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Post Menopausal ovarian cyst
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Post Menopausal ovarian cyst

I don't see a forum for ovary questions other than this cancer forum and this isn't a cancer question, but perhaps someone can provide some information.

I am 59 years old - post menopausal.  I had a hysterectomy at age 42.  At that time there was a large cyst on the left ovary that they thought was late stages ovarian cancer.  Fortunately, it was not and the cyst actually was a dermoid attached to the colon and rectum.  Since it was not attached to the left ovary, they left the ovary and removed the uteras and right ovary.

Approximately 5 years ago I was told I had three very, very tiny cysts on the left ovary.  I moved and was not followed.  In January, I went to an OB/GYN for a well-woman exam and pap.  When I told her about the 3 tiny, tiny cysts she ordered an ultrasound.

A couple of weeks ago she said that there are four cysts with two of them measuring approximately 3 cm.  She said it was characteristic of another dermoid.

I saw another OB/GYN she referred me to yesterday.  Also, I had a second ultrasound done on Monday.

The second doctor is saying that there is no indication of dermoid and the cysts appear to be simple cysts.  She said I could select surgery or leave them alone.

I'm very torn as to what to do.  Also, the CA125 test came back at 9.  Evidently, the cysts are growing and multiplying.  This doctor said a couple of things that sent up some red flags and did not instill confidence.  For example, she did not see where my medications were listed and said "I see you are in excellent health since you are not on any medication."  I saw where she was looking on the chart and it was blank.  However, the nurse had written down my medication - I guess in another area of the chart.  When I told her that, she didn't bother to look at the medications.  (I am diabetic and have some heart issues.)  Nothing further as to general health was discussed.  

She also mentioned (same clinic as to who did my PAP - first one in five years) that they would need to repeat the PAP since they had not collected enough cells to have a reading on the PAP results.  However, I had received a "Your PAP came back fine" letter a few days after having the PAP done.  I had been to this clinic once since the Pap was done and nothing was said about needing to repeat it.  Doesn't instill confidence.

What decision is the appropriate one for surgery?  If I were not past menopause, I wouldn't worry about this, but I'm not sure -- one doctor is saying dermoid -- another one is saying simple cyst -- looking at the same report.  I know both of these usually don't indicate cancer, but could it be something else going on . . . guess I've lost my confidence.  Am I OK leaving it alone?

Thank you
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6 Comments
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356929_tn?1246393356
Gee, all I can tell you is my own experience : I too had a very small cyst show up on an ultrasound.. I had the CA125 (which I understand is a not a reliable test for Ovarian Cancer esp. in younger patients but I, too am postmenopausal.).Mine was very low also.
     I was told I could take a wait and see approach as well. However, I'm not the patient "wait and see" type, especially at my age.  I was given the option of removing the ovary as well. I opted for the laparoscopic removal of left ovary, and tube.
     All went fine, and cyst was benign just as the Dr. suspected.. but I've learned from these great women here: you never can tell until it's been biopsied..I can only speak for myself though and I sure can't tell others what decision to make.. you'll know what makes you comfortable. My Dr. said I could probably have the cyst forever! Also though, I did have fluid in the uterus which she definitely wanted to check out and 2 fibroids which I shouldn't have had at my age that she wanted investigated.. Whatever you decide, good luck and let us know... Sandy
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Thanks Sandy
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360216_tn?1218746600
Like Sandy, I am also not a wait and see person.  I had multiple cysts on my left ovary, my CA 125 was 6, my gyn was a little concerned because of the shape of the cells in the cysts but the gyn/onc wanted to wait and see since the CA 125 was so low.  I chose not to do that - I had the ovary removed and all looked fine to my gyn - she said they were simple cysts.  Two weeks later the path report came back that I had ovca - granulosa cell tumor.  Fortunately, it was caught in a very early stage.  

