concerns about possible OC

[mls1604]

I had a partial hysterectomy November of 2005 and only had my uterus removed. Since then I've had constant pain on my left side again. I'm currently on an arimidex protocol until December to see if this helps with the pain. As of right now nothing has changed. Recently I went to my family doctor because I was having pain on my left side, constant bowel moevements, fatigue, pain in my back, and abdominal swelling. At first the dr. thought it was possibly kidney stones, so I ha a CT scan and bloodwork...........everything was fine. My last vaginal ultrasoud in October showed nothing wrong with my ovaries but the more I read about Ovarian Cancer and it being the "silent killer" the more I can't help to wonderif it's possible. my obgyn did say that when I go back in December if the arimidex hasn't worked surgery is inevitable. We've tried everything else. I really wanna call my doctor and voice my concern about this but I'm not sure if I'm way off on this one or not. I don't want to sound stupid or that I'm grasping for straws. I'm just in a great deal of pain and discomfort and no one seems to know why...........It's very frustrating! If anyone can offer and help or suggestions it would be greatly appreciated. Thanks!

Marcia

[Annekathryn Goodman, M.D.]

Hi There,

In  summary, you have had constant pain since your uterus was removed. You say that your uterus was removed because of severe endometriosis.
So I have a few questions for you:
-Did you have any pain prior to the surgery? If so, how is this pain different.
-if the pain only started after the surgery, when did it start? immediately? At 6 weeks? Or only when you tried to get back to your normal physical activity?
-is the pain associated with bowel movement, urination or sex?
-is the pain related to exercise or is it present at rest?
-do you have any other associated symptoms? Fever, back pain, blood in the urine etc?
-how was your hysterectomy done? vaginally?, with an incision? with a laparoscope?

If you had pain before surgery and you have endometriosis, the pain could be related to your endometriosis. This can be so even in the absence of ovarian cysts. The pain from endometriosis is not well understood but is related to implants of endometrial tissue along the lining of the abdomen (called the peritoneum). The pain is not related to size of lesions. Even the tiniest spot can cause terrible pain for some people.

Unless you had a vaginal hysterectomy and your abdomen was not evaluated, it is highly unlikely for your pain to be related to ovarian cancer. If the surgeon was just in your abdomen a year ago, a cancer would have been seen if it was present. However, when a hysterectomy is accomplished through the vagina, it is not possible to see into the abdomen and it is commonly not possible to even see and examine the ovaries through the vagina.

Postoperative pain can be due to infection, a problem with the scar such as a hernia, a severe muscle strain, adhesions, or an actual complication of surgery such as damage to the bowel , bladder, or ureters (the tubes that bring the urine form the kidneys to the bladder.)While people will commonly attribute post operative chronic pain to adhesions, the most common reason for pain after abdominal surgery is from muscle strain. In general, adhesions usually just allow the internal organs to not move around too much. Abnormal pain usually only occurs when the adhesions cause a twisting in a normal structure such as a loop of bowel.
take care

[dalip]

have same problem,same side but cysts were discovered on both ovaries. I too have had uterus removed many years ago and my consultant has surggested it may be adhesions. I have a tendancy to agree with him. Have they performed a colonoscopy to check the bowel?.This should really be the next step before more surgery I also get groin pain and pain when i open my bowels.Hope this helps. Dawn

[mls1604]

thanks for that! I think I still need to call my dr. and let him know what's going on either way. Maybe a lap. would be ok just to see what's going on before I decided to finish off the hysterectomy. The whole thing just scares me and I can't really afford to be out of work for 6 weeks right now but I know my health comes first but I sometimes I don't think my employer sees it that way.

