can a simple cyst turn cancerous

[FrancesCTD]

Dear Dr Goodman

I am a 50 year old woman with a aneochoic simple cyst on my left Ovary measuring 3.2 * 1.4 * 2.0 cm.

It said on my TVS that my left ovary was slightly bulky measuring 3.7 * 1.9 * 2.0 cm.
Right ovary was 1.9 * 1.2 * 1.5 cm and was OK.
I am peri-menopausal.

First of all what is the average size of the ovaries. I thought they were about 3cm in length.

Secondly can this turn cancerous. My mother died of OVCA age 44.

Also what does a pre-cancerous cyst looklike?

I live in the UK and am finding it difficult getting answers from my doctors. We still live in the dark ages where Docs don't like telling women if they have cancer. Are they hiding something from me? My mother died of OVCA in 1976 and they never told her she had cancer, just that it was an ovarian cyst.

I got my FSH levels measured today and they were 80. Last year they were 'normal' - according to my doc I was not menopausal then, but am now. I have a myrina so don't have periods.

Thanks

Frances

[Annekathryn Goodman, M.D.]

Dear Frances
thank you for your important question
first of all , there are three indications for the prophylactic removal of ovaries (at least in the US)
-a personal history of premenopausal breast cancer
-a family history of 2 or more first degree family members with ovarian cancer
-a personal history of BRCA 1 or 2 gene mutation

you should see if you can get tested for the BRCA mutation. If you have it you have a 40-80% risk of ovarian cancer and an even higher risk of breast cancer and should have your ovaries and fallopian tubes removed

a simple ovarian cyst is not associated wit ovarian cancer risk.

the size of ovaries will vary depending on where you are in your cycle or if you are through the menopause.
the size that you describe is pretty normal for your age

best wishes to you

[bonnie0115]

A related discussion, Should I be tested for the ovarian cancer gene was started.

[Annekathryn Goodman, M.D.]

A related discussion, cystadenocarcinoma of the ovary was started.

[FrancesCTD]

Hello Dr Goodman

I have found out the cancer type my mother had.

Papillary Cystadenocarcinoma of the ovary (Papilocystic adencarcinoma), apparently it is serous.
Could you please tell me more about this type of cancer, and is it hereditary. Is this a type of epilithian cancer.

Also does this cancer have a poor prognosis.

Frances

[Annekathryn Goodman, M.D.]

Hi There
good to know your path was normal.

as far as gene testing
all it is is a blood test which anyone can have
it seems that the inability iot be tested is an administrative and medical policy  decision.

about 10% of all women with breast and ovarian cancer carry the BRCA gene mutations
the remaining 90% of women with these cancers, have polymorphisms of their gens but no clear single mutation that we currently know how to track.

it is common to develop the policy that cancer survivors are tested first. If they do not carry the BRCA gene, then there is no indication to test their families. if they do carry the gene, then it is reasonable to test family members.

the problem that many families face is that their mother/sister/grandmother who had ovarian cancer has died and so there is no living relative with cancer to test.
what to do then?

family members can get tested but say you have a negative result. does that mean you are safe? or did your mother have a BRCA negative cancer?
therefore a negative test is less meaningful but clearly a positive test is always meaningful

take care

[FrancesCTD]

Hello

Just to let you know my pathology results came back and I got the all clear.

Frances

[FrancesCTD]

Hello Dr Goodman

My mother developed ovarian cancer at 41, and died of it at 44. She also found a tumour in her breast at 44, don't know if it was breast cancer or had metastasised from the ovary.
What are the chances she had a malfunction on the BRAC gene. I would say close to 100%. My maternal grandfather died of cancer at 52. It was in the bowel and lung. Don't know which came first.
If this is the case my chances are close to 50%, but I am in the UK and they wont test me as she is no longer alive, and they only do the primary mutation test on people with cancer, although relatives can have predictive testing if and only if the person is still alive, and will offer to be tested. I do not have any jewish ancestry that I know of, mother was Irish Catholic but may have some scottish blood.
First of all why can you only do a mutation search if someone has been disgnosed with cancer, why can't they do one on me?
My mother was an only child, and I was her only child so I have no living relatives on that side of the family. There are many members on my fathers family and no cancer there (except skin damage due to sun exposure).
I am really worried that I may have this gene, and there is no way I can be tested due to one half of my family all dying early from cancer.

Yes I am the only one left standing in the whole of my mother family. Yet the NHS refuse to test me, as I don't have the disease.

Also is mutation 2800delAA  more common in people of Scottish protestant descent, or people of Irish Catholic descent.

I tried to post this on the genetics forum, but it wasn't taking questions

Frances

[Annekathryn Goodman, M.D.]

no
postmenopausal ovaries are retired
no more estrogen

[FrancesCTD]

Hello Dr Goodman

Another question - do the ovaries still produce estrogen post menopause, and is there any benefits to keeping them that I will not have now they have been taken away.
For me I had to get rid of them for fear of getting OVCA, but for a normal 50 year old is there benefits to keeping them.
Will my risk of heart disease, osteoporosis etc be more than a post menopausal women my age with her ovaries?

Thanks

Frances

[Annekathryn Goodman, M.D.]

Hi there
sounds like you are doing alot of good work for yourself
the microscopic report takes a few weeks to come back as your doctor said.

hormone therapy is sometimes given but many doctors will wait 6 weeks postoperatively to see if you are having any hot flashes .
women with the BRCA mutation have a high rate of breast cancer. at least yearly mammograms and potentially other close interventions including consideration of prophylactic mastectomy may be discussed
best wishes

[FrancesCTD]

Another thing I found strange is that no one mentioned HRT to me. I thought they would givenI has a BSO. Although he did say I had gone through the natural menopause, as my FSH was 80.
what is the procedure for getting HRT.Do they start it immediately after a BSO. If someone has already gonr through the menopause naturally do they need it after an BSO.
Will I have more hot flushes and night sweats than I had before. Actually I havn't had a flush or a sweat since the op,and I was getting them all the time for thr past 3 months. Will this actually put them away, as hormones will be more stable now (zero) - as opposed  to up and down, like before.  After all older post menpausal women say 60 plus do not get sweats is that because their hormone levels have stablised.

Frances

[FrancesCTD]

Hello Dr Goodman

I am out of hospital - had both the little buggers and their tubes removed Thursday. BSO. My gyn/onc could not find anything suspicious, the cysts had gone. However he told me he wont know for sure for another 3 weeks as they have to do lots of pathalogical tests on them. They said they have already looked at the ovaries and tubes under the microscope and found nothing, but sometimes cells are so small that you can't see them. He was saying at worst it would be 1A and it has a 98% success rate. I would have thought if there was no tumor (esp under microscope ) then no cancer, but he won't give me the all clear for three week. I would have thought even there were a few malignant cells in them that were so small you could not see them under the microscope then I would be in the clear, as they are now no longer in my body.

Frances

[FrancesCTD]

Hello Dr Goodman

I am getting both my little 'buggers' removed on Wednesday. As my mother died of OVCA and I am now 50 my gyn/onc thinks its the best.
I am getting tested for BRCA but as my mother is no longer alive, they said it may be difficult to know which type of defect I have got.
Even if I get the ovaries removed, I still want to know if I am carrying the BRCA gene so I can keep a close eye on my breasts. Yearly mammograms instead of every 3 years.