Why a MRI

[springyes]

Hi I have been sent for a MRI now through my gyno.  I asked to be sent to the onc/gyno and they said to send me for MRI.  I have what they think might be a hemorrhagic cyst that is 5 cm and a elevated ca 125 of 80.  I have been sick with terrible stomach gas since last February.  My gastro sent me for a CT scan which showed nothing.  I'm not sure why the onc/gyno would ask the regular gyno to send me for the MRI?  Why wouldn't they when I asked to be referred to oncologist?  Someone please help I am so tired of all this waiting??

[springyes]

Thank you everyone, I don't know if the oncologist/gyn is seeing me or not. I have asked to be referred because I am losing confidence in my gyno and everyone on here says not to let a regular gyno take it out so I'm listening to you guys.  If my ca125 wasn't elevated to 80 I might have let him but not now.  He has been ignoring what I have been telling him about having to sleep sitting up because I'm so nauseated.  That was until he did the ca125.  He hasn't even asked to see the ct scan from the gastro doctor isn't that a little strange?  I'm a little claustraphobic so I don't know how I'm going to make out in this MRI???  He called it a hemorrhagic cyst at first and then said maybe I have endo which I think I would have known before this since I'm 46, I'm not sure?  I wish this cyst had burst or disappeared but it hasn't after 6 months.  I still have this twingy volcanic cyst every night when I lay down.  Thanks so much for all of your info it's how you learn what to say.  I will definitely start asking for my reports then maybe I can show the gyno what the gastro found.  I haven't got another appointment with the gyno to tell him.  I have to communicate through his secretary who said a MRI was in the process of being scheduled.  This is all wearing me out mentally.

[Jane39]

Wow you have been batted around like a ping pong, sorry and I understand your frustration.  Kevin and the others have given you great advice, take a deep breath, and take charge of yourself.  Get your MRI done, get copies of both the films and the report.  I personally get copies of ALL my test, blood work, scans, pathology reports, everything.  I keep it in notebook.  I just open it up and say here's my life.  It comes in handy.  You can actually call the radiology places directly and have them fax you a copy of the reports directly.  The most important person that you need to be seeing is an oncologist/gyn, that's where you should focus your engery on.  Good Luck.

[nyc lady]

Many GYN/Oncologists want a referral from a GYN before they will see a patient.  The GYN/Oncologist most likely wants another "picture" to what is going on.  Sometimes cysts will disappear, or burst, depending on where in your cycle you are.  

Cysts are very normal, especially if you still menstruate.  Also, an elevated CA125 could be caused by numerous different things and thus it is not a good diagnostic tool, but, better used to monitor recurrences.  

Try to relax....take a few deep breathes.....get the MRI done and let the GYN/Oncologist evaluate all the tests.  The waiting is the hardest part.  

Also, hemorradric cysts are usually filled with blood - which means that they are fluid....most of the time, an ovarian cancer tumor is a solid mass.

Hang in there....let us know how things go.

Pam

[kcd86]

It is very stressfull to have this hanging over your head not knowing what is going on or what the next step is. This site has some very knowledgeable people on it to guide you . I can see your frustration when your two Dr's are making you feel like a ping pong ball back and forth>

A transvaginal ultrasound (TV) is the most valuable diagnostic study in the evaluation of an adnexal or pelvic mass/suspicious cysts.  Cysts, hemorrhagic cysts(bleeding), endometriomas, and dermoids have a high predictive diagnosis via TV ultrasound.

