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Suspicious Cyst

fox
  • By fox
  • Posted September 21, 2008 at 10:35 am · 21 replies
  • In What, me worry?
  • Shared with the public
0 Recommendations

Hi,
I'm new to the group and just heard thursday that I have a 3.2mm cyst on my left ovary. I was so stunned (and not at all knowledgable) so I don't even know yet if its simple or complex or what. But needless to say, I'm scared to death. I'm 55 and perimenopausal but still having fairly regular periods. My doctor says to wait a couple cycles but given their sporadic nature and my age, it seems like I should be doing more. I've just read about HE4 and that the test has been pulled back, but maybe not. Can anyone confirm whether it's available and whether this is the right test (as opposed to CA125?) Also, why wouldn't just get the darn thing removed laproscopcally (sp) right now!

Explore topics in this discussion:

Cancer Surgery Hysterectomy Breast cancer Ovarian cancer Chemotherapy Pain Menopause Ovarian cysts

21 replies

SJS1958

I would talk to another doctor to get their opinion.
When I had my vaginal hysterectomy, the doctor said all went well after surgery. Then 10 days later he tells me that he couldn't find my left ovary and my right one came back with some cancer cells. He acted like it was no big thing, that he would go in back in and get it. So I talked to my primary doctor and he agreed that I really needed to go see a doctor in Memphis who specialized in Gynecologic Oncology. I'm so glad I went to West Clinic to see Dr. Smiley. She is wonderful. After the surgery she went to my room to talk to my husband and two girls. They had went down to eat in the hospital after they got the okay that all went well in surgery and I was in recovery. Dr. Smiley went to the dining room to talk to them there. How many doctors do you know would do that? Most would tell the nurse to tell the family she was there to tell them all went well.
I hope you find a wonderful doctor too. :)

fox

Thanks very much for replying. I live in Michigan so now I have the challenge of finding the very best doctor in my state - which, I'm finding, is harder than it should be.

momanderson920

I would get a second opinion and maybe see a gyn oncologist. But I think a CA125 should be done. I don't know why these doctors are so reluctant to do them as I don't think they are that expensive. Has a transvaginal ultrasound been done to diagnose the cyst? I had a suspicious growth about that size on my left ovary. My gyn ordered a CA125 immediately after discovering it on the ultrasound. It came back very elevated. I then had a CT scan with contrast done since I was having stomach problems (a common symptoms of ovarian cancer) and it showed the lump plus two 3.5 cm peri aortic lymph nodes that looked suspicious. Two gyn oncologists said it didn't look like cancer but they can only know if they do surgery and send it to pathology for examination. I scheduled the surgery pronto within 2 weeks of diagnosis and the two oncologists were wrong...it was serous papillary ovarian cancer. You don't want to mess around with this if it is possibly cancer. Caught in Stage I, you can be cured. Later stages you are only given a remission possibility since it usually comes back at some point. I think the older we get the statistical probability of cancer goes up with these things. I would err on the side of caution, get a second opinion with a well recommended specialist and if they say surgery, get it done. If it is not cancer, they don't have to do an invasive procedure but can do a laporscopic surgery. They start the surgery laporscopically, send the tissue to pathology while you are on the table for examination...if the answer comes back cancer, then they do the long cut and open you up wide to do the samplings and exploratory type surgery to see if there is spread or metastasis. In my case, there was only the tumor, the fallopian tube, and two inoperable lymph nodes that had cancer. The oncologist removed my appendix and omentum (which is a target tissue for the cancer), and did the complete hysterectomy. I then had 6 rounds of taxol/carboplatinum chemotherapy.

fox

Thank you. Very helpful. Can I ask if you're postmenopausal. I did have a transvaginal ultrasound which is how they found it. I asked for one because I have had bloating for a couple years (I believe related to perimenopause) and actually had a transvaginal u/s two years ago and it was fine. My bloating just seemed a little more frequent and I'm paranoid so I requested one again. When my doctor called my Thursday night, and said this cyst was found (I think she said there is some blood in it), I didn't know the questions to ask re: simple/complex; fluid filled/solid, etc. I'm hoping that since she said wait a cycle or two that it just appears to be a unilocular cyst, but I don't have a clue. I've asked for the report. As I said, she also didn't immediately say 'let's do a CA125' but went along with it when I said it. She's been my ob/gyn for 20 years so I've always trusted her but frankly was a little surprised that she isn't recommending a more aggressive response.

