What would you do?

[Fiveft4]

Last month while following up on a 3cm simple ovarian cyst on my right ovary a thumbnail size solid mass was found on my left ovary. This was with a trans-vaginal ultrasound. The simple cyst was found during an MRI on my hip joint a few months ago. The mass is pendunculated (sp?) and irregular. I am 47 years old had my uterus removed due to adenomiosis when I was 28. I have not had a gynecologist  since, only routine exams by my GP - and I've never had any problems. When this was found I located a gyn/onc/pelvic surgeon because if someone was going to go in there I wanted them to know what they were looking for and how to deal with anything. At my visit he said he thinks it's non-cancerous and is not keen on going in surgically due to my history of endometriosis. He said it may be a difficult surgery and the benefits out weigh the risk at this point. He had me do a CA125 which came back a wonderfully low 9. I am scheduled for another ultrasound on November 24th to see if there is any change. He also said he's gone into surgeries swearing he would find cancer and there was none, and the opposite - swearing it wasn't when it turned out to be. He basically covered all the possible bases and told me I could continue following the mass, or he would take it out whenever I decided. He said we would have to decide what he should do if he went in - the left ovary will be gone, but what about the right? Do we remove the cyst and leave the ovary? Or do we remove it all also? He said most women start menopause at age 51, and that's getting close. I have also been having bladder problems for the past year - 8 infections, frequency and urgency,  and I'm scheduled to have a scope exam of my bladder on 11/5.  Anyway, I guess I'm struggling with how to best handle this knowing the only sure way to know what this is would be to take it out.  My family and friends want me to have it removed ASAP. My boyfriend, who was present at my gyn/onc appointment wants to track it. What do you think? Am I on the right track with my doctor? Is there something more I should ask him? For how long and how often would tracking a mass like this best be handled?

[hopeshell]

Hi there,  I know what you are going through.  It is so hard to be waiting and wondering what to do.  I think that is great you are getting a second opinion.  I am 37 and went in for my normal gyno exam when my mass was found.  I had been having urinary urgency and frequency for several months. My dr. actually felt the mass during my pelvic exam and I had a transvaginal ultrasound, MRI and CT that confirmed the complex mass.  I was also told the chance of malignancy was slim due to my age, risk factors, etc.  They took my CA-125 and it was elevated to 61.  I was told this could be due to many factors and they suspected I had endometriosis which can also raise the number.  My gyno, primary care, and the gyn/onc all told me it was probably going to be benign but due to the size (6cm), the fact that it was complex and the elevated CA-125, they felt I had no choice except to remove it.  It is funny but in my head I knew it could be benign but in my heart I felt it was malignant.  I had also been having severe pain in my abdomen especially around my period and ovulation.  My surgery took 7 hours and looked like it was more advanced due to some areas suspicious for implants.  But, when all the pathology came back it was discovered I was stage 1a and the other tumors and fluid were due to benign cyst ruptures and endometriosis.  I wasn't that surprised when I woke up from surgery and found out the news because I had prepared myself for that possibility.  My husband was very shocked though.  The dr. told me in the hospital I was atleast a 1c and maybe a 3c so for two weeks I waited to find out.  I was pleasantly surprised to be staged at 1a and didn't need chemo.  I go in every three months for checks with the gyn/onc and am praying I will remain cancer free.  You have to trust your gut.  I hope your new dr. will recommend a definite path for you rather than just covering all the bases and leaving it up to you.  I had my surgery at a university hospital too.  They know what they are doing.  Hang in there.   It is tough to wait!!!!  Just know you can make it and fight it no matter what and hopefully you will have a benign outcome.  Let us know how it goes!  Best wishes to you.

[Fiveft4]

Thank you. Yesterday I made an appointment for a second opinion with a doctor at the Oregon Health Sciences University here in Portland. They're cutting edge and I know I will feel better having another opinion. The first doctor said with my history of endometriosis it could make surgery much more difficult due to the internal organs not looking as they should - scar tissue, adhesions, etc. That bothers me because there is just as big a chance that my insides are pristine and he could go in take out the ovary and it would be over. When my uterus was removed at age 28 there wasn't anything said about adhesions or any other abnormalities - it was only the uterus that had problems and once it was gone I didn't have any difficulties. I'm just not comfortable with that being the main reason to leave this thing in there. He also said the chances of malignancy is slim - but I already knew that - it's that small percent I'm not too keen on overlooking at this stage of my life. I would like to hear more of your story. What were your bladder symptoms? Thanks again for your input - it really helps.

[hopeshell]

Just my opinion...I would have it out.  My only reservation is that your gyn/onc doesn't want to do surgery.  ????  Although very slight...there is a chance it is malignant if it is solid.  Finding ovarian cancer early is rare and can mean a full recovery versus waiting and dealing with it in a more advanced stage.  I was dx with stage 1a and didn't have to have chemo.  Maybe you could get a second opinion by another gynecologic/oncologist just to be sure.  I would only have everything removed if it is found to be malignant.   I also had bladder symptoms prior to diagnosis.  Good luck to you.