Ovary Removal or Lupron?

[dorigen]

I have had two episodes of severe lower right sided abdominal pain in the last 6 months.  Ultrasound showed 3 extremely complex cysts on the right ovary enlargement to 8cm.  The biggest cyst is 5cm.  The cysts show solid mass.  There is also a cyst on my left ovary that is solid.

My ca-125 level was elevated to 852 so I was referred to a gyn onc.  I am only 27.  I saw two different gyn oncs within the last two days.  Both are not very concerned about cancer and think it is more likely that i have endometriosis.  They gave differing opinions on the course of surgery though, so i'm having a hard time deciding which way to go.

The first doctor said if he saw endo he would stop the surgery, leave the cysts intact, and treat with lupron.

The second doctor said he definitely wants to remove the cysts no matter what and most likely the ovary as well because of the risk of (additional) torsion.  He felt the masses were large and complex enough to warrant this course.

These seem to be two greatly varying opinions and I'm trying to weigh the pros and cons of each.  I do have very painful periods and have had two episodes of appendicitis like pain, but 90% of the time i feel great and have no pain at all.  Because of that, Lupron seems a bit extreme for me.

On the other hand, the risks of removing an ovary weren't really explained to me and I'm not able to find much online.  It seems like the left ovary will pick up the slack, but i'm concerned about hormonal fluctuations and other risks.

Any opinions?  Maybe i should see a third doctor?

[dorigen]

Just wanted to post an update:

I had my surgery on March 26th.  Everything went well and there was no cancer despite my ca-125 level was 850.  False positives do occur such as in my case, so don't lose hope!

My complex cysts turned out to be endometriomas or "chocolate cysts" with solidified material within them and they found a fibroid they didn't know about.  Most of my right ovary was removed with the mass but they were able to salvage some of it.

I have 4 tiny incisions, only one of which is slightly painful.  Recovery has been a breeze for me so far (knock on wood), and I am shocked as to how little pain i'm actually having.  I've been up moving around and working on my computer since day 1 and eating normally.  Just waiting on that first bowel movement post surgery!

I know everyone's experience is different, but hopefully my post will give hope to others.

Best,
Autumn

[dorigen]

Yeah, i was surprised, but they both said they have seen many false positives into the 1000s, especially in women with endo!  I was obviously quite worried, but they both seemed very non-chalant and said the odds say i have endo.  The second doctor even joked that sneezing can raise your ca125.

I'm clearly not out of the woods yet though.  My tentative surgery is next Friday the 26th.  I'm thinking i will go with the doctor who wants to remove the cysts because i am not crazy about this lupron thing and don't want to do a second surgery if the cysts didn't resolve.

I'm still debating on the third opinion since my surgery is scheduled so soon (i just want this done and over with!).  I'm taking the weekend to think on it.

Thanks for your response and I will certainly keep you updated!

[justscore]

WOW......That is a high CA125.  I have had the Lupron and it didn't work so well for me.  I had my ovaries eventually taken out and I had severe Endo.  It seems that with a CA125 level that high, they would want to do a biopsy???  

No matter what you decide it isn't an easy decision......  You have to do what you think will work best for you.  Because both Dr's vary so much on their opinions, you may want to seek a 3rd opinion.

Keep us posted.
Heidi