momanderson920

Don't panic. It may very well be a fluid filled ovarian cyst since you have not gone through menopause and I think those are not uncommon prior to menopause. I had a fluid filled ovarian cyst in my 40s when I was still menstruating. When I had the ovarian tumor, I was and am 54 years old and had been through menopause completely for about 2 years....no periods for that long. What I have learned in this journey is to be more assertive with my own healthcare. Good for you to tell your doc you want a CA125. If it is above normal, then there is alittle more cause for concern but still may not be cancer. I am not a doctor or ultrasound technician and don't know how they determine fluid filled from solid and all that. I know I had a transvaginal ultrasound once when I was in my early 40s and it revealed a fluid filled ovarian cyst and I did not have cancer at that point. I don't think it ever hurts to get a second opinion if in doubt. Most good doctors are not threatened by that. None of mine were. Try not to get panicked. It may very well just be a fluid filled ovarian cyst.

fox

I so appreciate your response. If you don't mind, I'd like to stay in touch. I've tracked down some great resources at the University of Michigan hospital - they seem to have a gynecological oncology center, so I'll call them tomorrow to send the report and ultrasound pics (which I haven't even seen yet). When were you diagnosed?

momanderson920

I was diagnosed on Jan. 30, had the hysterectomy on Feb. 15 and didn't get chemo until 6 weeks later because of an allergic reaction to an antibiotic that put me in kidney failure. But did eventually get chemo 6 treatments every 3 weeks and had the last treatment on July 14 and a PET scan 3 weeks later revealed I was in remission. My CA125 was 9 at that point, had been 871 at its highest measured prior to chemo and after surgery. You very likely just have a fluid filled cyst. It is just wise to get the CA125 to be sure and perhaps get a second opinion. It is always wise to be err on the side of caution.

MRosebud

Hi Fox –

I did not see if you mentioned – are you particularly concerned because there is a history of OC in your family?

You write that your cyst is 3.2 mm in size. If you meant "millimeter" that is actually quite a small cyst, about 1/13th of an inch. If you meant "cm" or "centimeter" it is still a fairly small cyst.

I think momanderson is right in a big way about “don’t panic” at this point. It seems to me that your doctor is following pretty standard protocol for the size and type of cyst (unilocular) she believes you have – and for the peri-menopausal stage you are in.

Being fairly close to menopause I think this information from CIGNA’s website probably applies to you:

"After menopause, ovarian cancer risk increases. This is why all postmenopausal ovarian growths are carefully checked for signs of cancer. Some doctors will recommend removing the ovaries (oophorectomy) when any kind of cyst develops on an ovary after menopause. But the trend in medicine seems to be moving away from surgery for small and simple cysts in postmenopausal women. In the 5 years after menopause, some women will still have functional ovarian cysts occasionally. Some postmenopausal ovarian cysts, called unilocular cysts, which have thin walls and one compartment, are rarely linked to cancer."

They show the citation for this as:
Modesitt SC, et al. (2003). Risk of malignancy in unilocular ovarian cystic tumors less than 10 centimeters in diameter. Obstetrics and Gynecology, 102(3): 594–599.

The link to this info is:
http://www.cigna.com/healthinfo/hw181644.html

Please note the phrase, “unilocular cysts. . . are rarely linked to cancer.”

I think it is perfectly reasonable to ask your doctor for a CA-125 – remembering that the results are not in any way a marker if you have not already been diagnosed with OC. The number could be way under normal and you could still have cancer – or it could be elevated for just the fact that you have a cyst. As momanderson said, if you test high – that is just an indication that you need a little more close watching – or possibly a CT scan.

As far as why she doesn’t just go in and take it out now – even laparoscopic surgery can be risky – as all surgeries have the potential to be. Ovarian cancer is statistically a low risk (unless you have a family history) and it does not seem like you have enough going on right now to make it an all out manhunt.

Hope this puts your mind at ease a little. -- Martha

Buttany

Hello,
I am from Michigan....Lansing area and I have a oncologist over at Sparrow Hospital that I like quite a bit.
Joseph Meunier, DO
Oncology - GYN
Sparrow Regional Cancer Center
1215 E. Michigan Ave
Lansing, MI 48912
(517) 364-2890 (voice)
I had my surgery done with a robot and minimal recovery....3 weeks. That was after a total hysterectomy with cancer staging. I am hoping you don't need the staging. He also looks at the slides himself which I really liked before I had my surgery because he wanted to see before hand what he was dealing with. So he has some pathology experience and I found that reassuring also.
Have you been having symptoms of OC? It may be just a cyst but they can be very painful. I had them go in and find out with the exploratory and I am glad I did. Stage 1a for me and what a blessing. It has been one year for me this week since I got my news and one thing that I have found through all this is we have to push sometimes for what we need medically. The more I read about others experience I see I am not alone.....
Keep us posted...and wishing you all the questions answered.
Beth

