Ovarian cysts with septation - I am officially scared
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Hello ladies - I'm glad I found this thread! I had bilateral mastectomy this past December 31 due to breast cancer in both breasts. Since it was diagnosed early I din't need radio or chemo but should begin on tamoxifen next month.
I went for a full pelvic check up prior to starting tamoxifen and ultrasound detected a 2cm 'Solid Mass' in my right ovary. The Dr. does not think I should worry but we should remove it because of my bc history and family history of bc.
I want to remove both ovaries but Dr. does not think it is necessary as removing both will put me into full blown surgical menopause. I'm 49 and it should happen sometime in the next 3 years anyway, but Dr. says symptoms are much worse on surgical than normal meno.
I'm really scared right now and I'm looking for information and similar situation. Maybe it'll put me a bit at easy
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Hi Ladies, I picked up the results of my tumor markers (ca27.29 and ca125) today, and they are both within normal limits (wheww!!) I know they are not always 100% accurate, but at least they weren't elevated.
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Does anyone know what it means when the volume of the left ovary goes from 1.17cm to 12.68cm in two months time, and the cyst is only 25x22mm? I had an ultrasound and was told I have a 25mm x 22mm complex ovarian cyst with low level echoes. I was given 2 options. Wait 30 days and re-do the US or go see a gyne-oncologist. My regular gynecologist said that they will probably want to remove my ovary(s) but he does not want to do it just in case it is something. He told me ILC breast cancer likes to recurr in the ovaries. Gee thank you for sharing that with me. I knew that, but hearing it scared me. I am choosing to not wait the 30 days and get a second opinion next week from the gyne-oncologist. One hand wants them to remove everything, but the other is afraid of the surgery. Thanks in advance for any help.
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Just two months after bilateral mastectomy with bc in both breasts, I went for a routine pelvic check up prior to start tamoxifen...Ultrasound detected a 2cm solid mass in right ovary. My Dr. and ultrasound report say it may be a dermoid cyst but ovary should be removed. I decided to remove both as I'm 49 years old and should be in menopause very soon anyway! So, March 8th is my ooph surgery.
In the mean time, I'm driving myself insane and I'm so stressed and depressed about this 'solid mass' deal. I am soo scared that it might be something else other then a benign dermoid cyst. This waiting period is agonizing!
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Gosh, there are now 3 of us currently in this cyst/surgery situation! I have a complex cyst with a "mural nodule" (I think that just means there is something solid in it?). My ob-gyn is worried about it since I should't be making functional cysts since I just finished chemo in December and am in chemo-pause. So that worries me about the implications if this thing grew throughout all that chemo, or if it has grown to 3 cm in 2 months! Did either of you have your ca125 tumor markers run? I know they are not 100% accurate, but it's a start. Mine was 8. I see the gyn-onc on March 10th. He didn't want to see me until I was finished with my radiation, and I'm not done with that until this next Thursday so I have to wait an extra 3 weeks! And that's just to see him for the consult. This waiting is really getting old.
I hadn't heard that about the breast cancer spreading to the ovaries. Maybe that's just in the case of the ILC??? I asked my onc if it was possible for it to be breast cancer mets, and she said possible, but highly unlikely. She said she had never seen breast cancer mets go to the ovary in her entire career (she's retiring this next year at age 65)
Please, Erika09 and NancyLa, keep us updated on this. Erika, you have the surgery coming up really soon. Do you have to have the big surgery since there is something suspicious? Or are you doing laproscopy? Did you have any chemo for your breast cancer diagnosis?
Please tell more!
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Hi Weety 911 -sorry about your diagnosis! Lets hope and pray for all of us that these nasty things are just plain old ugly cysts. My Dr. told me that many times solid mass means 'old cysts' and they become solid and read as solid mass.
I did the CA125 and it also came back as 8. This was a good lift for me even though it is not such reliable test.
My Dr. also said he thinks it is benign dermoid but due to my bc history it is best to remove it. I decided to remove both while he's at it so I don't have to worry about another danger organ that I don't need.
I'll keep you posted and good luck
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Oh - My surgery is laproscopy via robotic Da Vince device. My husband's insurance is good adn they were able to schedule surgery soon but as far as I'm hoping for, no emergency but just good timing to remove it since I have to start on tamoxifen soon.
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Weety911- Unfortunately, ILC (invasive lobular) does like to recur in the ovaries. I do not think it is a recurrence, but with the bc history they can never say never until it is looked at. I did have the CA 125 and it came back 7. I will say a prayer that all of are cysts are B-9.
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Hi Nancy and Erika, Just checking in to see how you're doing. I've been having some weird cramping today off and on. . . if I didn't know any better, I would think that my period was going to start soon. That's what it feels like. I don't think it's possible, though, because I'm still having hot flashes like crazy from the chemopause. I wonder though, since it feels just like it used to right before periods. . . hmmmm.
