Help with different options?

Hello, I've posted on different area's of the forum and finding it hard to find where I posted. I do know that this board was recommended. So, here goes my question. I had a cone biopsy and cryosurgery after my daughter was born almost 11 years ago. I was dx since then with PCOS. But, then the pain got worse and bleeding continued between cycles. I had a pelvic ultrasound that showed I had a 'complicated mass' on my ovary. This was ordered by my reg. doc and she has since moved. But, before moving she sent me to a gyno and they did their own pelvic ultrasound and she said there is no mass but a cluster of cysts that can make it look like a mass. I don't understand this since my reg. doc explained to me in detail about the wall between the mass.

The gyno has scheduled me for a LAVH which is next week. (July 26) My guestion is that I have read that if cancer is suspected there should be other tests (biopsy, mri, c125) And that the best operation for this is a adominal hysto so that cells don't leak back into the body if it is cancer. Am I doing the right thing? I'm a bunch concerned and a whole lot of scared!

I'm a little confused as to why the surgery---if the cyst is the only problem? Are they suspecting ovarian ca? Which tests, if any, depends on symptoms and what they suspect. In general, if cancer is suspected it's best to see a GYN oncologist. It's not necessary to have the abdominal hyst for ca, they commonly do davinci, similar to LAVH. I'm sorry you are dealing with this, I know it's scary. If cancer is suspected a GYN oncologist can be sure you have the proper tests and surgery. I know you are scheduled soon but a GYN onc can be sure it's the right plan.

Cannot answer all the questions, but I had advanced cancer of the uterus with spread and I had a LAVH, plus a radical pelvic lymph nodes dissection and that was the surgery that was indicated for that situation.
I believe they really should do a CA 125, but a lot of the other tests can be misleading preop unless they suspect that the cancer has metastasized.
The surgery itself can tell more about the cancer (if that is what it is) than an MRI>
If they think you may have mets then they do more testing, but that is often to determine if you should have chemo before surgery to shrink the cancer,
I am assuming that at this stage they do not expect mets and ultrasounds are pretty good tests for looking for mets in the pelvic area.

When was your last pelvic ultrasound? I didn't get a good feel for the timeline you've followed other than that your cone was 11 years ago.

Is your LAVH for the PCOS then? Or for some other reason?

I would ask your gyn if there is any possibility of cancer. I kind of get the feeling that if they haven't approached that with you that they are not considering that to be likely. With PCOS, as I understand, multiple cysts are common, so they might feel fairly confident that indeed, you just have a nice collection of cysts. However, if there is any possibility of cancer, then you should have at least a consultation with a gyn/onc because they are the specialists in this situation. A Gyn/onc may or may not recommend additional testing based on the US report.

Good luck! I hope your surgery goes well.

My last Pelvic Ultrasound was just a few weeks ago. The one before that was 6 months ago. They also recommended surgery but because of complicated mass. Which she says isn't there. I also have adnormal bleeding and fibroids. I had some lumpectomies about 7 months ago and was told then that my insurance wouldn't cover a ca 125. So, I am sure that is why she isn't running one. I've tried to get a second opinon but no one can see me before the surgery date.

I do plan to ask her alot more questions during the preop that I didn't have with me when I had the pelvic. I had no idea she would schedule a hysto that same day. I do plan on asking about a consult with a gyn/onc. I'm just wondering about this paticular surgery. In the chance the first US was correct.

She plans on taking the uterus, cervix, and one ovary.

Thank you, everyone for your replies. They do mean alot.

Dear Starz,

I'm sorry you're going through an uncertain situation. The others here have mentioned talking to a gyn oncologist, who is a specialist in cancers of the reproductive organs. That would be a great idea and would give you more information about your specific case.

About your original question: Yes, an LAVH surgery (as opposed to an abdominal) can be an appropriate option not only for a hysterectomy but also for a full cancer staging surgery--if performed by a gyn/onc. A cancer staging operation is usually recommended when cancer is suspected. The pathology report will show if you have any cancer and, if so, how far it has spread and how aggressive it is. This is important information just in case you needed any further treatments after your hysterectomy. It may turn out that you don't have cancer, but the surgery will give you and your doctor peace of mind.

Best wishes to you during this time--we're rooting for you here. Let us know what you find out.

Just an update to all the wonderful sisters here. I had my pre-op appointment and was surprised that there was no blood draws or anything. I really felt that she didn't know enough about my history to be doing the surgery. And, my diabetes was not even a concern. I asked her if there could be cancer and she said that with my history and the mass there was a chance but only a pathology report would tell. So, I asked her about a ob-oncologist. She said that the one at the hospital wont see women until after the dx. I told her that I was kinda disappointed in that. She had also told me that she planned on doing a LAVH with Right SPO .. but, because of my previous surgeries she might end up doing a full abdominal. I told her I didn't want to go to sleep thinking I was getting one thing and wake up getting a complete different thing. So, end case .. she is sending me to a ob-onc. It's a long ways from home though. I go the 4th. I will update as I know anything else.

Thank you for your responses.

So you didn't have the hysterectomy yet? I am so Proud of you!! Thats why second and third opinions are needed. We are told one thing but when we push or ask the same question to a different doctor you might get a different answer. I truly feel that when you have gotten enough answers that start making more sense to you, then and only then, will you feel comfortable with whatever your decision turns out to be Please keep us posted.