TLH: Hysterectomy coming fast (3/13) scared they will miss cancer

Hi. I am new here, although i did read here some last October, life was good then with only harder periods for past couple years and slightly irregular, but nothing i couldn't handle and thought maybe early menopause- when i rarely took time to think about it- and then, within like 2 weeks my stomach went from flat to looking 6 months pregnant, feeling bloated with heavy cramping, loss of appetite or full after 3 bites, constipation with almost make me pass out pain when i did go, but tired like never before like tired, (fatigued not sleepy), which in my 24/7 on call job, did NOT work well,so i saw my gyn and she ordered a uterine ablation, which was done 6 days later (and another mammogram, as i had been having 3 a year for one area to be watched) which was followed by 1/3 of my right breast removed 2 weeks later yet still no diagnosis so after consistent pain in the pelvic area, with fatigue worse, and 3 more trips to my gyn she said everything is benign so must be slight infection, then she said it has to be digestive since my weight was slowly climbing and i was still bloated with full fast, so i saw my GI and had upper and lower scopes all ok, so sent back to Gyn and she said it's nothing but prescribed a non estrogen mini BC pill, everything was consistent up until 2 weeks ago, where it became intense on the right side monday, feb 13, so on the 14th of Feb. saw my GYN she decided to do a transvaginal ultrasound where she was shocked to see a large 3 cm ovarian "cyst" on the right side where my pain had increased. So she says lets do a ca125 and if its normal we will do a full hysterectomy and if it is not normal, i will send you to a gyn/onc. Waited a week and CA12 came back at 14 so she has scheduled my hysterectomy for the 13 of March, meanwhile felt lump in left breast, sent for mammogram again, kept at hospital while radiologist read mammogram, sent on to ultrasound, then sent home. So now I have read so many stories of how the ovarian cancer was missed by GYN's but I know I have changed since Oct. 2016. I am fatigued, my sex drive gone, pain and bloated. Ido hope the hysterectomy works for all that, but she is so determined it isn't cancer, yet she will not prescribe me estrogen in any BC options for the reason mentioned above because she says estrogen will feed cancer
( that I don't have??!) and i bet i get a call for another lumpectomy on left breast since that's how the right went when it hit BIRAD 4. My issue is 2 things- if it is cancer will they miss it? and 2 if no estrogen how hard will menopause hit me after removing both ovaries? I am so very tired of all of this I do wish they could find cancer so I at least know where I stand! I am in no way saying that's not a big deal, it is. But the UNKNOWN is HUGE too. I am about to lose my job, my marriage is bad for the first time, and my grown kids don't like me this way.

You seem to have two different *possible* cancer issues going on. One is possible breast cancer. I assume that this is the possible cancer your gyn is referring when she says that estrogen will feed the cancer.

The other issue is that you have a large ovarian cyst and you're concerned that the cyst is malignant, i.e., is a sign of ovarian cancer (a different beast than breast cancer). Your gyn ordered a CA125, and the result came back normal. The problem here is that CA125 can have both false positives and false negatives. You might well want to talk with your gyn about possible false negatives on a CA125 and see if she'll refer you to a gyn onc.

Whether you have your surgery done by a gyn or a gyn onc, your ovaries and everything else will be sent to a pathologist for study. If cancer is present, the pathologist will find it. The main difference is that a gyn onc will sample some lymph nodes during surgery to check if the cancer has spread there. Your gyn probably won't sample lymph nodes, which means that *if* the pathologist finds cancer, no one knows what's going on with the lymph nodes and you face either more surgery or chemo and/or radiation recommended on a "just in case" basis.

thanks for that. no one else has said anything to me and I was really hoping for support. 6 days left and i am terrified cause no hrt with estrogen so i will have sudden menopause i think.. i am so close to backing out!

Hi llt88 -

I am so sorry you are going through all of this. Take a deep breath - I know all of this is very scary. Take this one step at a time, and do not get ahead of your diagnosis.

I had a very large complex ovarian cyst and had a cancer concern. While my CA125 came back normal, my OVA1 came back elevated. I also had an ultrasound and an MRI. My gyn onc surgeon took one look at all of my tests and said "You are having surgery ASAP. I have openings in my schedule for the next two weeks." Ten days later I am in the OR. All was tested in the OR and all was benign. (If there had been cancer, at that point he would have done sampling of lymph nodes and taken more tissue).

I understand your concern with surgical menopause and no HRT. Talk to your doctor about what are the alternative options. Also discuss your concerns about ovarian cancer and see if you can get a recommendation for a gyn onc.

We are here for you.

I'm in a small hospital with a regular gyn cause she refused to admit it can be cancer then she's same who says no estrogen as it feeds cancer. Today called and said left breast mammo and US shows masses. I have no idea what's up. Limited $ n insurance so not many choices. Lumpectomy of right breast was done last November week after ablation. So now she's shocked I have this "cyst" that's huge but jumped to total hysterectomy but that's 5-6 weeks down so what do I want to do about breast biopsy? Heck I don't know!! Ty for saying something to me. I so appreciate it. I'll try to find out more tomorrow on which is more pressing I supposed