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661941 tn?1297447355

Update

I had an apt. with my gyn/oncologist today. Basically, my options are as follows:
1~A huge incision (from just below the breast bone to just above the pubic area... about 12 in. long!)... in order to do a total hysterectomy ( uterus, ovaries, tubes)... this is her preferred method of treatment. (uterus is enlarged with 2 fibroids... 7cm complex mass on LT ovary and 2 cm complex mass on RT ovary)
2~ I asked her why we couldn't just do a smaller incision and take only the ovaries out, as that is what seems to be the biggest concern at the present. She said she can do that, but she apparently doesn't trust "bagging" them. She said the bags can leak, so I guess she prefers to remove them intact. Also, if we leave the uterus in, I may still have some bleeding issues, as I have fibroids, which tend to grow. So, I may have to have it out in time, anyway. Plus... if I end up requiring hormone therapy (which she does NOT like to do, but will if I really need it)... she never prescribes RHT to a pt. with a uterus. She said it can, and will, cause uterine cancer.
I have an appt, for a 2nd. opinion with my former gyn/oncologist next week (19th) and will make my decision in regards to what she tells me.
One of my biggest issues right now is that my husband is out of state working (new job)... I stayed behind to try and get our house sold. So, this is just a terrible time for all this right now.
She is monitoring my CA-125 on a monthly basis, as well as having me do TVU every month, as well- until I have my surgery. I really like her... she seems to be the type that just doesn't like to take any chances. But I am still unsure as to what I am going to do. As she said... she can only tell me what my options are... I have to be the one to make the choice.
So... that's it... in a nutshell!  :)   Not alot new really... just waiting for the 2nd. opinion.
Thanks for "listening"!   :)
God bless...
Cheryl
10 Responses
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483733 tn?1326798446
Your recovery time will be the same whether it is a bikini cut or vertical cut.  With the davinci it will be reduced slightly.
Helpful - 0
661941 tn?1297447355
Thanks for the advice/ info. What I am not understanding is why so many seem to be able to have their surgery done laparoscopically, or even with the bikini-line incision... and this Dr. wants to do a 12-18 inch incision on me! (I measured what she told me and it was 17 1/2 inches!) I read a little more on the robotic surgery as well and this is what I found out:
"Though some benign ovarian neoplasms may be treated, in some cases, with minimally invasive surgery, most ovarian conditions are treated by traditional surgery. Ovarian cancer is, almost invariably, treated with traditional surgery."
I guess I am just going to have to quit thinking this thing to death and wait to talk to my other gyn/onc. next week.  Uggh!
God bless...
Cheryl
Helpful - 0
187666 tn?1331173345
One thing I do agree with everyone else is - get the second opinion and a third if need be. I was in a similar situation although I'm post-menopausal. My doctor found a large cyst on my left ovary and a fibroid in my uterus. At first she said she wanted to take everything out since the cyst definitely had to go, the uterus was "abnormal" with the fibroid and the right ovary was just sitting there doing nothing. But. . . . she got a second opinion from the other surgeon (the gyn/onc I guess) and he felt it was better to do a less invasive surgery (laparoscopy) with quicker recovery, fewer risks. I don't have a history of cancer in my family. And fibroids tend to just sit there and gradually shrink after menopause.

My doctor told me that her plans had changed and why. She also explained that she would bag my ovary and cyst to avoid any contents from spilling into the abdomen. However, if they ran into problems or it looked suspicious, then she would open me up.
Everything turned out great even though my cyst was 10 cm.

So that's my story but I do know each person is different and each doctor is different. All you can do is get as much information as possible and then decide which doctor will help you out.
Helpful - 0
672379 tn?1229134609
Cheryl,

