Complex ovarian cyst in 78 year old woman

[Kaito]

Mom is 78  with Alzheimers. She also has a weak
bladder. Lost from 128 to 109 for no apparent reason. Has
lump on left pelvic that Doc was guessing could be a hernia.
About 1 and a half inch in diameter. Did full blood work up,
all normal. Cat scan on abdomen. Revealed density in adrenal
glands and a density on left pelvic wall about 1 to 1/2 in.
Did a follow up MRI..benign tumors in adrenal gland, but
also showed a Complex Ovarian Cyst in the area of the ovaries.
Did not say in ovary or on ovary,just in the area of. Can't hold
bladder so normal sonogram is out. Not sure we can convince her
to do a transvaginal ultrasound. Have ordered a blood test for
tumor marker. Regular doctor didn't have a clue how to follow up so asked a attending on call in gyn, who basically said full
bladder sonagram, which is not possible.

Question, is it strange for a 78 year old to have an ovarian
cyst? Should it be followed up on? I myself had one and
the GYN took it out to check if benign or not. Should the MRI
be able to tell if this is a ovarian cyst or hernia? If the blood test is negative for the tumor marker do we still need to
put my mom through the transvaginal ultrasound? Thank you for
any advice.

[Kaito]

Thanks Linda, that is a good suggestion I will bring up
with her Doctor. The trick is getting mom to agree to the
TV. I have been reading and everything seems to suggest that
a 78 year old should not have a ovarian cyst so I am real
concerned with her weight loss this could be ovarian cancer.

[MickeyVicki]

Oh, do I ever feel for you.   I mean this truly.  Besides helping care for family, I work as a caregiver.  I work  primarily with elderly patients but have also helped with the terminally ill (home-based "end care" but not quite to the point of hospice care); my specialty is in demetia care.  I know the exact situation that you are facing in trying to get the necessary tests for a close family member who no longer can fully understand her situation and is not physically able to cooperate with the requirements of a test.  Even then, once the test results are in, one must decide on treatment given the  condition and situation of the patient.   I have dealt with  similar situations.   Oh.

No, it is not normal or common for a woman of that age to have an ovarian cyst. Yes, the MRI should be able to provide good details on the composition of the mass, such as whether is it attached to or nearby the ovary, and whether it is fluid or solid filled.  In fact, an MRI is often ordered for patients when ovarian cancer is suspected for these very reasons.  However, if she was awake and moving a good deal, then the image would be less reliable.

As for follow-up and what to do in the event that treatment is necessary, well, that involves the entire issue of how one goes about treating and caring for a patient with any form of dementia.

[Kaito]

Thanks to both of you. Mom lives with me, and I have full
power of attorney. I make all her medical decisions because
she would not begin to understand although she still knows
who we all are, can bathe and dress. She is in the middle
stages.

I will check into the versed. I am dealing with Kaiser
which is very good here but still requires one to jump
through hoops. From what you are both saying it sounds like
the TV is a must if I am to learn anymore. I was a little
confused that the doctor could not tell me from the MRI if
this was in or on the ovary. She couldn't even say it it was
the lump I brought her in for on her left side. She asked what
would do about it if it is