibroids) or 2) a hysterectomy and oophorectomy. My husband is concerned and would like me to get a second opinion, preferably from a gynecological oncologist, but I would like to keep things simple and just do what my dr recommends. Has anyone else been in my position and what did you end up doing? Thank you for any and all advice.

Indecisivelady -

My situation is not exactly yours but I will offer what information I can that might be helpful to you. I was having heavy bleeding and my gyn recommended a D&C. He first had a transvaginal ultrasound done so he could see a little bit of what he might be dealing with. They found a mass but at the time thought it was what had been causing recurring benign cervical polyps. After my D&C everything was sent off for pathology and we found that it was early stage endometrial cancer.

I know that a CA-125 can be elevated for many reasons and not just cancer. I know that Ovarian Cancer can mimic symptoms of many other things that is why it often isn't diagnosed early. Knowing me if I had had another type of cancer I would be heading to a gyn-oncologist at least for a consult. Stats indicate that if it is cancer prognosis is better the earlier a gyn-oncologist is involved in the process. Over on the Cancer Concerns forum there are frequently ladies who weren't expecting cancer to be found in their hysterectomy and when it is that brings on a whole new round of concerns and questions.

Here's things that I would ask the gyn:

• Can he / she guarantee that if there is cancer when they drain the cyst that they won't spread it during the drainage process?
• Is the peritoneal wash to determine if cancer cells are already present or if a) some might leak from the drainage or b) if there is endometrial cancer is he/she concerned that the D&C will spread the cancer? Studies are divided on this point some say a D&C with hysteroscopy can spread cells other studies say no.
• If cancer is found in the pathology after the procedures is it his / her intention to recommend you to a gyn-oncologist?
• If this were there loved one would this be the process that they would recommend for them or would they refer them to a gyn-oncologist now, especially since you have had another type of cancer?

I'm not trying to be alarmist but I'm trying to think based on my experience what i would want to know or ask at this time. I hope it helps.

as you make your decision.

Thank you for your reply Tauruslady. You've been very helpful. I have made an appointment with another ob/gyn for a second opinion and I'll go from there. In the meantime, I just started my second period of the month, which would explain the thick endometrium on Tuesday.