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Ovarian Cancer  (Expert Forum)
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had diagnostic laparoscopy, need anything else to confirm not ovca?
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center Boston - MA
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This forum is for questions and support regarding ovarian cancer issues, such as: Biopsy, Chemotherapy, Clinical Trials, Genetics, Hysterectomy,Immunotherapy, Ovarian Cancer Types, Radiation Therapy, Risk Factors, Screening, Staging, Surgery.

had diagnostic laparoscopy, need anything else to confirm not ovca?

by kd0522, Jan 20, 2007 12:00AM
I'm a female in my mid-30's, with lower abdominal/pelvic pain since this last May, and I've gained ten pds. (124 to 134).  The pain resembles constant, dull menstrual cramps/discomfort with rare sharp pains shooting into vaginal and anal areas.  The pain moves from the center (above pubic bone) to (rarely) the left side.  The pain is never gone (can be from a 3 to a 7 on scale), but seems to be better in the morning and worse in the evening.  



I'm at a loss (as are the docs) as to what to do now.  I've had:  basic cbc blood test, STD testing (normal), a trial of Doxycycine, pap smear (normal), pelvic ultrasound (normal - ovaries normal in size, no masses), abdominal and pelvic ct scans (2)(normal-latest was last month), cytoscopy (normal), colonoscopy (normal), and lastly, a laparoscopy where the gyn. found my appendix had been inflammed and adhesions from the intestine to the rt. ovary were present, but nothing in the central area and left side which is my area of complaint.  A gen. surgeon was called in to remove appendix - adhesions removed, too.  I have no family history of cancers on my mom's side, and have no history on which to draw from on my dad's. My ob/gyn thinks we've excluded gyno issues now.



Even with all this testing, I still get panicky about cancers, especially ovarian.

My questions are:  Have I missed any ovarian tests?  Do I need the ca-125 blood test since I've had all the other work-up?  Someone mentioned that to me, but they didn't know I'd had lap surgery or the other stuff.  Does this appear to be anything gynecologically related at all?  

by Annekathryn Goodman, M.D., Jan 22, 2007 12:00AM
Dear KD,

Thank you so much for your very complete information. It sounds like you have had a wonderful evaluation. No, if you had ovarian cancer, it would have been picked up at laparoscopy.



I agree with you gynecologist. It probably is time to look into other possible reasons for pelvic pain such as fibromyalgia, levator ani syndrome,vulvodynia, and so on. Some pain is never explained by our present ability to name things. It is important to start the process of getting help for the pain such as acupuncture, exercise programs, massage, or a pain consultation.



While you tests are all normal this year and I do not see the need for additional testing right now, it is important to schedule a follow up appointment with your gynecologist in 3- to 6months fro a re-examination and an assessment of how you are doing.

Take care

Member Comments (3)

by kd0522, Jan 20, 2007 12:00AM
To: Doctor
I meant to mention measurements from ultrasound:  ". . .uterus measures 2.9 x 3.9 x 6.7 cm. . . .endometrial thickness is 3.88 mm which is normal. . .ovaries are normal in size and appearance. . .right ovary measures 1.2 x 1.9 . 2.1 cm. . . .left ovary measures 1.4 x 2.1 x 2.7 cm.  No adnexal mass or cul-de-sac fluid is seen."



However, last ct scan (dec. 15), as opposed to first ct and ultrasound, does mention ". . .since the prior exam there has developed a small amount of free fluid in the posterior cul-de-sac which is not unusual for a female this age."



Should I be concerned about this development or is it a result of the laparoscopy, or simply something that exists in someone my age like the radiologist said?



Sorry, but my question post didn't allow for this information.



Thank you for your time and service!

by debfromoakland, Feb 12, 2007 12:00AM
mqybe the adhesions are referring pain across to your other side?  You never know what dots those adhesions might conenct!
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