FavoriteAunt

Hi Fox,
Like the others say, you do need to see an gyn/onc. and get checked. It could be just a nuisance cyst, but you cannot assume that. Given that you have bloating too, I'd definitely want to find out why. I'm surprised your doctor didn't do further testing, including a CT scan. My cancer was discovered by my gastroenterologist who was suspicious of my stomach complaints (when the other docs were passing them off as other things) and gave me a sonogram right in his office. He then sent me straight to my gyn., who sent me straight to a gyn/onc. (literally the next morning).

I was IIIC, so it's a good thing. You may have nothing, or it could be very early - but you need to get tested and to find a gyn/onc to check you out. I wish you the good luck.

zircons

Go to another doctor for a second opinion. Get the results of all your tests and take them with you. Ask for another transvaginal ultrasound. Did they do your CA 125? I had basically no "real" symptoms. My gyn hollered at me for asking my internal med doctor for a CA 125 (I had read about it in a magazine). The CA125 was 128. I had IIIC ovarian cancer. Be responsible for your body, no body else will care as much.

sport

If you have an ovary removed, consider having a chemo assay done from live tissue. This has to be arranged prior to surgry.

verlinda

I had ovarian cysts show up on pelvic ultrasounds and vanish later. I did have ovarian cancer four years later. I don't know whether it was the same ovary--never thought to ask.

I think my CA125 was in the 40's or 50's with the vanishing cyst. It was in the low 80's with IIc ovarian cancer.

My main symptoms were bloating and fatigue. I had a 13.5 cm mass--gyn oncologist described it as the size of a softball--and never felt a thing! I wouldn't ignore it, but if the CA125 is O.K., I'd ask my gyn about a followup ultrasound in a few months.

If you have a family history of ovarian or breast cancer (mom, sisters, aunts), I'd be more aggressive about finding out what's in that cyst!

There was a really good article in Oncology Stat (I think) about who ultrasound technologists and radiologists can analyze an ultrasound to see whether a mass seems to be benign or malignant.

Did anyone read it? If so, can you give Fox that website?

Let us know what happens.

Blessings,
Verlinda

sport

Since you still have your ovaries, you're a candidate for the OvaSure test.

BJJ

I too had a large ovarian cyst the size of a nerf football which was found during my annual exam. I had no symptoms other than my tummy looking larger and a little spotting. I had not gone through monopause yet, but was near the end. My gyn ordered a transvaginal ultrasound which it was described as a "mass." The doc then ordered CA-125 and CEA blood tests and scheduled a CT scan for me. The bloodwork came back normal, the CT showed a mass. Fortunately, my gyn referred me to a gyn/onc for surgery just to be safe. He too thought it was a cyst. Had a total hysterectomy and initial pathology said "cyst." It wasn't until my parts were fully examined (nearly 2 weeks later) that they found cancer cells in my left ovary. My cyst was a cyst, but a blessing in disguise or my cancer would have grown and my prognosis wouldn't have been so good. I had to have a second surgery to remove my omentum, appendix and snips of surrounding organs and tissues to look for any remaining cancer cells. Fortunately, I was all clear. My cancer was caught early and no further treatment was required (other than dr visits and CT scans every 3 months for the first year. So far, so good. It was a terrifying time for me, but I'm thankful that I had a full hysterectomy and thankful for my cyst. I hope this helps you.

NatalieM

Hi,

Sounds like you are on the right road, getting a second look by a GYN/ONCOLOGIST. Also, CA 125 is an important test, however, it does not always show high numbers. I had a 20 on my first test (within normal range) and after 5 rounds of chemo it has dropped to 9. Make sure they do comprehensive testing (as written by the previous women). Be your best advocate!!