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Hi Weety911 - How is everything else with you aside from the nasty hot flashes?
I went today for my pre-op ooph on March 8th. My doctor wants to do a total hysterectomy, this way only one surgery and no worries about tamoxifen later. So, now I'm scheduled for a full clean up!
I did some reading on Mayo Clinic website and they recommend total hysterectomy for women in my situation. I'm 49, never had kids, history on bc... The biggest step for me was deciding to remove both ovaries because I think they play a bigger role in the body other than just making eggs, but, since I'm already doing the ooph and having surgical menopause anyway it makes since to do total hyst including cervix.
I was too focused on the ovaries and never thought about my uterus. I guess I'm going to be left with only my vagina now!:-) Sorry for being crude!
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Erika, Yeah, that's the plan with me as far as I know as well. My ob-gyn had already said (even before finding my "cyst") that if I was going to have surgery to remove the ovaries (to get rid of the estrogen component) that I may as well have everything taken out all at once. Once the ovaries are gone, he told me the whole hysterectomy is not that much worse since the ovary removal is probably the worst of it, in terms of side effects from the menopause. Did your gyn-onc tell you that you can still do the laproscopy surgery? Or do you have to do the more invasive one now that it involves more than just the ovaries? I meet with the gyn-onc next week, two days after your surgery. Tell me more about what happened in your pre-op consult so I can be ready with my list of questions when I go for mine next week!
Please keep me updated about it all so I can follow your progress and know what to expect since I'm a week or two behind you. You can either post here, or if you're uncomfortable spilling personal details, feel free to PM me.
Hopefor30, I'm not sure what's recommended when it's the uterus involved, since the ovaries are what seems to cause all the side effects because of the estrogen. My thinking is, if I take it all out, not only is there one less place for cancer to go to, but also, one less place for me to worry about (which I think is probably more of the reason--the anxiety gets to me real bad!)
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Weety911 - Not much during pre-op! Some blood work and talk to GYN. He said he'd try to remove everything including uterus via laparascopic & through the vagina but he'd know for sure what to do once he's at it, but said the incisions would be small (1-2") and total of 5, one near the belly bottom and two on each side near bikini line. If you google Da Vince robotic device you'll get a better idea how to prepare for surgery. They did not tell me to do a colon cleasing' but the website indicates to do it. So, I think I'll be more comfortable all cleaned up before because anesthesia tends to make elimination more difficult after wards
The fact that I never carried pregnancies seems to make things easier. I guess uterus is smaller??? I forgot to get specific details on this and when I came home I started asking myself those questions. I will make sure to ask him before my surgery on Monday and will let you know. Let me know if you have any specific question and Ill ak my dc.
He gave me a prescription for pain killers (strong stuff) for after surgery, and that I should be at the hospital overnight only, 4-5 weeks full recovery.
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Wow!!! The laproscopic surgery has that big of a recovery time??? I thought recovery was only that long when they open you up completely!
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My doctor said that in about 3-4 days I should be out and about, and that 4-5 weeks is the time it takes for the surgery to fully heal ,and weight lifting and sex should e avoided. This is what he said about my situation. You should ask your doctor what he recommends for you.
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I had the TAH/BSO (everything removed abdominally)--no heavy lifting for 6 weeks (pretty standard for any open abdominal surgery, since they have to cut thru muscle); I took off 8 weeks as I am a PT and I do heavy lifting every day. My sil had the laproscopic hysterectomy and was given only 3 week restrictions, but actually was back to her normal routine in only 2 weeks. (but works a desk job so a lot of sitting).
Erica--glad to hear you are able to have it done by lapro surg---definitely a quicker recovery with less pain. My gyn had me do a home enema the night before. Be sure to drink plenty of fluids afterwards, and colace and senekot work wonders for the constipation! (pain meds are very binding). Feel free to PM me if you have any questions,
Anne
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Hi Anne I got you PM. Thanks again for all your great information and advise!
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I had a salpingo hysterectomy on August 4, 2009, this was a Tuesday and I went back to work the following Monday, it was a desk job. I did have some lifting restrictions for 6 weeks and a twinge or two of pain but really didn't need any painkillers. It was done laproscopically via the vagina. I'd had one cycst on the left side that had ruptured already when I got up one morning with pain on the right side. I ended up in the ER getting a CT done, there was a large 11 cm tubular cyst (grapefruit size) that wasn't there on the CT I had less than 3 months before. When it was all said and done, the cyst turned out to be hemoragic, the scary thing was that there was a previously undetected 4 cm met on the ovary hiding underneath the cyst, it was breast cancer, not a new cancer so it can happen. I was originally diagnosed with IDC in September 2007, when I finally got a mastectomy done 10 months later much more additional IDC was found scattered in flecks through out the breast plus ALH.
