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Complex Cyst - Anyone Else??? Complex Cyst - Anyone Else???

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  #1  
Unread 01-20-2001, 07:41 PM
Complex Cyst - Anyone Else???

Hi Sisters, My DR. tells me that I have a "complex" ovarian cyst, along with fibroids. TAH/BSO & abdominal hernia repair is scheduled for 1/29. I have noted on several posts that sisters have Oncologists participating in their surgeries.

Although the GYN has encouraged me for several years to have surgery for the fibroids, it was only after finding a 6cm cyst that won't go away, that I finally conceded to surgery. The test (CA125??) test was negative, and the GYN said that the path report from two ultrasounds gave no indications of cancer, (appears to be cystic, but that it was "septated") she still recommended surgery.

I guess that as I rattle on and on....my real question is....do I need to inquire about whether an oncologist is needed at my pre-op next week?

Thanks much!

Ann
Memphis, TN
TAH/BSO & Abdominal Hernia Repair
1/29

[Edited by annh2 on 01-20-2001]
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  #2  
Unread 01-20-2001, 08:19 PM
Complex Cyst - Anyone Else???

Hi Ann:

I don't know how it works in the States, but here in Canada I think an oncologist is called in if the surgeon feels they are dealing with something cancerous or even a suspicion of it being malignant.

I know in my case the oncologist reviewed the results of the ultrasound and CT scan, and attended the surgery as well. I was told before surgery that it was very probable that they were dealing with a malignant tumor, so I was prepared for the worst.

I suppose it comes down to your confidence level in your doctor.
You may want to just ask if she feels the need to consult an oncologist and see what her response is.
Best of luck with your surgery!!! I will keep you in my prayers.
Maria
  #3  
Unread 01-21-2001, 09:19 AM
Me too

I too have a complex cyst about your size and I'm having TAH/BSO on feb 5. My understanding is that oncologists here (USA) deal with treatment options after a malignancy has been found. If one is needed they will see you after surgery to discuss treatment options. And if you need one you might want to interview several. Some gyn surgeons may also be oncologists, BTW. Surgeons deal with the repair of the body or physical removal of growths or organs. I'm not sure why an oncologist would be needed in the operating room.
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  #4  
Unread 01-21-2001, 11:30 AM
Complex Cyst - Anyone Else???

Hi all,

My experience is the same as Maria's. (By the way, Jennifer I'm also in Denver ) I was referred to an gyn oncologist prior to surgery and he ended up being the primary surgeon with my regular gyn assisting. He is also the oncologist now managing my treatments. Although not all oncologists are surgeons I'm sure glad mine was. I think it offers them a different perspective as they know what they're dealing with since they saw exactly what was there to begin with.

I think its a good idea to bring up on your next visit. Its wonderful that your tests have come back negative that's definitely a good sign.

Please keep us posted on how you're doing. We'll all say a prayer that your surgery will be uneventfull and take care of your problems.

Take care,
Vicki
  #5  
Unread 01-21-2001, 06:06 PM
Complex Cyst - Anyone Else???

Thanks to all for your replies. My pre-op is Tuesday, and I'll be certain to ask my GYN about it.

You're the greatest!

Thanks again,
Ann
TAH/BSO 1/29
  #6  
Unread 01-23-2001, 05:43 PM
May I add my 2 cents worth?

Hi Ann,

I also have complex (septated) cysts. While it is possible that they are benign, the septations indicate the possibility of cancer and they must be treated as such until proven otherwise.

The main concern is that whoever does your surgery is able to do proper staging. Normally this is done by a gynecologic oncologist, but it is my understanding that many gynecologists can handle Stage I cancer. In my case, for example, once the gyne/oncologist takes a look at the information, he will decide who will do the surgery and who will assist. If my gynecologist does the surgery the oncologist will be available and will step in if the biopsy done at the time of surgery is malignant, and he will do a full staging at that point, and perhaps an initial chemo treatment. If it is benign, she will continue and do a TAH. You do NOT want to be going back into surgery to have cancer staged. You want it done at the first go. To not do so can delay accurate diagnosis as well as treatment.

