Large cyst and oncologist?

Question

My gynecologist recently found a large cyst (10 cm) on my right ovary - it has thin, smooth walls, no echoes, no size change after a month of observation. I have had very minor symptoms - need to pee a little more often at night, but no pain of any sort and no discomfort at all during the day, and I have no family history of cancer. He said it was highly unlikely that it was cancerous, but that the size concerned him (torsion, rupturing), and he wanted to do a laparotomy immediately to remove it. I want the thing removed, but would like to avoid major surgery if possible, so I requested a referral to a doctor who would consider doing a laparoscopic surgery. Instead I was referred to an gyn-oncologist. When I asked why, he said he didn't think such a large cyst could be removed intact (in case it was cancerous - leakage, seeding worries) laparoscopically, but that an oncologist would be a better judge of the risk. In your opinion, would it be unwise to first seek a second opinion from another gynecologist who specializes in laparoscopic procedures, before seeing a gyn-oncologist? Does my cyst sound like a high-cancer risk? Thanks, joemy

loralai · Answer

I agree with the others. I've been all over this forum and I know I am on the right track with my gyn oncol and having a laparotomy. I am 34 and mine is 12 cm. I freaked out when I got referred to an oncologist due to some bad family history but I know now it's procedure and better to go this route. Like my husband says go with the oncologist who does 1000's of these surgeries than an obgyn who does 100's. I want to get it right the first time. Mine said even if he tried laprascopic and then had to finish up with a laparotomy then I'd have more healing to do. I will say if it makes you feel better about it all and you can even get an quick appointment then get the 2nd opinion. You need to be comfortable with the care you are receiving. Good luck and keep us posted on your progress.

Gatsby · Answer

Hi and welcome.  Dian is right, you are in the best possible hands.  Gyn/oncs are specialists and have more training in the area of female reproductive organs.  Your dr. is doing the right thing, and you are very lucky.  You are in my thoughts and prayers.  Godspeed
~Tascha

Anna-maria74 · Answer

I had exactly the same dilema with my surgery. I had a 20 cm tumor which my gny said he could theoretically remove laparascopically believe it or not its not simply a matter of size that dictates which type of surgery I know of woman with 40 cm tumors that have opted for keyhole surgery. 

My surgeon wanted to remove the tumor in tact because if the fluid spills into the abdomen it could be dangerous, not just because of the cancer risk but also - if it is dermoid for example - the contents of the fluid areas are toxic! 

We discussed the issue at length and because of my slightly elevated ca 125 and a dermoid diagnosis he wanted to do laparotomy (wasn't a dermoid as it turned out but hey lol) I sometimes feel a little pissed that I had a laparotomy but faced with the same choice I would do it again. Its not worth the risk! 

For me:

Vanity versus health = health

Whats 6 weeks recovery in the great scheme of things

Anna x

dian07 · Answer

Your gyn is doing exactly as he should...they all would folllow his example if they were as caring and competent as your gyn is....he knows a gyn/onc has more experience in dealing with the female reproductive tract and wants only the best outcome for you..you are a lucky woman as because of your gyn ...YOU WILL GET IT RIGHT THE FIRST TIME...they don't just work on women with cancer...they work on women with anything abnormal in their reproductive tract so don't think it must be malignant just because your gyn has called him in...99% of these things are benign.....
Peace.
dian

LindaF · Answer

From what I understand, a mucosal benign tumor rupturing would have been no small deal either as the contents themselves can seed and grow and prove fatal. I was stunned when I read that!!

L.

turtledovemom · Answer

I'm so sorry to hear that you're dealing with this issue.  I have to say that it sounds as if you're doc is totally on the ball...more so than too many of the other docs that we read about on this message board.  He/she is totally correct in that something of the size that you're describing runs the risk of rupturing and leaking during a laparoscopy.  Gyn/onc's have one job and one job only...that's to deal with cancers that strike women in their reproductive structures.  If your doc is directing you to a gyn/onc, PLEASE get there sooner rather than later.  

I totally understand your desire to have the least invasive procedure possible.  Please remember that the least invasive is not always the most prudent means of removing the problem.  

Whether or not your cyst sounds cancerous or non-cancerous...no one should be making that suggestion to you on this site.  The only true way to assess it is through pathology...that can only be done after its removed.  Again, it sounds as if you're being treated very intelligently.  I'm sure that more of our regular posters will be around to add their thoughts on your questions and concerns.  Please ask as many questions as you want or need to.  Keep us posted on how you're doing.  My thoughts and prayers are with you!
peace,
Anne

joemy · Answer

I forgot to add - I'm 33.

Large cyst and oncologist?

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