Chemo or no?

[KonaMel]

Hi all, 3-weeks ago I had an ovarian cyst removed laparoscopically along with a BSO by a ob/gyn.  The pathology initially came back as borderline but was amended to low grade (1) endometrioid adenocarcinoma after being sent to the Mayo Clinic.  After seeing the amended pathology my ob/gyn then informed me that they had ruptured the cyst while trying to remove it.  Neither the ob/gyn nor I had any reason to believe that the cyst was anything but benign so I did not feel the need to see a gyn/onc (CA-125 was 13).  In hindsight, I guess that is the route I should have taken because now I am scheduled for another surgery to stage the disease and debulk (remove the appendix, the cervix, the omentum and some lymph nodes for testing, etc).  The gyn/onc is guessing that the stage is at least a 1C or possibly a IIIC… my hope is that it won’t stage as IIIC because the ob/gyn said that everything else looked clean while he was in there.  He’s also telling me that I have to have chemo because of the rupture.  My understanding is that low grade cancers don’t respond well to chemo so I was wondering why I would have to endure such a life-debilitating process.  Does anyone think that it may be because of the current litigant world we live in (kind of a cover-your-butt scenario)?  Or am I not thinking clearly on this at the moment?  Any feedback would be appreciated.  BTW I'm 55yo

[dian07]

I was staged at IC also...because just like you, my tumor ruptured when it was being removed by a well known gyn/oncologist. If it hadn't ruptured I would have been stage IA and possibly wouldn't have needed chemo as all the biopsies were negative (except for the peritoneal wash which was contaminated with cells from the tumor).  I thought for sure this was unusual, but now have come to realize it is not.  It happens more than one would think.  I had the six rounds of chemo and am glad I did.
It's good they are going back in to check things out with eyes well trained for this type situation.
Hang in there....
Peace.
dian

[hopeshell]

Hi there,

I am so sorry to hear about your recent dx.  My gyn/onc also says that chemo is needed for 1C.  I had a detailed conversation with him about this because I was thought to be at least 1C at the time of my surgery.  Since your mass ruptured, there is a good chance it spread microscopic cells.  This will not be something that can be seen with your upcoming surgery.

If I were in your shoes, I would have the chemo. I know this is disappointing since you were told you were borderline originally.  But, the Mayo Clinic opinion is the one I would go with.  Good luck on making your decision!

Shelly

[KonaMel]

Thanks for the comment Jane, I did get a 2nd opinion from a GYN/ONC surgeon hence the requirement for a 2nd surgery and chemo.  The surgeon I'm seeing comes highly recommended and I am just having 2nd thoughts on whether his course of action on a low-grade tumor (i.e., chemo) is correct; and while I'm not looking forward to more invasive surgery I believe this alone will determine where I really stand at this point.

[jane65]

Since you have so many very important questions, why don't you make another appointment with your doctor and discuss them. Bring someone with you because we always forget things said to us when we're getting a lot of info.
Write down your questions for your doctor, as you did in your post.

Finally, if you're not comfortable with the treatment plan set out for you, perhaps you should take all your records and get a 2nd opinion with a GYN/ONC surgeon who is specially trained in female diseases.
Good luck and keep us posted.
Jane