Since it sounds like this dr is not very thorough, I would recommend getting another opinion, and since you are post-menopausal, removing the cysts is probably a good idea. 99% of cysts are benign so the odds are with you. Good luck, Chris P
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187666_tn?1331176945
I'm with the others - I would have it removed. At our age (I'm menopausal too) we shouldn't be growing things. My doctor was surprised that I had a large cyst (7cm at ultrasound time). She wanted to remove it so it wouldn't twist or rupture. By surgery it was up to 10cm. I wouldn't want to wait and see. If your cyst was stable and small, that's one thing. But you're getting more of them.  I hope you get some help soon, a doctor that will listen to your concerns.
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Thanks all.

Since my first post and sleeping on it, I just can't go back to that clinic and feel comfortable with them proceeding with surgery.  The doctor would give no opinion as to if I should have surgery or not.  According to her, it was entirely up to me.  She said "either decision I make will be the right one."

I am really torn as to what to do.  I live in a very small mountain community and the care in the area has been less than standard in my opinion.

I just changed primary care doctors since my doctor for the past three years spends approximately 90 seconds (I've timed her) per visit.  She never did a pelvic/pap even though I requested it -- it had been five years since my last exam -- and now I don't even know the results of the recent Pap.  Yikes - is it just me?

I took matters in my own hands and went to "the city" to an OB/GYN to have the exam and pap -- especially since I was aware of the three tiny cysts.  

In January I changed to another primary care (I'm only seeing the nurse practitioner) and I don't have another visit with her until May.  Since I have no idea where to go from here, I'm thinking I'll wait until May and may ask her opinion.  (I don't know the nurse practitioner's knowledge level and would prefer to run this by a doctor -- but not sure where to go for that.)

I do wish I could find some medical help I have some trust in.  I've never had any problems having long-term family doctors I felt comfortable with and had confidence in --until now.

I think I will try to get my ultrasounds so I have something in my hands when I do see another doctor about this down the road at some point.

I appreciate all your input - I feel like I'm out here by myself trying to sort out the right thing to do.
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360216_tn?1218746600
My personal opinion, and it's only me, is that you are being too passive.  Hopefully this is just a blip for you, but if it's not you are wasting valuable time.  If I had waited from March til May two years ago, I know my cysts would have ruptured (they were 1.25 cm - very tiny) and I'd have had cancer cells spread all over my abdomen - and I was assured by my gyn and her consulting gyn/onc that I was fine and could wait for surgery - they were wrong.

IT IS YOUR BODY, if you really feel something is wrong, TAKE ACTION.  YOU MUST BE YOUR OWN ADVOCATE.  Unfortunately, as you've seen, many doctors are too busy, blow symptoms off, just don't pay attention. This is YOUR LIFE - take control.  I am sorry if I'm coming off as an alarmist - but I wish I'd had someone to push me, and I swore after I got my diagnosis that whenever I heard of a women who was confused I would encourage them to GET AN ANSWER.  DON'T WAIT.  If nothing is wrong, don't you want to know NOW???  And if something IS wrong, don't you want to know while you can still be helped??? TAKE ACTION.  PLEASE.  Find a gyn/onc - even if you don't have cancer you'll have better care -and if you do have a problem the gyn/onc will know how to handle things.  DO NOT RELY ON A NURSE PRACTITIONER - I know they can do a good job with minor issues but that is not what you need now -  you need a doctor who specializes in gyn problems.

Stop using the fact you are in a rural community as an excuse not to find the correct help - you can't be THAT far from a city with a teaching hospital - and if you really ARE that far out - get thee to the nearest big city with good medical help no matter what it costs.  You deserve it, you owe it to yourself and you can always find a way to earn more money - money is the easiest replacable commodity as long as you are commited to earning it - you obviously have a computer so USE IT to find the nearest high tech medical help. I don't mean to come off as harsh - I am a very compassionate (and passionate) person - I just want you to be aware that no one cares about your health like you do - so you MUST TAKE CONTROL.  Big Hugs and let us know you found some help - I don't want you to be in my shoes, Chris P
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