Questions about Cysts and CA 125

[disney924]

A few weeks ago I had a laparoscopy, hysteroscopy, and d&c.  I was having very heavy periods and a possible fibrod so the doctor wanted to check it out.  Scrapings from cervix and uterus came back clean.  But what he thought was a fibroid was actually my right ovary.  It is 7 cm. He also noted my left ovary was enlarged.  I had a whole lot of adhesions in the pelvic cavity.  So much so that he had to remove them to even see my organs.  I have had a ruptured appendix and also prior laparoscopy surgery.  He looked at the ovaries and doesn't feel that they are malignant but wants them removed due to the size.  He decided as an after thought to run the CA 125 a week after my procedure.  It came back at 53.  He said he wasn't concerned about that number even though it is over 35.  The nurse mentioned he had consulted an gyn oncologist who was also not concerned at this number.  I am worrying myself to death over the possibility of it being cancer.  I have an appointment next week to meet with my ob/gyn to talk over the surgery.  He plans to remove the right ovary, uterus but try to salvage the left ovary so that I do not have to take HRP.  Should I be worried?  I know that I have a lot of scar tissue all over my pelvic region due to the rupured appendix and I have read this can cause the CA 125 to go up.  Thanks so much.

[Annekathryn Goodman, M.D.]

Hi There Dysney,
if you are confused, you should go see the gyn oncologist yourself and chat face to face.
best wishes

[rudyk]

hi..didn't they test your ovaries/cyst during the surgery?

[disney924]

My dr. thinks that the large cyst is an endometrioma.  He has schedule me to have this ovary removed as well as the uterus.  My left ovary is on the upper limits of normal and he feels we should take it out as well since we are in there.  Since I am 44 he feels that is the best option and then I should take HRT.  My concern is that my mother died of Breast cancer, although not one that was hormone receptive.  I am nervous to take HRT but leaving an ovary in that is already enlarged doesn't make much sense either.  Which would you recommend?  Also my regular gyno is going to do the surgery.  He said he felt comfortable after the consult with gyno oncologist.  He said he wouldn't touch me if he was concerned for malignancy but he said nothing is 100%.  Should I be seeing a gyno oncologist for the surgery?  Again one has been consulted by phone and images.

Thanks.

[Annekathryn Goodman, M.D.]

Hi there
it requires a biopsy to say if something is cancerous
take care

[disney924]

So do ob/gyn's have a good sense by looking at the ovary to determine if it is likely cancerous?  I realize that cancer is cells and that they course be found under the microscope but I am trying to feel positive that the doctor wasn't worried after seeing the ovary under the laproscope.

[Annekathryn Goodman, M.D.]

Hi There,
the CA 125 probably reflects irritation from surgery. It sounds like your doctor is being very careful.  It sounds reasonable to remove that ovary. It is reassuring that your doctor did not see any signs of cancer at laparoscopy
Please let us know how things go
take care