I am glad you are getting a 2nd opinion.  Get a 3rd and 4th if you need to.  The important thing is to make sure you are ok with what is going to happen.  I was very relieved when I woke up from my surgery to see my incision was much smaller than the doctor originally thought it would need to be.  I am lucky to have my mom, my teenage daughter, and my husband to take care of me.  I hope you can work it out to be near your husband!
Helpful - 0
661941 tn?1297447355
Thanks again... I did some research on the Davinci surgery. How amazing is that!  :)
I saw that my Dr. apparently is not trained in it, but the Dr. I am going to for a 2nd. opinion is. So, I will ask her next week if she thinks I would be a good candidate for it. What a blessing that would be if they could do that, instead of "split me in half"! (although I do need to lose weight!)  LOL
I also posted a question about it on the ovarian cancer board. So, I will see if anyone there has had any experience with it. Thanks so much for your help. I am so glad to have found this forum and only hope that I can be as much help to someone else, as you all have been to me!
God bless...
Cheryl
Helpful - 0
483733 tn?1326798446
I understand your question better now.  My laparotomy was from pelvic bone to breast bone but that is because I had previously had intestinal surgery with that cut.  I am surprised she can't do what she needs with a binkini cut.  I would say a 2nd opinion on that is definitely in order and perhaps someone who is good and local to you too.  Good luck!
Helpful - 0
408163 tn?1242949501
Hey Cheryl,
Robotic surgery is the latest and greatest laparoscopic surgery around. It is cutting edge. You need a really skilled surgeon to do it though. My gyn/onc was the chief of gyn/onc at Mass General Hospital. He is awesome.  All the other docs I saw wanted to do the laparotomy (big open incision). Thank God I went to Dr Fuller. It is called the DaVinci robotic system. You can google DaVinci hysterectomy and it will take you to their website. I think it is called intuitive surgical. It is there that you can find a doc that does the robotics from their website. It is really really amazing.
Yes I just looked. Go to   www.davincisurgery.com  That really explains it.
Take a look and let me know what you think.. Hopefully there is a doc in your area that does it...
Take care
Laney
Helpful - 0
661941 tn?1297447355
Thank you ladies, and yes I AM looking for opinions! I honestly do not know what to do! The smaller incision would still be an open incision (bikini line)- that I wouldn't mind as much. I've had it before... I've also had laparoscopy surgery (twice)... those were a "piece of cake" to me. Of course, I was 20 years younger too!  ;)   I just do not want to be cut from top-to-bottom. I asked her exactly what I could expect... incision-wise, and she had me lay down on the exam table  and took her finger and drew a line at least 12 inches long... that just seems so extreme to me! Also, I have to keep in mind that I if I choose the bigger surgery, I will have to have it done in Nashville... as that is the closest to my hubby. He just cannot take off enough time right now to come here for a couple of weeks- maybe one... but no more. Besides, after 31 years of marriage, we really need to be together now- with all that's going on- we both agree on that. SO... I don't know exactly why I am "playing with fire". I suppose I just believe in my heart that this is not cancer (does anyone?)... and am trying to make the most conservative, but safest decision possible. I do have a question... the gyn/onc recieved the report and based her "plan of action" on that. She has not actually seen any of the ultrasound pictures, herself. I picked up a cd with the US pics on it yesterday and took to her today. She wanted to view them, but her pc wouldn't open up the files. I came home and made her a copy and am mailing it to her, with instructions on how to view it. I guess my question is this:  do most gyn/onc want to view the actual films? My previous one did (in OH), which is the reason I got the cd -for her. I just wondered if that could make any difference. I know one time, they thought the complex cyst had grown, and when my Dr. in Ohio checked in to it, it had been read by a different radiologist and he had included the size of the ovary , when the other radiologist had not. That made a big difference in her decision on what to do. (can you tell that I am a very detailed person?)  LOL But she is too, so I guess that's why I trust her.
On another note... ROBOTIC surgery? How do I found out about this? I will start doing some research in it now. Does it enable them to make a smaller incision? If so, I'm game!  :) Seriously!
Thanks again ladies... all advice or opinions you give me is welcomed!  :)
God bless...
Cheryl
Helpful - 0
408163 tn?1242949501
Hi Cheryl,
I too echo Trudie's sentiments. I had a similar situation to yours. I had multiple large fibroids, bilateral suspicious masses on both ovaries and suspected severe endo. I went to the best gyn/onc around and he did not let me down. I too had 3 opinions and am glad I chose what I did. He gave me the option of leaving my uterus with the hope that the fibroids would probably shrink after he removed my ovaries. Since my mom had uterine cancer in her 50's, I wasn't taking any chances of getting that 10 yrs down the line when Im mid 50's at that time. After discussions with my gyn/onc, he agreed to just take it all out at the same time. I know also, that if you have a uterus you need estrogen and progesterone as hormone replacement. I take estrogen replacement, the bioidentical vivelle dot patch. It is working wonderfully. Also, I didn't want yearly uterine biopsies as was suggested I would need if I left my uterus in. I had them in the past and they are no fun. I guess what I am saying is, for me the removal of the whole shooting match made more sense as to avoid a future surgery. Ihope you can make a decision you are comfortable with. Oh, and my gyn/onc did my surgery robotically, bagged the ovaries and delivered it all through the vagina. Worked well for me
Good luck with whatever you decide... Take care
Laney
Helpful - 0
483733 tn?1326798446
Cheryl, this is a really tough decision.  I'm not sure if you're looking for our opinions or not but I will give you my thoughts and these are based on if it were me.  I think you should go ahead with her plan - the reason for a gyn/onc is because they are the best at getting these out.  I am assuming the smaller incision option is laparoscopic?  With that there is risk that the cysts could break open and if it is cancer then the cells could go everywhere.  You would still have the issues with the fibroids and absolutely no HRT.  It will still be 2 weeks before you can do anything after surgery, and still 8 weeks with no lifting or twisting.  If you go for the laparotomy (makes no difference on size of incision - this is what I had) you will know that another surgery will not be required down the road and you have eliminated any other gynaelogical cancer risk.  By the end of 3 weeks you will start to feel better and the 8 week rule applies.  Yes, those first 3 weeks will be tougher but you'll feel better with those fibroids gone.  

Try to think of your life long term and not just the short term moving issue.  Everything will come together regardless.  I really feel for you.  Good luck.
Helpful - 0
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