Am I being mistreated? Ovarian tumor etc....

[Mommyof3hellions]

I went to a specialist after many many months of agonizing pain in my pelvic and abdominal areas. They found cysts on both ovaries and my cervix as well as endometriosis and a 2.5cm bilateral tumor on my right ovary. The doctor reccommended me for immediate removal of the right ovary for biopsy and possible hysto once the extent of the rest is clear. This particular specialist is a teaching hospital. The gyn board decided to see if they could diagnose from the outside as opposed to removing the mass against my doctors strong reccomendation. They want to do more blood work and yet another transvaginal ultrasound 3 months later to monitor the growth of the tumor. Am I being put at risk for metastis? If this thing is malignant, they are really pushing it by just poking and prodding as opposed to removing. My doctor is still quite adamant that I need surgery 2 months ago instead of this **** but the board over rides her. If it helps I am 25 years old with 3 children and a massive family history of "female cancers" and endometriosis. I have not been on any type of birth control since I was 17. I'm sick and tired of being in pain and now scared to death that by being a guinea pig, I'm not getting proper care.

[Annekathryn Goodman, M.D.]

Hi There,

There are definitely situations where there are several possible approaches.  For young women with pain and ovarian cysts, the most common approach is watchful waiting so as not to do unnecessary surgery.

Commonly, one would consider adding a medical intervention to suppress ovarian cycling such as the birth control pill or even inducing artificial menopause with something like lupron. If the pain and cysts go away, then it is usually reasonable to continue on the pill.

Now if you have a strong family history of ovarian cancer, it is important to have a careful risk assessment. I would recommend a consultation with  a genetic counselor to fully evaluate your family tree and understand exactly what are your statistical chances for ovarian cancer. There are several blood tests that check for gene mutations. Depending on your family history, it may be reasonable for you to have this testing.  If you are at high risk for ovarian cancer, the current recommendation is for the prophylactic surgical removal of the ovaries and fallopian tubes. The age that this is done is usually 10 years earlier than the age of that your family members developed their cancers.

So say your mother got ovarian cancer at age 45, you should consider having your ovaries and fallopian tubes removed in your mid 30's.  On the other hand if all your relatives had cancers after the menopause like in their 70's, that is a very different risk pattern.

Now if you are in pain and medical interventions are not helping, then surgical evaluation by laparoscopy makes sense
best wishes

[gmwf1]

rather than asking if the question was helpful to me, i would prefer to see an answer from someone in the medical community