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I am very concerned that I may have ovarian cancer.
Hello, my question will be lengthy, please bear with me. Here goes.
Back in January of this year, I noticed a very tiny spot of brown discharge, only on paper and one time on my panties, well, being post-menopausal for approximately 3 years, I decided to investigate it. I called the local clinic here, (I live in New Zealand, but am an American citizen), they ran the usual test, you know, the pap smears, etc, all came back normal. So, I was referred for an TVultra sound. Here is what was discovered:
Findings:
Both transabdominal and transvaginal scans were performed.
Uterus: anteverted, normal size, longitudinal 65mm, AP 34 mm, Transverse 55 m. Volume 57 mL
Myometrium: Heterogeneous with 5 fibroids. Largest=subserosal and posterior, measuring 15mm. None has any significant submucosal involvement.
Cervix: normal
Endometrium: normal appearance, 4.9 mm. No focal abnormality nor abnormal vascularity.
Pouch of Douglas: No free fluid.
Now, here is what scared me and still does:
Right Adnexa: 39mm mass containing low level echoes, reasonly homogeneous. There is an echogenic rim. No vascularity demonstrated within it. Right ovary is not separate from this.
Left ovary: Contains a 10mm follicle, volume 2.1 mL. No other adnexal abnormality.
Comments: Endometrial thickness approaching the upper limits of normal. Right Adnexal mass appears to be solid. We are unable to determine it to be a pedunculated fibroid.
Fibroid Uterus changes elsewhere.
Recommend review by gyn specialist for advice on management in view of the complex of changes.
So, I am then referred to the Christchurch women's hospital, there, they do another ultra sound, this time, it was scarier, here is what it says:
Endometrium noted to be around 7mm and poorly defined, the right adnexal lesion was joted to be persisten measuring 38x39x42mm, with a hetergenous echotexture but no internal vascularity and note has made that this did not move separately to the uterus. The right ovary was not identified separate from the mass but the left ovary was not identified either at this stage. A review of the imaging results was made at a multi-disciplinary meeting on March 25th with possible aetiologies being those of a pedunculated fibroid or a possible ovarian mass such as a fibroma with the noted endometrial thickness again commented upon and a plan for surgery is now suggested. Recommendation of a hysteroscopy, dilatation and curettage with a concurrent diagnostic laprascopy proceeding to a salpingo-oophorectomy or removal of pelvic mass with the option of a bilaterial salpingo-oophorectomy after a further pre-operative discussion in the Gyn Outpatient Clinic.
Ok, so I am concerned over the fact that the hospital ultra sound says that my uterus is poorly defined, the first ultra sound, done at a womens only ultra sound clinic, said it was clear. Also, the thickness, how can it be 4.9 one month and then 7 the next? Of course, that dang mass has me very worried.
I had a CA 125 done, it was 16.
I am planning on moving back to the states in June, Lord willing, so, I had originally canceled any further treatment as they had me on a 4 to 5 month wait list for the procedures, I figured it could not be too bad if they wanted to wait. Well, when I told them I was leaving, I got this letter informing me I could come in earlier, and have it all done in May, before I left. My husband, a kiwi, is all for it. You see, we do not pay a cent for any of this, it would cost us a good chunk of change back home. I guess I am worried because they decided to get me in so quickly all of a sudden. I worry lots
I am 57, have no family history of ovarian cancer, and when I had my periods, they were always normal, I never had any "female issues". I have always been prone to ovarian cysts however, As I shared, I have not had a period in close to 3 years.
I will be going in for my pre-op visit May 13, the surgery is scheduled for May 22. I am a nervous wreck. Oh, the report also stated that I have vaginal atrophy.
Anyway, this is my story, I would appreciate any comments or feed back. I am sick over this. Thanks lots.
Back in January of this year, I noticed a very tiny spot of brown discharge, only on paper and one time on my panties, well, being post-menopausal for approximately 3 years, I decided to investigate it. I called the local clinic here, (I live in New Zealand, but am an American citizen), they ran the usual test, you know, the pap smears, etc, all came back normal. So, I was referred for an TVultra sound. Here is what was discovered:
Findings:
Both transabdominal and transvaginal scans were performed.
