Should I do it or wait?

I am 53 and supposedly post menopausal. However, due to unusual bleeding (I shouldn't be bleeding at all) for 6 weeks my gyn did an ultrasound and found multiple ovarian cysts on my left overy and a small one on the right. My uterus looks fine. I do have fluid in the falopian tube on the left.

My gyn is concerned that at my age the chances for ovarian cancer are greater than if I were younger. She says that the only way to know for sure is surgery.

She has given me about 6 different options from the "wait and see" aproach (do another utrasound in 6 weeks) to radical removal of uterus, ovaries and tubes by an oncologist, with several "in between" options.

I would feel silly getting all that done if it is not malignant. BUT if it is, I would be sorry I waited.

How do I decide??????

Has your GYN given you the option of laparoscopy? The best visualization would be direct, I would think...and you could probably choose between converting if needed on the spot, or waking up and weighing your options before proceeding.

Have you had a CA-125? They're rather notoriously inaccurate, but if they are elevated due to severe endometriosis or ovarian CA, you still would need surgery to deal with the cysts.

Absolutely do not sign up for any surgery for this without consulting a GYN oncologist. If, G-d forbid, it is cancer, they would need to do the surgery anyway. They have more extensive training in lymph node excision, biopsy, and can repair intestine should that become necessary. Even if it isn't cancer, an oncologist is also ideally suited to endometriosis surgery.

It is possible, as endometriosis manufactures its own estrogen, that you have generated enough of the stuff to "cycle" once again. You don't mention whether or not you are using HRT -- if you are, you might want to talk with your GYN about stopping the estrogen until you know for sure what this is.

There is so much research to do, and this is such a difficult decision to have to make, especially if you've never had any problems before. And I know how scary it is. But it needs to be looked at, and the earlier, the better, is my on the subject. I know that, in my case, the combination of the large cyst and the elevated CA-125 made me just want to get that nasty thing out , cancer or not. And I wanted to know, not to sit and wait.

But then I'm not good at waiting anyway

Let us know what happens, OK?

Audrey

Hi,
Audrey has basically covered it real well as far as making the decision. There are alot of unanswered questions. Hysterectomy is a serious surgery. And it isn't an easy thing to decide. If you aren't ready for a hyster, don't do it. Such as one of things Audrey suggested is go for a lap first. That is what I would do. And alot of research. Also, get a 2nd and 3rd opinion. That would be a good way to go. Even if you are comfortable with your doctor, I think another opinion wouldn't hurt.

Good luck

Angl

Hun, I agree tht a lap is another choice. Whatever decision you make, it has to be one that you yourself feel completely happy with in your heart. Yes a hyst is major surgery and not a decision to be made lightly. Is there ovarian cancer in your family history? That would be a cause for concern. Please take your time and read and get all the information you can before choosing. Again alot of what you read you can take with a grain of salt. Keep posting here as here there are woman of all ages, who have had many different symptoms and you may find someone who has been in a similar position as yourself. Good Luck with your choice and please let us know what you decide. Hugs Vicki

Its me again. Yes laproscopy is one of the options she gave me.

I guess I'm thinking that if they have to go back in, that is 2 procedures (being put under, off work, uncomfortable, ect)
Plus, not knowing when I go under whether I will go back to work on monday or be out several weeks is not only difficult for me but also for my employer.

I guess I am leaning tword getting it over with--all or nothing. At least I would know one way or the other, and wouldn't have these bleeding issues anymore.

This unusual bleeding has happened before. I had a uterine biopsy about a year and a half ago. Also was checked every 6 months for abnormal cells before that. This is the first time ovarian cysts have shown up.

I have been on HRT for about 12-13 years. Thats another thing, I'm trired of always haveing to do adjustments to dosage. Have tried neary every product out there. The last couple of years it has been premarin and prometrium, taken every day and supposedly I should have no periods. Last time this hapened,(the bleeding) reducing the dosage solved it for about a year. We had already decided to do that before the results of the ultrasound came back since my hot flashes have disapeared pretty much completely.(A few years back we were raising the dosage because my night sweats and mood swings were so severe. ) My CA-125 is normal.

No family history of ovarian cancer that I know of. Lots of breast cancer in the women and prostate cancer or skin cancer in the men. I've had benign cysts removed from my left breast and they come and go in my right. Also just had my thyroid med adjusted (that can also cause bleeding issues, I understand).

Sorry to get so "long-winded"!!!

s Dmusicwoman

I was diagnosed with advanced ovarian cancer at the age of 49.
My strong advice to you would be to proceed directly to a gyn oncology surgeon for a second opinion before any decision is made. Take along the results of your ultrasound (hopefully it was transvaginal) and let the expert continue to help make the diagnosis and order further testing.
The gyn onc will probably order a ca 125 blood test. Not an exact marker by any means, but it is often helpful. They may also order a pelvice abdominal CAT scan and perform a recto-vaginal exam.
Laproscopic surgery is not often performed to diagnose ovarian cancer. The risk of spilling some ovca cells is too high. And if spillage occurs, your staging advances. A laporotomy is a much more controlled environment. And unfortunately this is major surgery.
If you err, err on the side of a needless hyster. Ovarian cancer is still the deadliest of gyn cancers.
Please visit the cancer concerns forum on hystersisters and let us know how you make out.
Best wishes to you.

karenann

I agree with Karenann - err on the safe side. I'm 49 & have had long & heavy periods for some time now. I also had a large ovarian cyst which my gyn was going to remove laparascopically until a suspicious thickening in the wall of the cyst was discovered on a transvaginal ultra sound. I wasn't too happy that the surgery became more ominous, but can't say I am sorry. Still waiting for the pathology, but things look good. No elevated ca125 level & no history in my family. It isn't silly to be overly cautious in a case like this, in my humble opinion.

Also, 2nd & even 3rd opinions can never hurt.

Good luck,
Mongie
tah/bso 9/27