Good luck,

Natalie

grammy_linda

Hi Have them schedule a CT scan they can confirm if is it a cyst or tumor ( solid in nature) WITHOUT surgery. Tell them you want it done! Relieve your mind. Cysts are common and are liquid filled..hense them calling it a cyst, but to make you feel at ease they can do this one simple test and be done. A friend a bit younger then you just had the same thing...after a whole body scan saw no less then 5 cysts were found..located ovaries liver etc., they told her the stats are less then 5% to be anything less than benign and simple cysts, that they would not remove them due to the fact that if you are prone to cysts it would just come back, the body will most likely absorb them on it's own, but they do need watching.
I know to say don't worry is easy for me, and not so for you...hang in there and make them put you at easy by confirming!
Hugs
Linda
ps a CA125 is still good, and yes I also read the other tests are now determined to be premature, so insurance coverage would be difficult at best.
and as always going to a gyn/onc is always the safest choice one you have a right to be seem by
maybe get the scan and take it all to the gyn/onc...if anything other then benign he/she would be the only place to go anyway?

sbender3

2 AND A HALF YEARS BEFORE MY DIAGNOSIS-I HAD A CYST OR CYSTS ON MY OVARY OR OVARIES. I HAD DYFUNCTIONAL UTERINE BLEEDING. I ASK AND GOT A CA125, HAD 3 OR 4 ULTRASOUNDS. I WANTED A HYSTERECTOMY, BUT MY DOCTOR WOULD NOT DO IT. EVEN THOUGH MY CA125 WAS NORMAL, I HAD OVARIAN CANCER THEN. SO 2 AND A HALF YEARS LATER I AM STAGE 3C AND THE STORY GOES. I HAD 2 CONSECUTIVE YEARS OF NORMAL CA125S BEFORE MY DIAGNOSIS, AT WHICH TIME IT WAS ABOUT 1300. 2 TUMORS, ON LYMPH NODE. I RECENTLY HAD A FRIEND WHO IS 57 GOING THRU SIMILAR STUFF, AND SHE PUSHED FOR THE HYSTERECTOMY, AND GOT IT. THANK GOODNESS EVERYTHING IS OK FOR HER. BUT IT IS BETTER TO BE CAUTIOUS THAN TO LET IT GO. IF THEY HAD GIVEN ME A HYSTECTOMY WHEN I WANTED ONE AT THE AGE OF 35, AT 50 I WOULD NOT HAVE BEEN DIAGNOSED WITH OVARIAN CANCER-I TOLD DOCTORS REPEATEDLY, I DON'T NEED OR WANT THESE PARTS ANYMORE-AND I HAD HEAVY PERIODS. SO BE IN CHARGE AND GET A SECOND OPINION, GET A THIRD, GO TO AS MANY AS YOU NEED UNTIL YOU GET PEACE OF MIND...GOD BLESS. SHERRY

Shawnsanders

Oh my goodness. I am so frustrated. Went to the gyn with symptoms of bloating,gas, ab pain nausea, some vomiting, frequent urination, feeling really full and not being able to eat much (I had a clean colonoscopy 6 months ago). I didn't know anything about ovarian cancer symptoms (so it's not psychosymatic) My Dr did Trans vag ultrasound and a bunch of blood tests, including ca125. Everything came back normal except ca125 was slightly elevated (40) The ultasound sonographers report said I had some fluid in the pelvis (not much) and three cysts on right ovary (The largest measuring 17mm, and multiple tiny cysts on left ovary. but the radiologist report said "No fluid in pelvis, no cysts etc. Had to beg my Dr to look at the actual pictures he said not to worry come back in 3 weeks (Different time in my cycle) to take ca125 again. Ca125 was still 40 3 weeks later. Dr ordered ct scan radiologist noted some fluid in pelvis and a 27 mm cyst on my right ovary that has "a Contrast enhancing rim" Gyn refers me to oncologist. Went to the oncologist he said (without even asking about my symptoms) that it was not cancer blah blah blah. He said my symptoms are "Confusing" and don't point to any one thing. He said it is probably endo and said I could have the right ovary removed (just to be sure) but that he would not do it, he would have a reg gyn do it. He said he would NEVER do a ca125 on someone my age, and that my symptom were not that of ovarian cancer (???!!!) I feel like a hypochondriac but I have had symptoms every day for a month and a half. My stomach is 4 inches bigger than it was 5 weeks ago. I'm not TRYING to have ovarian cancer, but everything seems to point to that and my symptoms are driving me nuts and keeping me (and my husband) up at night. I am so frustrated!!! the still slightly elevated ca125 and the cyst that grew a cm in three weeks did not get an explanantion from the oncologist, he said "It could just be sonographer error (If there is that much of a margain for error that what else did they error on???) I feel like I am battling to be taken seriosly!! Even by an oncologist I didn't aticipate this. Has anyone else had the experience?

koh847

Hi, you should probably post this as a new discussion, bet you will get more responses. I only saw it because I was interested in Fox's suspicious cyst because I have one too. :)Kim

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