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Hi Vhqh - I'm so sorry about all you've been going through! (((((tight hugs to you)))))
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Diane I ended up having to have a hyst and ooph because of Tamoxifen also......I had 3 tumors in my uterus and solid complicated cysts on both ovaries and thickening of the uterine lining......I was sent to a gyn-onc in case I needed staging also...It scared the crap out of me!.....It had only been 10 months since I had been dx with bc.......I had the salpingo hysterectomy and also a TOT sling on my bladder as it had fallen over the years and was weak......I had been warned when I started Tamoxifen that this could happen......No wonder I love my oncologist so much!.....She is always up front with me on everything......I hope all goes well with you, Diane and you too Weety911.......Oh an d my revcovery time was only 3 weeks!...I wound up staying in the hospital for 3 days though because of infection and hemmoraghing (sp) which is rare..........
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Erika,
Good luck tomorrow! Keep us posted as to how the surgery & recovery are. Will be praying for the easiest removal, and of course, benign results! My consultation is on Wed.
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Weety911 - Thank you for your good wishes and prayers. I will send a note s soon as I'm out og the hopital. Good luck with your consultation
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Erika09: I hope you are feeling well after your surgery.Make sure you don't overdo things-pamper yourself. If anything comes up, feelfree to PM me.
TCK
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Erika, Hope surgery went well and you are recovering nicely!
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Ladies,
I'm sure many have heard the news about the OVA1 test for ovarian cancer, but here is a link to explain it. I don't know if it's used as a screening tool, but it sounds like it is a step up from the ca 125, which can be an unreliable predictor of ov ca
MM
10. March 2010 01:48
OVA1TM, the first blood test cleared by the U.S. Food and Drug Administration (FDA) for aiding in the pre-surgical evaluation of a woman's ovarian mass for cancer, is now available nationally through Quest Diagnostics, Inc. (NYSE: DGX), the world's leading cancer diagnostics provider. With the availability of OVA1, physicians can assess, prior to a planned surgery, the likelihood that a woman's ovarian mass is malignant in order to direct her to the most appropriate surgeon, promoting more favorable treatment outcomes. Vermillion, Inc. (OTC: VRML.PK), a molecular diagnostics company, developed the test in cooperation with Quest Diagnostics.
OVA1 is the first FDA-cleared protein-based in vitro diagnostic multi-variate index assays (IVDMIA), a new class of state-of-the-art software-based diagnostics. The test combines the results of five well-established protein biomarkers to produce a single numerical result to help a physician classify the likelihood that a woman's mass is cancerous or benign.
"The availability of a new test that can help gynecologists and other physicians determine the likelihood a woman's mass is benign or malignant is a significant development in the battle against this devastating disease," said Karen Orloff Kaplan, MSW, MPH, Sc.D., chief executive officer of the Ovarian Cancer National Alliance, a leading patient advocacy group. "It is a big step towards helping each woman get the most appropriate care for her unique situation."
Ovarian cancer is the leading cause of death from gynecologic cancers in the United States and the fifth-leading cause of cancer deaths in women.(1) Ovarian masses affect an estimated one million women and lead to as many 300,000 ovarian mass surgeries in the United States each year, according to an analysis by third parties on behalf of Quest Diagnostics.
Clinical practice guidelines recommend that women with ovarian cancer be under the care of a gynecologic oncologist. Yet, pre-surgical evaluations of ovarian masses, which include clinical evaluation and radiological tests such as CT scans and ultrasound, may provide inconclusive evidence of cancer. An estimated one third of initial surgeries for ovarian cancer are performed by gynecologic oncologists.(2)
"Studies show that surgery performed by a gynecologic oncologist to remove a cancerous ovarian mass is associated with more favorable outcomes," explained Fred Ueland, M.D., associate professor gynecologic oncology at the University of Kentucky's Markey Cancer Center and principal investigator of the prospective, multi-center OVA1 clinical trial evaluated by the FDA. "Based on my clinical experience, I believe OVA1 will not only help identify more women with ovarian cancer for referral to a gynecologic oncologist and improve cancer treatment outcomes, but it also will give other women greater confidence that their ovarian tumor is benign."
In a prospective clinical study, OVA1, when combined with pre-surgical clinical and radiological assessments and used by non-gynecologic oncologists, detected 92 percent of malignant ovarian masses compared to 72 percent without OVA1. In addition, 14 of 20 woman who participated in the study whose cancer was missed by pre-surgical clinical and radiological assessments would have been identified as having malignant ovarian masses had OVA1 results also been evaluated prior to their surgeries.
