Complex ovarian cyst remains unchanged for 1.5 years post menopause.

[lupette]

I have had ovarian cysts for a long time but now I am worried. I am 54 years old and 1 1/2 years beyond my last period (and my last ultrasound). I have HCV and Hashimoto's. Last weekend, after 2 1/2 weeks of terribly sore nipples, I felt like something ruptured on my left side. I had felt this before so I figured it was an ovarin cyst. I went to the doctor who didn't find anything upon exam, but sent me for an ultrasound. In addition to two previously appearing small fibroids that remain unthreatning though unidentified, they found four cysts, 3 of which were present on my previous ultrasound. On the right ovary, a complex cyst now measures 2.9 x 2.2 x 2.4 cm, previously measuring 3.1 x 2.5. x 2.8 cm. Also a simple appearing cyst measuring 2.9 x 2.3  x2.9 cm, previously measuring 2.2 x 1.2 x 2.3 cm. Left ovary: The left has a simple appearing cyst withing it measuring 1.8 x 1.1 x 1.8 cm, previously measuring 3.2 x 2.0 x 1.8 cm.

Conclusions on report:
1) Decreasing right ovarian complex cyst now measuring 2.9 cm.
2) Slight increase of the simple appearing right ovarian cyst now measuring 2.9 cm.
3) Decreasing left ovarian cyst now measuring 1.8 cm. Essentially stable endocervical mass/complex cyst. Consider direct visualization for further evaluation.
4) Essentially stable uterine fibroids as described.
5) Interval development of a 7 mm myometrial cyst adjacent to the endometruim around the anterior lower uterine segment.

My questions are as follows:
1) Should I have surgery and if so what type? The Doctor mentioned removal of right ovary, removal of both ovaries, or removal of both ovaries and uterus as options. Are there other options? What about cystectomy?
2) If I wait how often should I have follow up testing?
3) If I have surgery will Medicare pay for it or will it be considered elective?

Thank you to anyone who can offer help or advice or just their own similar experience. I don't know what to do!

[hdebbie7]

Hi lupette, I really think you should keep your appointmrnt , you have to put your mind at rest like you said. Worrying all the time doesn't help your health in the long run. Surgery is not that bad , honestly i have had two major now in 12 mths and yes it's scary but wow it makes you feel a different person when recovered to think you have got another thing sorted to able you to get on with your life without the pain. If thats the road you are advised to go down then you will get lots of support on here from so many lovely people , right up to the day you go in and then they are here waiting for you when you come out , no judgement just loyal no questions ask love and support. Yes do keep us posted lupette and hope your appointment goes well. take care Debsx

[lupette]

Hi Debbie! I tried before to post here in response. I don't know what happened . . I think it never went up because I wasn't logged in. Anyway, I wanted to thank you for your reply to my post and all the good advice. I am sorry that you are having so many problems. Losing both of your parents is tragic! How sad for you. It seems unfair that after that, you now have to go through all these health problems. It's good news that they caught your cancer early and were able to remove the ovary and the problem. Take comfort in that!  Look forward and not back and always think positive. The way I see it . . . you have paid your dues and should now have smooth sailing for a while. Stay healthy and happy. I will keep you in my thoughts and hope for the best for you.

As far as I am concerned, I will keep my appointment with the GYN-OC and make a decision once I have seen him. I have a sense that this is not cancer but every time I think about cancelling the appointment, I get scared and decide to keep it. I am really not too concerned about losing my ovaries, as you said, I don't need them any more. I really just don't want to have surgery and wish to avoid it if at all possible. It's hard though because how else can you be sure?  And if you are not sure . . .then how do you keep from worring all the time? I will post here again and let everyone know what I decided after my appointment. In the meantime . . . take care!