Uterus: anteverted, normal size, longitudinal 65mm, AP 34 mm, Transverse 55 m. Volume 57 mL
Myometrium: Heterogeneous with 5 fibroids. Largest=subserosal and posterior, measuring 15mm. None has any significant submucosal involvement.
Cervix: normal
Endometrium: normal appearance, 4.9 mm. No focal abnormality nor abnormal vascularity.
Pouch of Douglas: No free fluid.
Now, here is what scared me and still does:
Right Adnexa: 39mm mass containing low level echoes, reasonly homogeneous. There is an echogenic rim. No vascularity demonstrated within it. Right ovary is not separate from this.
Left ovary: Contains a 10mm follicle, volume 2.1 mL. No other adnexal abnormality.
Comments: Endometrial thickness approaching the upper limits of normal. Right Adnexal mass appears to be solid. We are unable to determine it to be a pedunculated fibroid.
Fibroid Uterus changes elsewhere.
Recommend review by gyn specialist for advice on management in view of the complex of changes.
So, I am then referred to the Christchurch women's hospital, there, they do another ultra sound, this time, it was scarier, here is what it says:
Endometrium noted to be around 7mm and poorly defined, the right adnexal lesion was joted to be persisten measuring 38x39x42mm, with a hetergenous echotexture but no internal vascularity and note has made that this did not move separately to the uterus. The right ovary was not identified separate from the mass but the left ovary was not identified either at this stage. A review of the imaging results was made at a multi-disciplinary meeting on March 25th with possible aetiologies being those of a pedunculated fibroid or a possible ovarian mass such as a fibroma with the noted endometrial thickness again commented upon and a plan for surgery is now suggested. Recommendation of a hysteroscopy, dilatation and curettage with a concurrent diagnostic laprascopy proceeding to a salpingo-oophorectomy or removal of pelvic mass with the option of a bilaterial salpingo-oophorectomy after a further pre-operative discussion in the Gyn Outpatient Clinic.
Ok, so I am concerned over the fact that the hospital ultra sound says that my uterus is poorly defined, the first ultra sound, done at a womens only ultra sound clinic, said it was clear. Also, the thickness, how can it be 4.9 one month and then 7 the next? Of course, that dang mass has me very worried.
I had a CA 125 done, it was 16.
I am planning on moving back to the states in June, Lord willing, so, I had originally canceled any further treatment as they had me on a 4 to 5 month wait list for the procedures, I figured it could not be too bad if they wanted to wait. Well, when I told them I was leaving, I got this letter informing me I could come in earlier, and have it all done in May, before I left. My husband, a kiwi, is all for it. You see, we do not pay a cent for any of this, it would cost us a good chunk of change back home. I guess I am worried because they decided to get me in so quickly all of a sudden. I worry lots
I am 57, have no family history of ovarian cancer, and when I had my periods, they were always normal, I never had any "female issues". I have always been prone to ovarian cysts however, As I shared, I have not had a period in close to 3 years.
I will be going in for my pre-op visit May 13, the surgery is scheduled for May 22. I am a nervous wreck. Oh, the report also stated that I have vaginal atrophy.
Anyway, this is my story, I would appreciate any comments or feed back. I am sick over this. Thanks lots.
Best Answer
The chest and shoulder pain does not last long. The shoulder get stiff from being in one position while you have surgery.. Not everyone has the pain. Recovery is not bad. When you are ready you can have the surgery.
Alex
Alex
Thanks again for all your help. I feel somewhat better now that I have canceled, but some folk are calling me crazy, etc. Well, maybe so, but, I just was not emotionally or physically ready for it. Of course I do not want to do anything stupid, and I would not have canceled if they had not started with the long wait list, then changed after they heard I was leaving. *sigh*
I also do not know if they would do it after getting my health sheet I filled out back. You see, I have lots of herniated discs as I said in the letter, and my upper back, shoulders and neck always hurt. I have read that after the laprascope, a person can have horrendous chest and shoulder pain, well, I would not have anyone to help with it. As I also said, my marriage is not great, and I would be lucky if he helps me at all, he would probably do the bare minimum. I have no one over here.
