Ovarian Cyst

[Sid38]

I have an ovarian cyst with a slightly elevated CA-125 of 52. I am booked in to have a laparascopic cystectomy in 3 weeks. There is a history of ovarian and breast cancer on my mother's side of the family. I have had two failed IVF attempts and this cyst was discovered during the 3rd IVF attempt which has now been abandoned. I have had no symptoms and would not have know about the cyst if it wasn't for the IVF down regulation scan.

My doctor said it is unlikely to be cancer as the CA-125 would be higher if it was. Is that correct? If it is endometriosis would I have had symptoms?  What else could cause an elevated CA-125? (I have a history of autoimmune disease - lupus is quiescent, graves disease is active but controlled, autoimmune hepatitis is cured).

[Annekathryn Goodman, M.D.]

Dear Annette,
if you have a family history of breast and ovarian cancer, you should ask your doctor about genetic testing and about risk reducing  surgery.

If you are at risk for ovarian cancer either from a gene mutation or family history (2 or more first degree family memebers with breast or ovarian cancer), you should consider the surgical removal of your ovaries and fallopian tubes. If you have abnormal bleeding, pain, or other issues with your uterus, you should talk to your doctor about taking out your uterus at the same time.
I hope all works out.
best wishes

[AnnieO22864]

Hello Dr. Goodman,

I am a 45 year old mom with 3 children.  I suffered a miscarriage last November and a small cyst was found on my left ovary (less than .5 cm).  My doctor recommended an oral contraceptive and I was on Loestrin (sp?) until April when I started to bleed through my cycle. I was under alot of stress at the time and attributed it to that.  I discontinued the oral contraceptive in April and have not had a period since.  I have symptoms of a period;  i.e. cramping, irritability, back pain, but no blood loss.  The pain does subside so it is not all of the time.

I am concerned as I have a family history of ovarian and breast cancer.  I have an appointment with my gynocologist but she is out of town and I can't see her for a couple of weeks.  Are there certain questions that I should be asking?  I have had a CA-125 test a couple of years back and it was slightly elevated (36).  Internal ultrasound was fine.

Thank you for your assistance.

Annette

[Annekathryn Goodman, M.D.]

Hi There,
you are getting perfect care. I agree with your doctor.  CA 125 can be elevated for many reasons such as inflammation, endometriosis, fibroids
best wishes