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question about ovarian cancer question about ovarian cancer

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Unread 05-31-2004, 10:28 AM
question about ovarian cancer

I have a question about ovarian cancer...

I had my hysterectomy (LAVH) 2 years ago - I kept both ovaries. Until about 6 months ago I had no problems with the ovaries. About 6 months ago I began to develop pelvic pain (mainly on the right side). In January I had a vaginal ultrasound and it indicated that my right ovary had adhered itself to the vaginal cuff - the ovary had also developed several cysts which were simple and fluid filled. The plan was to wait 2 months and do another ultrasound to see if there were any changes. In March I had another ultrasound - the cysts had gotten bigger and were showing changes in appearance and structure - my pelvic pain was also increasing. I chose to wait another 2 months and had a third ultrasound earlier this month. The cysts have now become much larger and are complex. The pelvic pain is severe enough that I am using narcotic pain medication. My doctor has said he does not like how the ovary looks and it needs to come out - no more waiting. I am scheduled to have surgery this Friday to remove the right ovary. The plan is to have laproscopic surgery - the doctor said he will check the left ovary too and if need be they will both be removed. I have any pre-op appointment in 2 days - blood work will be done, including the CA 125.

My questionis this: is the only way to positively determine if the ovary has cancer is to actually look at the ovary and by pathology?

Thanks for any information you can share. I quess as my surgery date draws near I am getting more worried.

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Unread 05-31-2004, 11:11 AM
question about ovarian cancer

Welcome to hystersisters,

I had no problems with my ovaries....I was dx with endo-cervical adenocarcinoma, stage 1B. Before my surgery my gyn/onc could not give me an accurate dx on the staging....he said it could be carcino-in-situ on up to 1A-B. In other words, it is more accurate if they can actually see the affected area and send biopsies off for pathology. The bloodwork and the CA 125 tests will be helpful to the doctors, however, without doing surgery and biopsies, they can only make an educated guess.

As your surgery looms closer it is only natural to be scared and have questions...I know I did.

Sending good thoughts your way.
Unread 05-31-2004, 01:37 PM
question about ovarian cancer

Unfortunately - removing the ovary is the only way to be sure - because if it is cancer a biopsy may "seed" the inside lining of the abdomen with cancer cells.

In fact, if ovarian cancer is suspected at the time of a hyst, the surgery is performed with the organs removed "en block" or in one whole mass to prevent leaking cancer.

But, the combination of CA-125 and an ultrasound can give your doc an idea - but there is error both ways. My DH who is a DR recently had a person with a complex cyst and a ca-125 of over 700 end up with a benign finding - although her gyn onc had her in the OR in 4 days (just enough time to prep).

I hope the surgery goes well and everything is OK

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Unread 05-31-2004, 02:41 PM
That is what I was told ...

No way to positively identify the structure or tissue without a biopsy. I had a complete hysterectomy and then had growths where the ovaries once were. I went through the same testing and had a "suspicious mass" on the trans vaginal ultrasound and complex cysts. They did multiple CA125 tests and CT scans. I got a good pathology report after the surgery. But had to have yet another surgery ( which was not laproscopic) to address this concern. I am recovering fine, the waiting before the surgery was tough. I wish you good results like mine and hope you don't need any additional treatment. I would recomend that you have a GYN/ONC do the surgery.
Unread 05-31-2004, 03:08 PM
question about ovarian cancer

The others were correct.

Only a biopsy of the mass can diagnose an ovarian cancer. Also a gyne/oncologist is the best choice to operate when cancer is suspected. They have the skill to debulk as much cancer as possibleat the time of surgery.

It is very normal to worry. Soon you will know the answer.
Good Luck.


Ruth S
Unread 05-31-2004, 03:11 PM
question about ovarian cancer

Hi Lynn...

Wishing you lots of good luck with your surgery.

Will an oncologist/gynocologist be doing the surgery??? I certaily hope so and if you are not sure, please ask for one. If there is even the slightest chance that cancer may be present, an oncologist/gyno is the way to go...They are the experts.

Also, I am just curious...why not abdominal surgery??? My doctor would only do mine that way because he really wanted to get in and take a good look around.

Hope all goes well.
Unread 05-31-2004, 03:36 PM
question about ovarian cancer

Thanks for your replies.

I have an excellent doctor - gyn/onc.

The original plan was lap surgery but all that may change after I have the final ultrasound and blood work on Wednesday. The doctor has said that it may need to be changed to abdominal surgery. Whatever incision is necessary - I just want the surgery over with and the pain gone.

I appreciate all your answers and ask for your prayers. Thanks.

Unread 05-31-2004, 05:15 PM
question about ovarian cancer

s Lynn

I was glad to see your latest posting.
My gyn onc will not do laproscopic removal or biopsies of ovaries.
If the chance of ovarian cancer exists, she insists upon a laporotomy for removal.
From the sounds of your own gyn/onc he may share her thoughts.
Best wishes to you. Hopefully it will all just be a very painful cyst.

Unread 05-31-2004, 05:21 PM
question about ovarian cancer

Hi there!
I want to re-emphasize what the other sisters have already said. A gyn/oncologist should definitely do the surgery if cancer is suspected. Also, my understanding (please correct me if I'm wrong, sisters) is that if the ovary is suspicious, that an open procedure is indicated. If they do a lap and remove a cancerous ovary there is a higher incidence of seeding at the trocar sites. That's what I've read on the good ole' internet anyway!

And yes, the only way to be 100% sure of a cancer diagnosis is through direct observation of the tissue.

Please keep us posted on your condition!
Unread 05-31-2004, 05:25 PM
question about ovarian cancer

I'm having brain fog here, but I think there is some formula of ultrasound findings plus ca-125 readings that lead gyn oncs to decide whether an initial incision for an ovarian abnormality is a laparscopy or a laparotomy - all based on the odds.

MaryLynn - remember that these tests are "conservative" in that if the doc thinks there is any chance of cancer, s/he may opt for the more involved procedure. So don't fret too much


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