What can I expect?

[Trackey79]

I am hoping someone can kind of give me a real idea of what to expect when I go see my OBGYN next week.

A lil history - I am 40 years old and the mother of four. Until December 2010 though I had never seen an OBGYN. None of my babies were born in the hospital (the first was born in a birth center and the other three at home) and the same midwife delivered all four :o) Last summer I started noticing my periods were acting funny and called my family practitioner when it did not straighten out after several months. So on 10/22 I had an U/S that determined I had multiple cysts on/in both ovaries that were each around 2 cm in size. So they wanted to do a followup U/S in 8-12 weeks to recheck them. As well, my family practitioner went ahead and sent me to the OBGYN to get checked just in case. (He knows I have an extensive family history with cancer.) The OBGYN checked me, did a D&C and a biopsy of that. (Biopsy came out okay.) She pretty much just told me I was getting older and needed to lose some weight and that these things were probably causing my issues.

Fast forward to 2/7, I had my followup U/S. The cysts on the right had resolved themselves, but the cyst in my left ovary has grown to 8x9x1.7 cm and is mildly complicated. The report also says the cyst has a small amount of liquid and irregular walls. As well, they are now noting a thickening of the uterine lining that was not there before. I have an appointment with the OBGYN on 3/3 and from what I am reading online I am thinking she is going to say surgery is needed, but I was hoping you can tell me more accurately what to really expect. Is this cyst small enough for laproscopic surgery? Will I most likely be able to keep the ovary? Are there any indicators from my report pointing to cancer? I understand you cannot tell me for sure what will happen in my case, but if you can share your own experiences I would appreciate it. Thanks!

[Ichoosejoy]

It would be worth the drive to go to the next largest town to *at least* consult with a gyn/onc - even if it means driving a few hours each way.  The one factor contributing to better outcomes with ovarian cancer is having a gyn/onc involved. It could add years to your prognosis, if, it turns out to be cancerous.  I can't stress this enough.  You only have one opportunity to make this decision, after your surgery your options change.  

I too am a believer, and trust in Christ my Saviour.  Who's to say that he did not lead you hear to guide you...to heed this very advice?   Not wanting to scare you or confuse you...in any way....it is just ovarian cancer is a formidable foe.

[Trackey79]

Thank you for the advice, but unfortunately my city does not have an OB Oncologist any longer. (The one we had moved out of town last year.) Luckily, I do have one of the absolute best OB's in my city, so I will have to have faith and trust in God that all will be handled the best way possible.

[Ichoosejoy]

I would strongly recommend to you, that you seek a second opinion from a gyn/oncologist *before* your surgery.  If you are now facing surgery for a suspicious ovarian mass that could be cancerous, you must find a gynecologic oncologist to perform the procedure. Only a gynecologic oncologist is specially trained to do the surgery that will be needed if ovarian cancer is found. Research has shown that women with ovarian cancer who are treated by gynecologic oncologists tend to fare much better than those who are not.

[Trackey79]

Dr. Goodman,

Thank you for your reply. For you to come here and answer all these questions from complete strangers shows a true dedication to your work most people don't get to see anymore!

After discussing everything with my doc (i.e. - family history of uterine, cervial, colon and breast cancer, the pain I am in, etc.) we have scheduled me for a partial hysterectomy and removal of my left ovary and falopian tube. She also has made it clear that depending on what she finds, I may lose the other ovary as well and anything else that may be effected. Four weeks from today, I will know for sure.

Thank you again and I will post an update once all is said and done.

[Annekathryn Goodman, M.D.]

Hi There
definitely a cyst that is larger than 4 to 5 cm should be removed.
Some a mostly fluid filled and can be removed laparoscopically. Others are too solid or are suspicious for a malignancy.

I suspect that to answer that question, a few other tests might be necessary such as getting a CA 125 blood test. Sometimes, if there are solid elements, an MRI to further characterize the cyst is helpful
as far as a thick lining in the uterus,that can vary depending on where you are in your menstrual cycle.
if you are having irregular bleeding, you need a biopsy of the uterus as part of your evaluation
please let us know what happens
best wishes