[hdebbie7]

Hi lupette, i dont know if i can help, but ill have a go with what i know by going through it. I had major bowell surgery last year and realised that i should have been recovering a lot quicker than i was, i become post menopause at a early age of 43, apparentely brought on by shock of loosing both my parents, So when after 8 mths of having surgery i lost a lot of blood over 2 days this sent me back to the dictors, the pain i was feeling i associated with the bowel surgery but i was wrong, they found a cyst that measured then 5.5x4.5x6.5, like you i was put on wait and watch , ( i didnt get nipple probs though). After numerous ultra and trans scans it kept growing and finally was told it had to come out,i was told like you it could be one ovary or the two or the lot. After some dicussions my gyn decided that he could not remove the uterus because this acts like some sought of buffer from the last bowel op i had , so that was decided against, I went in for sirgery on the 6th of this month so only 2 weeks post op and in the end they took the right ovary and tube and the cyst now measured 10.5x8.5x9. They did not remove the left ovary as the bowel had attached itself to much to it, they had enough of a prob to get to the right. I think they stay with the watch and wait untill it reaches 5cm dont know why. Anyways im glad they left the right because like you even though im post menopause i dont afree that we  dont need them. I believe that by keeping the one and have read lots of research it does still produce enough to help steer other probs away even into your 80's if your that lucky. My CA125 tast kept coming back in the normal range at late 20's but my outcome was that i had border line cancer but have been lucky to not need any further treatment, it was contained. So at the end of this long story lupette, i think the answer is to go with what you feel is best for your body. When you are doing the watch and wait i would be having like i did have scans every 3 mths at least this had been going on since last october for me. I had to have a laparoptomy because of my previous surgery, i dont know if they will do a cystectomy with you being post not sure. As for your medicare i cannot help you with that as i live in the UK and with have a different health service here. Hope i have helped you a bit lupette , keep strong my love and keep your thoughts positive take care Debs x

[Ruthiejb]

I'm sorry...I thought you had posted on my thread but I now realize it was a message.  I'll also reply to your message with my above post.

[Ruthiejb]

Hi, I saw your comment on my thread regarding my ovarian cyst.  I have quite a few issues similar to yours.  I am also post menopausal, was diagnosed with thyroiditis over a year ago (my doctor never called it Hashimoto's but that's probably what I have since I've been on synthroid for more than a year), I have a small uterine fibroid and I've been going for follow up ultrasounds for a 1.6 cm complex cyst on my left ovary since September 2009.  I originally went to the doctor because of pain I was experiencing on my right side (which I still have), but the cyst was found on my left side.  It hasn't changed much according to two follow-up ultrasounds.  I have my third follow-up ultrasound next week (I've been going every 3 months).  Did you have a CA-125 blood test?  It isn't a definitive test, but it's considered more telling in post menopausal women than in pre-menopausal.  I had two CA-125 tests around 8 months apart and they were both in the normal range.  In my situation, I would like to have everything surgically removed.  I'm tired of going for these follow up ultrasounds.  I even consulted with a gynecologic oncology surgeon but he told me that since the cyst hasn't changed, I don't have cancer and didn't recommend surgery.  That's fine, however, I'm constantly reading that there is no definitive test for ovarian cancer, so how can they be so sure what's going on inside of me?  If your doctor recommends surgery, I don't think it would be considered elective.  You're only 54...you're on Medicare?  I don't know much about what Medicare covers, but if your doctor deems the surgery necessary, I believe it would be covered.  Since you're post menopausal, I don't think the doctor would do a cystectomy since your ovaries are non functioning and you don't really need them anymore.  In many cases doctors can do complete hysterectomies via laparoscopy which is less invasive and an easier recovery.  If it's been 1-1/2 years since your last ultrasound, I think you should have another one to see what's going on.  Also, I think you should ask your doctor about having a CA-125 blood test.  I'll know in 1-1/2 weeks if my cyst is still there or has changed.  I'm guessing if it hasn't changed that my doctor will have me go yet again for an ultrasound in 3 months (this would be my 5th).  If it's grown, I really want to discuss having her talk to the surgeon about removing everything so I won't have to worry about it anymore.  I wish you the best of luck and please keep us posted.