Anyway, thanks again, I will let you know if I change my mind, but at this point, I am sticking with my decision for a few months at least.
I also do not know if they would do it after getting my health sheet I filled out back. You see, I have lots of herniated discs as I said in the letter, and my upper back, shoulders and neck always hurt. I have read that after the laprascope, a person can have horrendous chest and shoulder pain, well, I would not have anyone to help with it. As I also said, my marriage is not great, and I would be lucky if he helps me at all, he would probably do the bare minimum. I have no one over here.
Anyway, thanks again, I will let you know if I change my mind, but at this point, I am sticking with my decision for a few months at least.
False negatives are rare with the CA 125. You have to do what is best for you. I took a break from cancer treatment and my doctor said I was nuts. I was so sick and under weight I probably would have died . I stopped and gained my weight back and started chemo again. Listening to my gut was the best thing I could do.
Alex
Alex
I was told that the CA125 can have both false positives and false negatives, but not as much when a person is post-menopausal like I am. The whole thing confuses me and gives me more anxiety attacks and skipped heart beats, YUCK.
Thanks for all of your comments, they help. I have been crying all day. I have decided to put it on hold. I wrote them a letter explaining why, here it is:
To Whom It May Concern:
I am still having strong doubts regarding the Laprascopic surgery for the right, adnexal mass. I have been under such extreme stress for the last three years; I am actually at my breaking point. I do not feel I can handle any more stress at this time.
I cry constantly, have mini anxiety attacks, my marriage is not good, we are in a financial bind, I am planning on moving back home to America but am having a difficult time in arranging that. I do not want to make my emotional status any worse by adding this surgery to it. I would not be entering into it with a positive attitude and I fear this would have some bearing on the outcome and the way my body handles the anaesthetic. As I have never been under anaesthetic before, I am also concerned as to how my system will react to it. I understand that some folks can react quite badly, I do not need that.
As to my health in general, it is OK, but, when under stress, my blood pressure goes high, it is normally low to normal, even after exercise, but, all this stress since discovering that mass, has caused it to rise when ever I am at your clinic. I would not want to be treated for hypertension un-necessarily. Since I have been in New Zealand (3 years), my depression has gotten worse, as have all my health issues. I have extreme bad back pain, due to herniated discs, hip pain which makes it difficult to walk at times, and chronic neck pain which causes headaches and dizziness from time to time. My chiropractor back home was able to help these issues, but, the ones I see here do nothing, so, these issues are getting worse. At one time, it was believed that I had fibromyalgia, but no tests were performed to rule that diagnosis out.
To be honest, at this time, I just do not want to go through with it, I just can not handle any thing else. It is going to be detrimental to my health. I just want to return to the states, regroup, get better, and then re-***** the situation, I should be thinking more clearly as well. At this point, I am definitely not thinking as clearly as I should.
I realize that I might be hiding my head in the sand, so to speak, but, it can’t be helped. I have to do what I feel best. I have filled out all the forms and am returning them, this way, they can be in your records should I decided to return to New Zealand around November for the procedure, this was actually my first plan, and I had told doctors that as well. As I said, however, I truly feel at this time, I just can not go through with it.
Thank you for your time and help
Susan A Coombes
Please forward this to Dr Emma Jackson, she is the one, I am guessing, that is working with me, though I have never met her.
They had me having so many doctors, and each one gave different reports, except for the one named "Emma" the others said not to worry, but do another ultra sound in 3 months, well, she did not like that and has opened this can of worms. Well, sorry, I am just too raw to do anything else stressful. My poor nerves are shot, I even cry if I see a cute picture, and that is not like me at all.
To Whom It May Concern:
I am still having strong doubts regarding the Laprascopic surgery for the right, adnexal mass. I have been under such extreme stress for the last three years; I am actually at my breaking point. I do not feel I can handle any more stress at this time.
