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large ovarian cyst large ovarian cyst

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Unread 05-16-2003, 10:53 AM
large ovarian cyst

I posted last week about an ultrasound I had to have - I had a TAH RSO in April 2002. Life afterwards has been blissful! But nearly 2 weeks ago started having bad ovulating/period type pain that kept me up at night, etc. Regular doc ruled out urinary tract stuff due to clean urinalysis - ordered ultrasound. Turns out I have a 10x12x9 cm "simple" ovarian cyst. She has since had me do a C-125 and told me to get my butt to my gyn (scheduled for next Tuesday).

My questions:
1. Has anyone had such a large cyst on a their remaining ovary?
2. Even tho the 1st ultrasound did not detect any strange wall structures or anything, what are the risks?
3. What is the urgency of dealing with something like this? Except for relieving my discomfort (pain has diminished considerably this week, except for today I am a little crampy).
4. Even if the cyst looks benign, will my gyn probably want to remove it (since it probably should've come out last year anyway but apparently looked healthy, but was attached to my intestinal wall with scar tissue - I think, that's the story).

Of course, waiting is the most miserable part of all this.
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Unread 05-16-2003, 11:27 AM
large ovarian cyst

Of course, waiting is the most miserable part of all this.
So it is, especially the part about the CA-125!

These are all questions that will need to be raised at your appt. on Tuesday. In fact, I would print out this thread to take with you, as you know it's difficult to remember all these questions under the pressure of a (possibly hurried) appointment.

My own take on this, having had a cyst of much the same size last year, would be to have it removed. You do not wish to have it rupture !! And, cancerous or not, it's causing pain and (already) adhesions and can interfere with normal intestinal or bladder functioning.

Quite honestly, once I knew that I had a cyst that size (and it explained so many of my symptoms), I wanted it OUT. I was hoping at the time that it would be a laparoscopic surgery, but it was not to be. And, in retrospect, I'm very glad that I went with a GYN-oncologist, a route you should explore.

If this is adhered to your intestines or peritoneal wall (and if, G-d forbid, it's not benign), the oncologist has the specialized surgical skills to perform the surgery that you need. Dissecting an adhered cyst off the intestinal wall may be a bit tricky, but the oncologists know their stuff.

You ask about the urgency. If I had your scenario (and mine was similar), I would want to move relatively quickly. Often it takes some days to get into the oncologist's office and then to get surgery scheduled. This thing isn't going away on its own. And about whether or not to keep that remaining ovary: again, I'll share with you what my doctor had to say about it. She told me, "if you've formed a cyst this large before, odds are that within a year you'd form another one". At the time, I felt strongly that we could not afford another surgery so soon, either financially, emotionally, or physically. So I elected to have both ovaries removed. As it turns out, it wasn't so "elective" -- everything was fused to everything else anyway .

So, if you're over 45, and have no contraindications to estrogen replacement (history of blood clots, cancer, etc.), most doctors would probably recommend having that ovary removed. It may be that your surgeon has no choice anyway.

Do research your HRT options prior to going ahed...visiting the Hormone Jungle will be educational. I'd bet this remaining ovary isn't working so perfectly anyway under the load of that cyst!

Good luck to you, and let us know what the GYN has to say, OK? I do hope your pain improves. And, please, be careful during this time -- nothing that requires abdominal straining (and my doctor said no "innercourse"). You don't want that to rupture!

-- gently,

Unread 05-16-2003, 11:42 AM
large ovarian cyst

Thanks for the insight. I am already on .3 mg estrogen (only) as last summer I started having major hot flashes, sleeplessness, etc. Again, that's why I say the last year (esp. after the estrogen) has been bliss!

I am already prepared to say to the gyn that I want the absolute best surgeon on this job - since he obviously chose not to remove the ovary last year.

I remain positive (my mom is waiting the results of a breast biopsy - she has already had one breast removed - luckily I am adopted so I don't have that fear...), but the more I read and try to be objective, the more concerned I become.

I do have insurance, so the cost of surgery is not a concern. The time off may be a drag, but again, if we survived last year's 8 weeks of disability, we can do it again.

When they order a C-125, are they legitimately concerned? Or are they just screening.
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Unread 05-16-2003, 11:51 AM

A CA-125 is a routine any time a cyst that large is found. The problem is, it's not very sensitive: some ladies have a very high CA-125 (I was one of those) without cancer...and there have been ladies with cancer who had low levels.

Endometriosis can elevate the CA-125 as well. It's more useful as a marker for you specifically -- if cancer or endo are found, it can be tracked to monitor any therapy that may be needed. So I wouldn't panic over an elevated CA-125; nor would I have been reassured by a low one, although a low one in conjunction with the ultrasound appearance of a "simple" cyst, would offer pretty slim odds of that cyst being cancerous.

I'm glad you're looking into finding a surgeon. If this cyst turns out to be endo, you may want to reconsider the HRT options and a little research would be beneficial there! We have lots of threads about endo in the Jungle and the Oasis.

Given your mom's history, you quite honestly have some real concerns. The CA-125 is going to be a bit more important to you...and if her cancer is the estrogen-dependent type, you'll also be researching your options hormonally.

I hope her biopsy turns out well. You're waiting on two fronts, aren't you?? . Let us know!

Unread 05-16-2003, 12:20 PM
Audrey Gave Excellent Advice

I can't improve on that. That it's a "simple" cyst is a good sign. But that's b-i-g for sure so as soon as a gyn/onc can get you in and take it out, the better. Keep us posted! Ellen

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