"Too often, a gynecologist will operate on a patient for an ovarian mass only to find an invasive malignancy requiring the skill of a specialist to remove," said Jon R. Cohen, M.D., senior vice president and chief medical officer, Quest Diagnostics, and a surgeon. "When this happens, the physician may need to prolong or terminate and reschedule the operation unless a gynecologic oncologist is readily available. OVA1 may help gynecologists and other physicians direct more women with cancer to a gynecologic oncologist for their first and hopefully only surgery."
Approximately 21,600 new cases of ovarian cancer will be diagnosed in the United States in 2009, and approximately 14,600 women will die of the disease.(3)
The FDA announced it had cleared OVA1 in September 2009, and Quest Diagnostics is the only national laboratory services provider to offer it broadly in the United States.
SOURCE Quest Diagnostics Incorporated; Vermillion, Inc.
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Posted in: Device / Technology News | Women's Health News
Tags: Cancer, Cardiology, Hematology, Oncology, Ovarian Cancer, Ultrasound
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Thanks! I will ask about that at my appt this morning!
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Just got back from the gyn-onc visit. He doesn't seem as concerned as my regular ob-gyn was (he kept saying how RARE ovarian cancer is) but of course that doesn't take the fried nerves away from me because no one suspected my breast lump was cancerous either until the biopsy came back. Anyways, he is still recommended surgery with a gyn-onc present (him) just in case it does find any malignant components. I'm trying to decide right now which way to go--I can do the traditional "open" surgery with him and remove everything (uterus, ovaries, cervix) for preventative reasons for both the breast cancer (estrogen) and ovarian cancer OR I can do the laproscopic surgery, still removing all components with a regular ob--gyn, but with him on call as an "assistant" in case something malignant is found. The "open" surgery could be done in as early as 2 weeks (but involves much more recovery time because of the open incision) The laproscopic surgery wouldn't be able to be done for 4-5 weeks (but involves a much shorter recovery time) I guess the question is whether or not a few weeks delay would make a difference in the outcome if any cancerous cells were found. The gyn-onc didn't seem to think so. What do you all think?
Also, mymountain, I asked about the OVA1 test you mentioned above. He said it is very, very new and mostly used to help decide whether or not a regular ob-gyn can do the surgery, or if a gyn-onc should be doing the surgery because it is at a higher risk of malignancy. In my case, either way the gyn-onc would be there, so no need for the test. Thanks for posting the info--that's why we on this board always know so much about what's new and upcoming in our treatments!
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Hi Weety911 and TCK - I got back from the hospital the day before yesterday, 7 hours after the surgery. Apparently, everything went OK and Dr. seems to think all is OK and mass was just a cyst & pathology report will be available in 5-8 days. I'm expecting the best.
As for the post/recovery, They injected air in my abdomen for the laparascopic surgery, and they don't seem to remove all that air out after wards. Since I came home I feel sooo bloated and it is very painful. But other than that everything seems OK and no bleeding or menopausal symptoms yet. I guess those will kick in in a few days...Thank you for your concern and good wishes.
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Erika, YAAAAAAYYYY! I know its not completely official until the path report comes back, but soooo glad they think it was just a cyst.
Did you have everything removed, including the cervix?
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Erika,
Congrats getting through! and hope your path will be perfect and b9!
Weety,
Did your surgeon say what kind of incision she would use, vertical or horizontal? They are both about 6-8 inches long. That is the reason I'm refusing the surgery at this point. I have a grapefruit sized fibroid (with the accompanying uterus and ov cysts) that have to come out too. Therefore I am being discouraged from having it via laparoscope. From what I understand they have to pulverize what can't fit through the tube, and then suck it out. Not a problemif they are 100% sure your pathology will be negative. If not those rogue cells could escape through the pulverization. I have the hip to hip scar from my diep, and don't want to be cut again.
I hope the OVA1 will replace the ca 125 which isn't the most accurate.
MM
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Hi Weety911 & mymountain -I got pathology report in and everything is B9 and I'm so happy and thankful! I'm also so happy I went ahead with the decision to remove everything. Apparently my reproductive organs were starting to give up. (I guess they felt neglected over the years without use as I never had kids) My uterus was 3 times bigger than normal with Leiomyoma & endometrial polyps, right ovary had hemorrhagic corpus luteum cyst left ovary had cystic follicles....My surgery was laparoscopic robotic w/ Da Vince device. They removed specimens intact through the vagina (cervix included) and I had 5 small incisions on my abdomen.
You might want to check with your Drs about it . You may be able to avoid large vert/horiz cuts or pulverization depending on the situation. Some hospitals don't have this robotic device. It is worth checking to make sure your hospital/insurance area offers it. Best of luck to both of you on whatever you decide. Erika
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