I cry constantly, have mini anxiety attacks, my marriage is not good, we are in a financial bind, I am planning on moving back home to America but am having a difficult time in arranging that. I do not want to make my emotional status any worse by adding this surgery to it. I would not be entering into it with a positive attitude and I fear this would have some bearing on the outcome and the way my body handles the anaesthetic. As I have never been under anaesthetic before, I am also concerned as to how my system will react to it. I understand that some folks can react quite badly, I do not need that.
As to my health in general, it is OK, but, when under stress, my blood pressure goes high, it is normally low to normal, even after exercise, but, all this stress since discovering that mass, has caused it to rise when ever I am at your clinic. I would not want to be treated for hypertension un-necessarily. Since I have been in New Zealand (3 years), my depression has gotten worse, as have all my health issues. I have extreme bad back pain, due to herniated discs, hip pain which makes it difficult to walk at times, and chronic neck pain which causes headaches and dizziness from time to time. My chiropractor back home was able to help these issues, but, the ones I see here do nothing, so, these issues are getting worse. At one time, it was believed that I had fibromyalgia, but no tests were performed to rule that diagnosis out.
To be honest, at this time, I just do not want to go through with it, I just can not handle any thing else. It is going to be detrimental to my health. I just want to return to the states, regroup, get better, and then re-***** the situation, I should be thinking more clearly as well. At this point, I am definitely not thinking as clearly as I should.
I realize that I might be hiding my head in the sand, so to speak, but, it can’t be helped. I have to do what I feel best. I have filled out all the forms and am returning them, this way, they can be in your records should I decided to return to New Zealand around November for the procedure, this was actually my first plan, and I had told doctors that as well. As I said, however, I truly feel at this time, I just can not go through with it.
Thank you for your time and help
Susan A Coombes
Please forward this to Dr Emma Jackson, she is the one, I am guessing, that is working with me, though I have never met her.
They had me having so many doctors, and each one gave different reports, except for the one named "Emma" the others said not to worry, but do another ultra sound in 3 months, well, she did not like that and has opened this can of worms. Well, sorry, I am just too raw to do anything else stressful. My poor nerves are shot, I even cry if I see a cute picture, and that is not like me at all.
I agree with HVAC that it probably not cancer. In addition to general 1.4%, to your statistical advantage is that postmenopausal women have predominantly epithelian type which correlates with elevated ca125. Rare types -clear cell or germ - correlate more with normal ca125 levels, but they hit younger women. Ultrascan does not have terribly good resolution, so no surprise two of them may be different. Keep in mind that ovaries are very small postmenopause, depending on the machine, they may have hard time to be detected. I had two U.S. in two different places. One had everything resolved well, another could not detect ovaries at all. By reading their surgery plan, it looks to me diligent. They suggest removal of ovaries/fallopians from one side only, laparoscopically. Another side - only after additional review of first surgery results at the clinic. So you will have one ovary , considering age it is not bad. Do not assume you will have better treatment in the US unless you have reliable references lined up and / or connections to medical field. Stories in this and other health forums are testaments to this observation. Wish you good luck
I agree that it probably is not cancer. My ultra sound showed cancer I was in surgery in days. You have a 1.4% chance of ovarian cancer in your life time. Women will have periods after menopause especially if they are stressed. Ultrasounds can be different especially with different machines and different people reading the test.
CA 125 can have false positives not negatives so 16 in normal anything under 35.
Alex
CA 125 can have false positives not negatives so 16 in normal anything under 35.
Alex
Oops - Somehow my comment posted before i was finished typing. Let me restate the last paragraph:
Unfortunately, the medical profession in a number of countries treats the female organs as if they are only needed for reproduction. But just as a man's organs have lifelong non-reproductive functions, so do a woman's (and sex is not the only function).
Please do your research. The uterus has a number of non-reproductive functions - anatomical, skeletal, sexual, and hormonal (indirectly since it works with the ovaries). The ovaries are shown to produce hormones, especially androgens that the body can convert into estrogen, up to at least age 80. These hormones are essential for good health and well-being. And the ovaries work together with other endocrine glands (it is the endocrine "system") for "normalcy." Removal of any part of this system can wreak havoc.
