What would you do?

[Fiveft4]

I have a 3cm simple cyst on the right ovary and a solid mass the size of my thumbnail on my left ovary. I have a follow up trans-vag u/s scheduled mid November to see if there is any change in either. The cyst has been there for over 4 months with the mass being found last month while following the cyst. I'm 47. My CA125 was 9. Because there is no way of knowing what the mass is without removing it, I'm leaning toward surgery sometime in December, but I'm not sure what to do with the cyst. Are these types ok to leave alone? Is it possible to remove only the cyst and leave the ovary - how successful is that? What if they have to remove the right ovary too? What is that like at age 47?

[Fiveft4]

Is your cyst a simple one? I'll be seeing my gyno/onc Monday to schedule surgery and I want to keep my ovaries. I hope he is able to tell me there is a reasonable chance that can happen. If not, I hope he can at least leave me one. Have you had any symptoms from your cyst? My uterus was removed at age 28 and I haven't missed it :-) Personally, I'm looking forward to getting in there, having the doc take these things out and for me to get on with it without the looming question of is it or isn't it? Best to you. I'm thankful for this group :-)

[KateRider]

I am 51, 3 cm right ovary cyst, CA-125 also a 9.  Since I am already in the middle of menopause, I have accepted that I will likely lose both ovaries, although I would prefer to keep them.     My gyn/onc is great - she admits being prejudiced against ovaries after childbearing is done.    
But she is leaving the question of whether to lose my uterus up to me.   As far as we know it is healthy but serving no purpose except possibly helping hold my bladder up.  
I told her I would like to keep my cervix, which she said looks fabulous, and my PAP tested negative for HPV.     She said she does not recommend keeping the cervix but it is up to me.    
Unfortunately I went 2 years without a pelvic exam or pap so I don't know how long the cyst has been there.   So I need to make a decision about my uterus and cervix soon and get to surgery.  I am so glad I found this website. Good luck to everyone.

[Fiveft4]

Thank you for your information. I was able to reach the gyno/onc yesterday and I have a surgical consultation with him on Monday. I'm sure we'll put our heads together and come up with a "Plan A" "Plan B" and any other contingencies :-)  I'm comforted hearing solid masses are generally benign. Do the solid ones also have a blood flow that they monitor? I remember that part of the ultrasound went on for quite a while. The solid mass comes off the ovary on a stalk and then bulbs out. It seems to me that will make it easier to remove. Would there be any reason to lean more toward taking the entire ovary out instead of simply removing the growth? Thank you so much for taking the time to share your expertise and opinions with us. It is truly appreciated.

[Annekathryn Goodman, M.D.]

Dear Sharon,
It sounds like you have had a good evaluation. With ovarian cysts at that size, getting a follow up ultrasound to check for growth is very reasonable. So now you know that the 3 cm cyst is stable. The other mass may be a hemorrhagic cyst after ovulation or it may be a small tumor such as a dermoid or fibroma. Cysts that are completely solid are usually benign. It may not have been seen before because it is related to ovulation or because it was there before and there was bowel gas in the way.

I agree with looking laparoscopically,. It is possible to preserve your ovaries and just remove cysts most of the time.
best wishes

[Fiveft4]

I'm glad to hear things went so well. How were you able to see a doctor and have surgery so quickly? Was he the one to suggest the surgery? I do want to find a doctor who will do his best to simply remove the cyst and the mass and leave my ovaries. It sounds like I need to give your doctor a call. I don't want to wait and continue having all this follow up only to end up at the same place. Will you be back at work on Monday? Is the surgery that easy?

[saville]

I am finally out of hospital.  The cysts were endometromas.  I apparently had endometrioma everywhere.  They used a laser to remove the endometromas, and spared the ovaries.  The pathologist did an on-the-spot analysis and the cysts did not appear to be malignant, but the final pathology report will not be done until next Wednesday.  The smaller cyst was easy to remove and the larger cyst was apparently very difficult.  If you have to have surgery, get in sooner rather than later!  My physician was great, and I recommend him highly,  Dr. Arnold Petersen.  His office is at Portland Adventist, but the surgery was at Providence.  The surgery was a piece of cake, and, except for little soreness, I feel as good as new.

[Fiveft4]

Wow! We do have a lot in common! As I write this you are probably in surgery and my thoughts are with you. Please, let me know how it all goes. Yes, I would love to know who your doctor is. I don't want to lose my ovaries either...I'm in my prime and I just don't want to get into the menopausal mode any sooner than I have to. My mom had breast cancer at age 50 and had a double mastectomy, and her grandmother had breast cancer too. I wonder what that means for me when it comes to hormone replacement - that's a subject that hasn't been discussed. For months I have had symptoms, mainly terrible pain in my hip joint and a very cranky bladder. I have intermittent sharp pains and often feel bloated and tender. The waiting is difficult and I agree with you - it seems the sooner they are removed the less likely they are to damage the ovary. That is what bothers me about waiting. Take care and please stay in touch.

[saville]

Hi, Sharon:  

We have lots in common.  I live in PDX, too.  I am 46.  My CA-125 is 9, too.  I have bilateral, complex cysts (simple are normal; complex are bad).  They were first revealed in an ultrasound 4 weeks ago.  They are 4.7 and 2.5 cm.  I had a follow-up with a MRI which revealed one was probably just an endometrioma.  The other one is probably a hemorragic cyst.  However, there is no way to know if cancer without laproscopy.   Even the Ca 125 is not a reliable indicator, but a low level does make it less likely.


My first physician wanted to give me a hysterectomy!  I sought a second opinion, and found a great doctor.  He is very conservative, and did not recommend a hysterectomy. I looked for an OB/GYN with lots of surgery experience.  I am having surgery tomorrow. YIKES!  He is going to do a cystectomy (remove cysts).  He is going to attempt to remove the cysts without harming the ovaries.  He did inform me that you only need one ovary to maintain your horomone levels.  In my case, If they  are endometriomas, and he can't remove them without removing the ovaries, he is going to leave them, and put on a six month drug therapy and monitor them.  (I have no symptoms.)  I can't remember the name of the drug, but it mimics lactation in the body.

I really did not want my ovaries removed.  My horomone levels are very good (9 fsh), and because of the history of breast cancer in my family I could not take artificial  horomones.  Plus, I am just not ready for menopause.

My physician told me that whether a cyst will be easy to remove depends on how integrated into the ovary it is.  I do not know, but I would think the earlier the better!  

It is all very scary.  I will let you know how it turns out.  I love my physician if you want a referral.