complex ovarian cyst

[j-mom]

I have been diagnosed with a complex ovarian cyst on my
left ovary. My first intravaginal ultrasound was in March and
had a follow-up about a week ago.  The reports show the cyst
has not changed, but is still there.
My doctor has recommended either waiting 1 month and re-checking
or having a complete hysterectomy, "because ovarian cancer can be sneaky" as he puts it.
I have had a CA-125 done and the result was 20.
What are the risks of waiting another month or two?
The doctor said it's he's 90% sure it's benign, but he said the only way to tell for sure would be to have a hysterectomy.
I'm just completely thrown by all of this. What are the chances that a complex cyst is cancerous?  Are there other tests that
can be done without having a complete hysterectomy? I am nearing
50 years old, so I'm told that's what they do with women my age.
Please help guide me!

[Annekathryn Goodman, M.D.]

Hi there,
Most cysts are benign.
Risk factors for ovarian cancer include:
family history of ovarian cancer
family history of breast cancer
personal history of breast cancer
endometriosis
certain forms of infertility

In terms of suspicious findings that would make surgery strongly encouraged:
-cyst size greater than 5 cm
-complexity to the cyst - solid areas within the cyst
-ascites or free fluid outside of the cyst in the abdomen
-elevated CA 125
-pain, bowel changes, bloating, swelling of the abdomen
-a cyst that is growing over time

In general without the above mentioned issues, I usually recommend a repeat ultrasound in 1 to 3 months
best wishes to you

[j-mom]

Forgot to add that I do have uterine fibroids and a simple cyst on my right
ovary. Not sure if that would make a difference in what type of care I should
receive.