Need opinion on LMP cyst

[islandgrl47]

I am scheduled to have my ovarian cyst/tumor removed on 3/22. My gyn/onc who is wonderful. He is the Senior gyn/onc at University Hospital and basically teaches all the other gyns how to be a gyn/oncs. He is 99% sure it is a boarderline or LMP. He has given me all my options. 1st if it is completely benign a laparotomy to remove it and a D&C to take care of endometriosis and polyp that I have in the uterus. If it is borderline like he expects, I have more options. Get a complete hysterectomy, and staging surgery just in case: some omentum removal, some lymph nodes removed, I think an apendectomy diaphram scrapping (my terms not his)  and something else or do the the original surgery and take a wait and see approach? If in the rare instance it is malignant (which he does not think it would be) then the surgery would pretty much be the same. My question is if it is benign, mucinous or serous cystadenoma, should I just go for the hysterectomy anyway and get rid of all furture concerns? After this last period of back pain and cramping the prospect of being done with that for good sounds very appealing. I'm 47, two teens, not going to have any more, probably going to start menopause within the next few years anyway. Any advice or things I should consider?

[islandgrl47]

Thank you Shelly for your information. It is greatly appreciated. Friday is my pre-op screening and I will be able to review the options with the Dr. again. I will keep you posted.
Thanks again

[hopeshell]

I am so sorry to hear of your cyst and the tough decisions you face.  If I were in your shoes, I would have the complete hysterectomy and staging.  It is wonderful that your gyn/onc things this is borderline.  The overall prognosis is wonderful for this early stage of cancer.  However, there is no way to know for sure the type of mass without surgical removal and pathology.  Since you are so close to the normal age for menopause, I would opt to have the hysterectomy and remove the possibility of having another mass in the future.  I know the borderline category is controversial and there is not an agreement among professionals about the borderline category. But, I had invasive carcinoma and a borderline when I was diagnosed.

I am not a doctor, but based on my pathology, I truly believe that borderlines could be a precursor of invasive carcinoma.  So, if you can remove it all and not have the risk of cells being left behind, this is the best choice in my opinion.  If you were interested in preserving fertility, I would recommend that you not proceed with the complete hysterectomy.  But, since you are so close to menopausal age and not interested in preserving fertility, then most recommendations are that a complete hysterectomy is the best choice.

If your final pathology turns out to be borderline or benign, then you should consider taking HRT to help you through surgical menopause.  If you end up having an invasive  malignancy, then it is my opinion that you are better off to not take HRT.  

I have to be completely honest in that I have had a very hard time with surgical menopause.  I was only 37 when I was diagnosed with ovarian cancer.  I am now almost 41 and I have osteoporosis, depression, weight gain, vaginal atrophy and lack of libido.  I honestly wouldn't ever want these changes to affect anyone else on this earth!  I have tried supplements and many alternative remedies.  But,  still continue to have these negative side effects of the total loss of hormone.

Cancer is tricky and you really have to follow your gut about what you think is right!  It is a hard road.  I do think quality of life is very important and I have truly had a lesser quality of life since I lost all of my hormones.  Follow your heart and if you don't have an invasive malignancy...you may be better off to have the HRT.  I truly believe you will know the right path if you follow your heart!  Hang in there!!!

Shelly