Concern about Ovarian Cancer

Hello, I've been experiencing menstrual irregularites for about 2 years. (Irregularities=heavier, more frequent, longer duration--had all of this over the last 2 years). Two years ago in April, I had to visit the E.R. for severe abdominal pain. Doctors never did figure out what caused it--it took about 3 days before I felt 'normal' again. They initially thought I had appendicitis (I had a very elevated white blood cell count). I was given Demerol thru the night and by morning, the pain had lessened, so they sent me home. Soon after that, I had a colonoscopy, endoscopy, and transvaginal ultrasound. Nothing at all was found. RECENTLY, I went back to my gyn because the abnormal bleeding was continuing and she sent me for another transvaginal ultrasound-this time they found ovarian cysts, and one 2-3 cm 'mass'--the advice I was given was to get another ultrasound in 3 months. A few months ago, I WAS having alot of bloating, and pain every other month on my right side (the side with the cyst/mass), but both of these symptoms seem to have subsided. Even the bleeding symptom seems to be lessening. I've researched on the Internet and asked my doctor for the CA-125, which I now realize is not conclusive. My CA-125 level is 'normal' (14.4), but I understand the test is more accurate for later stage cancers. Should I be asking for some other test? Should I wait the 3 months or can I do something else sooner? From what I've read, there are no good early detection tests for ovarian cancer. Just for background: I am 44 and was on the bc pill for 20+ years. Stopped it when I turned 40.

[Annekathryn Goodman, M.D.]

Hi Diana,
Ovarian cysts come and go as part of the regular menstrual cycle. I am more interested in your irregular bleeding. Have you had a biopsy of the lining of your uterus? If not, you should ask your doctor about that. If your pain persists or the ovarian cyst persists, that is a reason to consider a laparoscopy to take a look
best wishes to you

[dianar23]

No, I have not had a biopsy of the lining of my uterus.  If the problems persist, I will definitely ask about that, so thank you!
My gynecologist indicated that the ovarian cysts could be causing the abnormal bleeding. Today, I sent a fax with my test reports and a letter expressing my concerns to my primary care doctor.  He called me back and said he knows it's hard to wait, but that's what he would recommend also. He said if the cyst grows to > 4cm OR if my CA-125 level was elevated, he'd be more concerned and recommend a visit to a gyne oncologist to have the cyst removed. He recommended a retest of the CA-125 in a month or two.

What's really odd is that my menstrual cycle (so far anyway) has been pretty "normal" this last month (since I had the pelvic sonogram, it seems)...