Good luck!

  #7  
Unread 01-23-2001, 05:46 PM
May I add my 2 cents worth?

Hi Ann,

I also have complex (septated) cysts. While it is possible that they are benign, the septations indicate the possibility of cancer and they must be treated as such until proven otherwise.

The main concern is that whoever does your surgery is able to do proper staging. Normally this is done by a gynecologic oncologist, but it is my understanding that many gynecologists can handle Stage I cancer. In my case, for example, once the gyne/oncologist takes a look at the information, he will decide who will do the surgery and who will assist. If the gyne/oncologist does the surgery, my gynecologist will assist. If my gynecologist does the surgery the oncologist will be available and will step in if the biopsy done at the time of surgery is malignant, and he will do a full staging at that point, and perhaps an initial chemo treatment. If it is benign, she will continue and do a TAH. You do NOT want to be going back into surgery to have cancer staged. You want it done at the first go. To not do so can delay accurate diagnosis as well as treatment.

Good luck!

  #8  
Unread 01-24-2001, 09:49 PM
Complex Cyst - Anyone Else???

Hello Annh2,

I also have a large complex cyst about 10.5 cm. I am scheduled for a TAH-BSO on Feb 12. Yes indeed you need to have a gyn-oncologist there. The reason is for them to be able to do any lymph node biopsy if the frozen section comes back positive in the OR. Most hospitals will not let every surgeon do lymph node biopsys because it requires special training and great skill. When they let any surgeon do the lymph node biopsy there are often no nodes found (in other words they did't do the job right) and then they would have to go back in to do another biopsy. My question is why do all of us need a TAH_BSO. Why not just the cyst and the ovary removed if there is no cancer. Can anyone answer that? Good luck on your surgery. I will keep all of you in my prayers.

Debbie (Evergoodx5)
  #9  
Unread 01-25-2001, 04:37 AM
why remove everything?

The answer I got to that question is that if you are 'done' with your uterus, and especially if you are already growing suspcious tumors, they want to take out the uterus and cervix, usually, to keep you from getting cancer later. Or at least to try to keep you from getting cancer.

Regarding the gynecologic oncologist, it is a unique specialty in that the doctor is a gynecologist who has had further training in oncology - therefore he can follow you all the way your treatment whether it is surgery, chemo or radiation. No other branch of oncology has this specialty and it is definitely a bonus for us. If the staging is not done correctly, nobody can tell you what the best treatment is.

I'm getting nervous, with surgery on Monday.
  #10  
Unread 01-25-2001, 11:59 AM
Same thing happened to me

I am so glad I opened this message board today. Since I had my TAH/BSO on November 7th and everything was benign, I usually don't come to this board, but usually go to the hormone jungle since that's what I'm dealing with now.

I can't tell you how similar your case is to mine. I, too, had a complex cyst that was about 10 cm, septated or multiloculated is the term they also used for mine. My gyn said that whenever cysts of this nature begin to change - begin to have more solid parts, they like to take them out. Looking back, I'm not quite sure why my gyn wasn't more reassuring that it wasn't malignant except that he probably didn't want me to be so very upset after the surgery - which I would have been - if he had said it was benign and it wasn't. There are no assurances of anything until they get in there and look and do the pathology reports. So, while I had no reassurances that it was benign going into the surgery, my gyn also said that after reviewing all my ultrasounds, tests, etc., that he didn't think it was necessary to have an gyn oncologist present during surgery. (I asked.) Again, in retrospect, that probably could have been a clue that he wasn't too worried about it being malignant. So, depending upon your confidence level in your gyn and what he/she says about the advisability of having a gyn oncologist present during the surgery - this may give you some clues.

Bottom line --- I just want you to know that I was so very scared and everything turned out okay. That will be my prayer for you too - and any other sister that is facing something similar.

djd

P.S. I'm 49 and just in the beginning stages of menopause so that's why my gyn and I decided before the surgery to take both ovaries. And since I had a small fibroid - the uterus too. Turns out, there was a small cyst on the other ovary and a collapsed one around one of the fallopian tubes. Guess you never know.
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