ovarian cysts

[islandchic]

I am a 38 year old woman diganosed with stage III colon cancer. colon resection 12/07. 3 out fo 12 lymphnodes. Met. to right ovary after 7 months of chemo. 10 cm tumor. I know have been seeing my GP and my ONC for abdominal pain. Mostly around my incision. I my incision is hard and very lumpy. They ordered a pelvic CT and pelvic ultrasound and vaginal ultrasound. They found two 1 mm cysts on my left ovary. 5 weeks earlier On 11/27 I had my Pet scan and 3 days prior a CT. Both NED. I had a colonoscopy and also NED. They wantedt to wait and see if they changed in two weeks times so I have a new ultrasound scheduled for next week. i have read alot of posts and seem that ovarian cysts are very common and especially after chemo. If they stay the same can they biopsy my ovary and the cysts before removing the ovary. Or should I just bite bullet and have them take it out? More chemo? What's next.

[HeinrikMD]

Hi,
I'm a bit confused with your timeline.
You had colon cancer diagnosed 12/07 (is this Dec 2007?)
Then ovarian metastasis after 7 months? (did you mean Dec 2006 originally?

If you haven't has any menstruation in the interim between the imaging studies - I wouldn't really be surprised that there isn't any change in terms of size.

The fluid collecting in the cul de sac may be normal. If there are some cysts that have ruptured - the fluid may collect in that area. It is possible that you may have actually ovulated, some cysts ruptured, and you may have menses in a couple of weeks or so.

SInce you are experiencing some pain - discuss some pain medications with your doctor, preferably something that won't impair wound healing - in the event that a biopsy would be deemed important soon.

[islandchic]

Thank you for your post. I had a follow up utrasound today and the cyst are not even smaller and look like simple cysts. They did see, however, fluid in the cu-de-sac. I am still in pain in my abdomen on the left lower side. Not sure what to do now.

[HeinrikMD]

Hi,
You are correct that ovarian cysts do occur during the period that chemotherapy is being given. Hence, I don't see the need to take out the remaining ovary if the appearance is benign. Decisions are usually based on the odds of finding something against the odds of finding nothing.
You may be under the impression that performing the operation is entirely to your advantage since you will make sure that there is no longer any disease. This is an incorrect notion, because ultimately there is no way of making sure that disease is extirpated by simply opening you up and taking a look. Imaging tests fail when the lumps are too small, the surgeon's eyes will of course, also fail if the lumps are too small. Even if you get more information by performing all the imaging tests and surgery, there is a point in which the risks of surgery will outweigh the chances of getting a positive finding. At the end of day, decisions are weighed based on odds not certainties, so if there is no clear indication for the operation - I doubt if any surgeon would perform it even if the patient believes it is a good idea.
Continue with your follow-ups and discuss your concerns.Stay positive.