A web search for "pubmed bilateral oophorectomy long term health" will show you the many increased health risks and quality of life "robbers" caused by ovary removal. Removal of any part of the "reproductive" system can have these same effects. So if your cyst has to be surgically removed because it continues to grow or is suspicious looking then it is best to have just the cyst removed if it is benign (per frozen section). I wish I had revised my surgical consent form to make clear what could and could not be removed and under what circumstances (cancer vs. no cancer).
Sorry for the novel but I could not think of a way to shorten it and give you all pertinent information. If there is concern about this cyst, you would want a gynecologic oncologist doing the surgery. Best of luck in deciding how to proceed. Please keep us posted.
Unfortunately, the medical profession in a number of countries treats the female organs as if they are only needed for reproduction. But just as a man's organs have lifelong non-reproductive functions, so do a woman's (and sex is not the only function).
Please do your research. The uterus has a number of non-reproductive functions - anatomical, skeletal, sexual, and hormonal (indirectly since it works with the ovaries). The ovaries are shown to produce hormones, especially androgens that the body can convert into estrogen, up to at least age 80. These hormones are essential for good health and well-being. And the ovaries work together with other endocrine glands (it is the endocrine "system") for "normalcy." Removal of any part of this system can wreak havoc.
A web search for "pubmed bilateral oophorectomy long term health" will show you the many increased health risks and quality of life "robbers" caused by ovary removal. Removal of any part of the "reproductive" system can have these same effects. So if your cyst has to be surgically removed because it continues to grow or is suspicious looking then it is best to have just the cyst removed if it is benign (per frozen section). I wish I had revised my surgical consent form to make clear what could and could not be removed and under what circumstances (cancer vs. no cancer).
Sorry for the novel but I could not think of a way to shorten it and give you all pertinent information. If there is concern about this cyst, you would want a gynecologic oncologist doing the surgery. Best of luck in deciding how to proceed. Please keep us posted.
Oh, I forgot to add, I am also concerned as to why the mass on the first ultrasound was homogenous and on the last ultrasound, it was heterogenous. It does not seem to make sense. I am glad that neither one has any vascularity involved.
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There was a woman on here (in Australia if I recall correctly) who was all ready to go into surgery for a "complete" hysterectomy - uterus, ovaries, tubes - for an ovarian cyst. She asked for another ultrasound before the surgery. And guess what? The cyst was gone. She was so glad she asked for that extra ultrasound. And she was angry that she almost lost all her sex organs unnecessarily.
Small fibroids as well as uterine polyps can make the lining appear thicker than it is. And ovarian cysts have hormonal effects which can cause the lining to thicken and also cause changes in bleeding. Plus post-menopausal bleeding is more common than most people realize and can usually be chalked up to sporadic ovarian activity since the ovaries produce hormones up to at least age 80 in women who have all their parts. Fibroids are another source of bleeding especially if they are submucosal.
I was 49 when I was rushed into surgery for an ovarian cyst. Mine was complex and larger than yours (9.5cm) so it probably had to be surgically removed. But when the frozen section done while I was in the operating room came back benign, my surgeon should have sewn me up and sent me to recovery. Instead, he continued removing organs - both ovaries, my uterus, and tubes. All he should have removed was the cyst. The lifelong non-reproductive functions of these organs quickly became apparent. Even though I was 49 YO, everyone thought I was in my 30's before the surgery. By 4 months post-op, I had lost SO much hair (plus sections turned gray), skin collagen, subcutaneous fat, and muscle mass that I looked close to age 60. I am 9 years post-op and I miss my organs every day. The anatomical and skeletal changes caused by the loss of my uterus have caused chronic back pain that will only worsen as time goes by. And the figure changes are devastating too.
Please do your research about the lifelong non-reproductive functions of the uterus and ovaries. The uterus has anatomical, skeletal, sexual, and hormonal (indirectly since it works with the ovaries), and sexual functions.