Suspected Ovarian Cancer

[ribaux]

Hi I'm new to this forum and would like some input as to the reading of my ultra sound and what I can expect when I meet with my Gyno and what questions to ask. I'm unsure of how I sould be feeling towards all this - Is it cance?

My report is as follows:-

The uterus is anverted and of normal size and myometrial texture.  The central endometrial echogencity is inhomogeneous with several nonshadowing echogenic areas that may reflect enlarged mucous glands. No fluid or other endometrial abnormalities were seen.  In the left adnex related to the ovary there is a large mostly cystic lesion 6.7x5.0x3.7cm. A small 11mm solid nodule is noted at is perphery and it appears hypervascular. As a reult a complex cystic ovarian mass lesion is suspected and histological evaluation indicated.

Is it cancer and if it is could it have spread. What can i expect?
Thank you all so much I have been reading all your posts before I added mine and wish you all the best

[ribaux]

Forgot to add that I am 48 and have not had a cycle for the last couple of years have not has any menopausal symptoms that I can say.

[Curls]

Hi Ribaux,  I'm not familar with all the terms in your report, but there are many things that can be going on down there that aren't cancer.  Only a very small percent actually are cancer.

Solid isn't ideal, but they are suggesting a type of US that's histological which is often used to look at polyps, which are usually not cancerous but are removed because eventually they can get that way.  I don't know if a fibriod would be also ever seen as solid (I just don't know one way or the other.)

The comment on the cyst is vague since they often make a guess of what kind it is, dermoid, endometrioma, simple fluid filled, complex, complex with septations.  It's on the large side for just leaving in, so it's very likely your doctor will want a follow up test to see if it's changing and then to schedule to remove it.  If it's a simple cyst (vs. complex) it might just shrink on it's own with no surgery needed.  The surgery is usually laparascopic (with scope) with a few weeks recovery instead of the older version of direct incision with 6 weeks recovery.  Which is used depends on the situation.

Did you have symptoms that got you started on taking the test.  Most ovarian cancer symptoms can also be caused by a benign cyst as well, so the symptoms don't tell you anything.

I haven't heard of enlarged mucuos glands so no idea what that means.  However, no free fluid is a good sign.  It's the ovca that generates the ascites, free fluid beyond a few cms worth.

There is no definitive test for ovca except biopsy of the cyst, which is part of why surgery is used to remove it.  Again, the rate is like 99% NOT cancer.  The CA-125 is used to track the cancer, but it's not very useful as a pre-test at all and can make you nervous if positive for no useful reason.  It is good to get though before surgery as a baseline just in case.

I'm sure you'll get a clearer picture when you talk with your doctor.  One important note.  If there is some suspicion of cancer be sure a gyno-oncologist does the surgery or is at least on call for it.  The survival rates are statistically much better with their advanced training doing the "debulking" (removal).  Some gyno don't mention this to their patients and seem to want to rush schedule the surgery for themselves.

[ribaux]

Thank you so much for your response and reassurance.  Although I did originally go to the doctors for indegestion which lasted ove a week and then turned to pain swallowing, I also had nausea and have had for the last two weeks and stomach bloating - the night before my appointment I have severe stomach pains - so I requested the ultra sound. This was not my usual doctor so he just gave me a referral to a gyno gave me the report and left it at that. I see a gyno tomorrow on the 15/08 so will let you know how I go.

Thanks

[Curls]

Hi! Something not obvious, but worth a mention - these cysts are usually on the - inside of the ovary.  Not on the outside like everyone tends to initially picture.  If the ovary isn't too damaged they can be "shelled out" from inside it (cystectomy).  If the cyst is too big, the ovary will have stretched or it will have grown into the blood supply, and the whole ovary will need to be taken along with the fallopean tube (oopherectomy).  Don't count on my spelling though.

[ribaux]

Hi! Went to the Gyno yesterday and after reading all in this forum I was able to ask all the questions about surgery and etc.  - I had blood tests yesterday for Markers - tests are CA125 CA19-9, CEA & AFP HCG - I am also having a CT Scan on Friday. My Gyno said that they have to take the ovary but he wants these tests done before surgery, once we have the results he said we will book surgery.  I am scared, scared of the surgery more than anything, never had an operation only cessa for kids, so I am a bit nervy about the whole thing. I am trying to stay really positive and can't do much but wait, which is draining and frustrating. My Gyno was really good, I told him I know what to expect and that I had been on the internet - he gave me a look of horror - I said no its been good and really helpful after I explained he was really impressed.  Will keep in touch.