Complex cysts premenopause recurring

[lilly75319]

I am 34 years old.  I went in for a MRI on my back last spring as I was having low back pain and the Dr called telling me I needed to go to a OBGYN because he could see masses on the MRI around my uterus.  Freaked out, I called my regular Dr who immediately sent me for an vaginal ultrasound and referred me to a specialist obgyn.  The vaginal ultrasound found both ovaries had large cysts, functional cysts greater than 5cm on both ovaries.  I was scheduled for surgery to remove and biopsy the cysts.  This all happened within like a month, my family has no history of cancer.  I was sooo worried and scared.  The surgeon removed the cysts and said they were mostly fluid filled, but did have some mass to them, which they sent for biopsy.  This came back normal.  So they wanted to start me on birth control YAZ.  I was dumb and really didn't want to take the birth control.  I have been on birth control in the past, when I was in my 20's but had stopped taking them in recent years.  Not sure why.  So after the surgery the dr's wanted to just so followup pelvic exams to double check.  Back in December everything was normal.  Then I went back just last month, and I noticed I have been feeling bloated, weak cramps in lower abdomen, irregular periods, tired all the time, and instead of frequent urination, I have this feeling when I am peeing that is like a sharp pain that stops me mid stream...so I don't finish. Which is uncomfortable.  We did another ultrasound and found both ovaries again have cysts, this time complex about 3-4cm in size.  When the surgeon went in last time she said both ovaries were enlarged and covered with cysts, she tried to remove as many as she could while she was there.  They also did the blood test for Ovarian cancer, but it was negative.  SO now about a year later this has returned, seemingly more complex...my Dr this time is taking a wait and see approach, and said she just wants to do a repeat ultrasound in 6-8 weeks.  But it brings up all these scary feelings again.  I have researched everything I can find on this subject.  How common is Ovarian Cancer for someone my age without family history?  Also, I read that weight can be affected by this, is this true?  I have always been overweight, but lately I feel pregnant...and I never have been...my belly is big...and I haven't changed anything major.  Should I be asking for more urgency or just go along with the dr wait and see approach?

[MarieMichele]

Your doctor is taking the normal approach for newly discovered cysts which is "wait and see".  If these are the type that will go away on their own, then it will be sooner rather than later (1-2 menstrual cycles), so that 6-8 week wait and see makes sense.  If they are still around and causing you pain and symptoms 2 months from now, it might be more feasible to consider removal at that time.

Not having a family history improves your odds but by a very little percentage.  I just read a UK study that showed only a 1% improvement.  The cancer is RARE thankfully.  Being prone to having cysts doesn't pose an increased cancer risk.  But complex cysts are typically more worrisome because of their complexity and ultrasounds cannot always give a full picture of what they contain.  If in doubt, take it out.  But you can probably wait the 2 months the doctor is suggesting to give your body a chance to get rid of them naturally.  Did the doctor recommend hormone/bc treatment to help get rid of the cysts this time around?  I hope they resolve on their own for you.

You are still your own medical advocate.  If you really want them out now, you have a right to request it. In other words, you do not have to settle on the doctor's recommendation if your instincts tell you otherwise.  Or you can seek a second opinion.  It is not an easy decision process.  Nobody wants to undergo surgery (and for you it is potentially becoming an annual event), especially if it turns out to be something that could have been avoided just by waiting.

One other option would be to ask the ladies on the ovarian cancer forum how they think you should proceed.  I don't know what conditions they faced prior to being diagnosed. They may be able to support or set aside your fears based on their own experiences and choices as to  whether "wait and see" is a good or bad idea.