The blood test CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer, approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. Please keep in mind that CA-125 can be elevated if your menstruating and some other causes of inflamation..
Unfortunately with any type of suspected ovarian mass/tumor/ suspicious cyst(s) surgery will be the only way for the Dr's too make a definitive Dx. It is NOT recommended to biopsy any ovarian mass/tumor/suspicious cyst as it can rupture and seed the pelvis with cancer cells if that what it turns out to be.  Please make sure you have your blood drawn for the following blood tests,Inhibin A&B, CA125 and CEA so at the very least you have baseline blood work.
Since there is some suspicion based on your TV-sonogram I would immediately find a good GYN/Oncologist surgeon. I am not suggesting what you have is cancer but studies have shown that treatment of ovarian cancer by nongynecologic oncologists and by low volume surgeons is associated with suboptimal surgical management. I would reccomend going to a large tiertiary hopsital where they see large volumes of patients.  This is not to make you worry even more but to make sure that the Dr who treats you has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal.
Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a Radiologist that specializes in GYN/ONC, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC to see a GYN/ONC surgeon Dr Carol Brown who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive and stay on top of your phycicians. Get copies of all your tests/results as you are entitled to them. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best and willing to help guide you thru this
Kevin
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[springyes]

Sorry about confusing you but I started in February 2010 with what my gp called mid ovulation spotting and then this clear fluid leaked for about 5 days like my water had broke.  Freaked me out so I told him I wanted a ultra sound and to see a gyno.  It took a month and I seen a gyno who then sent me for a ultra sound on April 13th.  I told the gyno I felt like my ovary was volcanic and he laughed and said he had never heard that one.  I said it errupts every night when I lay down and gurgles up into my stomach which makes me very nauseated.  He said go see a gastroentologist your problems are not due to you cysts.  He said the one on my left ovary was hemorrhagic and I had another normal one on my rt but too small to be causing those kind of symptoms.  He said I will send you for another transvaginal ultra sound just to make sure.  In the mean time I go see my gastro dr who sends me for tests and I tell him about the cysts but the gyno doesn't think it is from that.  I go the next day to see the gyno after I see the gastro and the gyno says whoops I made a mistake the hemorrhagic cyst is 5 cm and could be causing your stomach problems.  I am already booked for a ct scan with the gastro so I go to that to see what shows.  The gastro says he sees a 5cm by 3cm by ? on the scan.  He thinks it is a gas bubble from previous surgery due to my colitis.  I tell him no the gyno says I have a 5 cm hemorrhagic cyst on my left ovary.  The gastro says that is probably what it is. The gyno then tells me my ca125 is at 80.  I then say I have had enough of this guessing I want to see a onc/gyno in the city.  He says he will refer me.  I get a call today saying that the onc/gyno wants a MRI done now.  Why is my question, they are freaking me out with all this waiting.  I just want this alien out, I feel I'm very sick just to have a hemorrhagic cyst with all this stomach upset.  Every night since February I have had this thing errupting,  it twinges all the time I have no inner peace.  Almost like a baby moving constantly inside of me instead it is this flipping alien cyst.  If my CA125 wasn't at 80 I might not be so freaked out.  I am 46 years old and would like to be here a little longer if you know what I mean.  I just need these gyno's to listen.  The MRI just feels like I'm being put off again.  I know I'm venting but better on here than at my family.  I feel so out of control and hormonal I'm getting whip lash from my own mood swings, lol.  I'm trying to hold it together for my kids but I'm getting very frustrated.

[chelan3]

Likely the gyn/onc wanted an MRI before he/she sees you so they have something more to help them decide the best route for your for treatment.  That being said they can't tell if it's benign or cancerous without surgery AND testing the cyst.  CA125 can be elevated with a number of things including benign cysts, your period, infections and more.  The waiting is hard.  Everyone's been there and understands.  
Take care and let us know how your doing.

[Jane39]

Are you required to have a referral to go to a gyn/oncologist?  If not, I would just make the appointment and go, don't wait.  I would think that an ovarian cyst and an elevated CA125 and more so consistant pain for OVER A YEAR-- warrants a specialist.  You say your CT scan shows nothing, but then you say you have a 5cm hemorrhagic cyst, that is something.    Are you saying that the gyn/oncologist is saying you need to have the MRI first before seeing him, I am confused.  All I had was the CT scan before seeing my gyn/oncologist, so not sure what you are saying.  But having problems for a year is TOO LONG.  More than likely it is nothing, but giving anything "time" is not wise.  Good Luck and keep up updated.  Jane