[dalip]

yes agree you need to talk over options with dr. I have family history of ovca so i really want mine out but like you my employer is very anti-ill, plus i can not afford to be off ill.What sort of "surgery is enevitable" though,as next step?. Why did you have hysterectomy for in first place?, that might have some bearing on this, as you dont say in your post.Dawn

[mls1604]

I had the hysterectomy originally because i had severe endo. My husband and I out out a lot of money to try and conceive and were told that no matter if I get pregnant or not I wasn't going to be able to carry to term because of the endo. So after I had my uterus out last Nov my doctor said that my uterus was that of an 80 yr old lady, that's how bad it was. So we decided to see what happened after the surgery whether the pain and everything would go away. well I've had 2 laporoscopies since then to remove scare tissue and stuff like that. So he told me that we've tried every route that we can and if this arimidex doesn't work then my ovaries need to come out and that's that. he said that after being on the arimidex for 2 months we'll be able to tell if it's helping or not. it's been a month and nothing has changed, things actually have gotten a little worse. So that's why I said that surgery is the only option at this point. I have disability insurance that would pay me to be out but I just started this position about 8 months ago and I hate doing that.......

[mls1604]

I was wondering if you could take a look at my original post and give me your opinion.

Thanks,
Marcia

[dalip]

somtimes it takes dr goodmam a little time to reply but she will eventually.

[mls1604]

that's fine! Thanks!

[mls1604]

I had the pain before surgery and still have it to this day. I had about a 5 inch incision above my bikini line when they took out my uterus. The pain is constant but becomes harder throughout the day. I have an appointment with my Dr. in December to check things out so we'll see what happens. As far as the other symptoms........yes I've had back pain and some blood in my urine but it was nothing that was very heavy and it only happened once or twice. Thanks for your help!

[sat14]

Hi,
I am a thirty-four year old women with no children and one pregnancy.  I have a history of endometriosis and ovarian cyts as well as cervical dysplasia that I had cryo for a few years ago.
My husband and I are being treated for infertility(unexplained, since endometriosis is in remission).  I have been taking Follistim and Ovidrel on and off for 1 year.
I had a cervical dilitation two weeks ago.

Over the last few weeks, I have had major weight gain, bloating, GI issues, and right lower quadrant and sometime excruciating right thigh and leg pain and back pain.  I have a "spare tire" around my mid section.  I have always weighed about 115 lbs. or less so this weight gain is abnormal.  I have had my TSH anf TFT's tested and they are normal.
I have a history of breast cancer in my family at a young age(my mother 39 years old, unilateral mastectomy 18 years and still going survival). I have not taken the fertility drugs in over three months.  Unrelated to these symptoms, I have "flare ups" every so often and during this time I have myalgias, fevers, fatigue and major reflux and chest pain. I saw a Rheumatologist two years ago after a GI doc suggested that i may have an auto-immune disease.  I had a positive ANA and nothing further was done from there.  The Rheumatologist felt that I did not have Lupus or any other disorder.  The symptoms went away for a year or so.

My question?  Is it possible at the young age of thirty-four that I could have ovarian cancer?  What steps should I take from here so my doctor does not think I am crazy?  I have a fertility doctor in Boston and we are due to start an IVF cycle in three weeks.  I am nervous, scared and just annoyed by these symptoms and the lack of diagnoses I have received over the years.
Any suggestions?
Thank you kindly.
Susan

[akg]

Dear Marcia,
yes it does sound like your pain maybe related to endometriosis then.
good luck with your work up
take care

[akg]

Dear Susan,
first of all, you are not crazy to worry about cancer. Everyone worries. You have a few risk factors which include a family history of premenopausal breast cancer, endometriosis, and infertility. These are not real strong risk factors for ovarian cancer but there are there.

When you go for your IVF cycle, you should go over this with your doctors. I imagine that you will be getting a pelvic ultrasound to look at your ovaries for egg retrieval. It will be reassuring to see normal ovaries.
best wishes and good luck to you.

[sat14]

Dear Dr. Goodman,
Thank you so much for responding to my post.  I think it is amazing that you have time to answer all of these posts being in the position that you are in.  My husband is a surgeon who just finished his residency(7years!) the last thing he wants to hear when he gets home is me talking about my medical issues.  I am grateful that you were available to answer my concerns about ovarian cancer.  
Regards, Susan