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Early symptoms, mildly elevated CA 125 and clear test results
Dear Dr. Goodman,
I am 43 years old with two children. My past medical history includes thyroid cancer, I-131 treatment with complications for salivary, parotid and tear ducts. About 1 1/2 years ago I went to gyn for severe bloating, constipation (which has never been a problem), mild nausea and lower back pain. Had DC for polyp removal and cysts showed on pelvic US, although small. CA 125 was at 2. Redone about 6 months ago for worsening symptoms and came back at 22.
I haven't been on birth control, no history of endometriosis and up until the polyps, no irregular bleeding. Once I had the DC and ablation, periods were regular. However, the past two cycles have been with extreme pain, constipation, severe rectal pressure to the point of passing out during both cycles because of the pain.I went back to the gyn and he did another internal ultrasound and said everything looked good but redid the CA 125. Test results are now at 40. I had an abdominal and pelvic CT and colonoscopy and all were clear so GI symptoms don't appear to be coming from the GI tract. He now thinks that it's endometriosis so he put me on Lybrel. I haven't had the rectal pain again, but have only been on the pills for 3 weeks.
In summary, I still have the following symptoms: constipation, mild nausea, severe bloating, lower back and leg pain, feeling of fullness when I do have an appetite. CA 125 has gone from 2, 22, and now 40. All GI tests are negative. Any suggestions would be very helpful. Thank you.
Melinda Docter
I am 43 years old with two children. My past medical history includes thyroid cancer, I-131 treatment with complications for salivary, parotid and tear ducts. About 1 1/2 years ago I went to gyn for severe bloating, constipation (which has never been a problem), mild nausea and lower back pain. Had DC for polyp removal and cysts showed on pelvic US, although small. CA 125 was at 2. Redone about 6 months ago for worsening symptoms and came back at 22.
I haven't been on birth control, no history of endometriosis and up until the polyps, no irregular bleeding. Once I had the DC and ablation, periods were regular. However, the past two cycles have been with extreme pain, constipation, severe rectal pressure to the point of passing out during both cycles because of the pain.I went back to the gyn and he did another internal ultrasound and said everything looked good but redid the CA 125. Test results are now at 40. I had an abdominal and pelvic CT and colonoscopy and all were clear so GI symptoms don't appear to be coming from the GI tract. He now thinks that it's endometriosis so he put me on Lybrel. I haven't had the rectal pain again, but have only been on the pills for 3 weeks.
In summary, I still have the following symptoms: constipation, mild nausea, severe bloating, lower back and leg pain, feeling of fullness when I do have an appetite. CA 125 has gone from 2, 22, and now 40. All GI tests are negative. Any suggestions would be very helpful. Thank you.
Melinda Docter
MEDICAL PROFESSIONAL
Hey there,
you do not need to leave me alone!
I would still do a laparoscopy. You need a diagnosis
best wishes
you do not need to leave me alone!
I would still do a laparoscopy. You need a diagnosis
best wishes
Dear Dr. Goodman, Me again....one last question and then I promise I'll leave you alone!! Took another CA 125 and it has gone down to 19. I still have the symptoms. Dr. is suggesting to wait another cycle on the Lybrel and then do another CA 125 and ultrasound. Do you still suggest the laparascopy with the drop in CA 125? Thanks so much.
Dear Dr. Goodman, Me again....one last question and then I promise I'll leave you alone!! Took another CA 125 and it has gone down to 19. I still have the symptoms. Dr. is suggesting to wait another cycle on the Lybrel and then do another CA 125 and ultrasound. Do you still suggest the laparascopy with the drop in CA 125? Thanks so much.
MEDICAL PROFESSIONAL
Hi There,
Most ovarian cancers are present on the surface of the ovary and can be seen.
Ovarian cancer comes from the epithelial lining of the ovary which is external. For sure some ovarian tumors are confined and make large tumors within the ovary.
Also if you have endometriosis, that is also a surface process on the lining of the abdominal cavity (peritoneum) and can be seen.
In the absence of a ovarian mass seen by ultrasound or MRI inside the ovary, I am not worried about the inside of the ovary. But more worried about the external lining
best wishes
Most ovarian cancers are present on the surface of the ovary and can be seen.
Ovarian cancer comes from the epithelial lining of the ovary which is external. For sure some ovarian tumors are confined and make large tumors within the ovary.
Also if you have endometriosis, that is also a surface process on the lining of the abdominal cavity (peritoneum) and can be seen.
In the absence of a ovarian mass seen by ultrasound or MRI inside the ovary, I am not worried about the inside of the ovary. But more worried about the external lining
best wishes
Dear Dr. Goodman,
I'm so sorry to bother you again, but I have a few questions in response to your answer.
How would a laparascopy detect and early ovarian cancer if there is no visible tumor and no fluid? Could their be a small inside the ovary rather than on it making it difficult to see?
What happens if there is no visible endometriosis?
The last CA 125 was 3 weeks ago. How long should I wait before I have another lab done?
Thank you again for all of your help.
I'm so sorry to bother you again, but I have a few questions in response to your answer.
How would a laparascopy detect and early ovarian cancer if there is no visible tumor and no fluid? Could their be a small inside the ovary rather than on it making it difficult to see?
What happens if there is no visible endometriosis?
The last CA 125 was 3 weeks ago. How long should I wait before I have another lab done?
Thank you again for all of your help.
So sorry, I forgot to add....blood in urine and stool. Cystoscopy was negative although now I'm having what seems to be chronic bladder infections; antibiotics help but cultures always come back negative with urination about every 20 minutes when it is bad. Endoscopy revealed specks of blood in stomach lining.
MEDICAL PROFESSIONAL
Dear Melinda
thank you for your complete information. I think your probably need a laparoscopy to look inside. Your doctor has taken excellent care of you. It is probably right that you have endometriosis . Endo can truly elevate the CA 125. However, I am a little worried about the trend and your new symptoms.A day surgical procedure, laparoscopy would confirm the diagnosis of endometriosis if it is there. It would also be reassuring to know we are not missing an early cancer
best wishes to you
thank you for your complete information. I think your probably need a laparoscopy to look inside. Your doctor has taken excellent care of you. It is probably right that you have endometriosis . Endo can truly elevate the CA 125. However, I am a little worried about the trend and your new symptoms.A day surgical procedure, laparoscopy would confirm the diagnosis of endometriosis if it is there. It would also be reassuring to know we are not missing an early cancer
best wishes to you
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