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Cancer: Cervical & Ovarian Message Board


Cancer: Cervical & Ovarian Board Index


Hello Mantra,

Perhaps I can offer you some reassurance.

I was in exactly your situation over the past years. In 2007 they discovered an ovarian simple cyst which was about 7 cms (much larger than yours). At that time, all the doctors said that it was a normal follicular cyst but at my follow up ultrasound it had grown just slightly to around 7.5 cms. Like you, I had followup ultrasounds every six months and it grew in increments of .3 to .5 cms at a time. Then at one point my cyst developed a very small solid part of a few mms and this made me extremely nervous. My gynecologist at that time told me that a few mms was nothing to worry about and the radiologist said that this sometimes happens with cysts that have been there for a long time. Finally, this past February I went for an ultrasound and the cyst was almost 9 cms. The radiologist compared this result to all of my previous results and said that although the cyst did not look dangerous it was taking up space and he left it up to the treating physician to decide whether or not to remove it. My gyne told me that perhaps it was time, since I did not want to have a more complicated surgery to remove it later on (it was still small enough to remove by laparoscopy). I had surgery this past April 28th and as suspected, it was a benign serous cyst.

Having been in your shoes, here is what I would recommend to you:

1. Get a copy of the radiology report and read it. The radiologist will give his impression of how dangerous the cyst is and you will have a full description of the growth in the report. At the end, he or she will say something like ... recommend surgery to remove the cyst or cyst does not appear dangerous ... or recommend a followup ultrasound etc... This is extremely important because a radiologist's impressions about the appearance of a cyst on ultrasound is even more accurate than the cancer antigen test for ovarian cancer (CA-125). Radiologists have become quite excellent at knowing what looks like cancer and what doesn't.

2. Contact your G.P. and see if he or she can send you for a CA-125 test. This is a simple blood test that checks for a cancer antigen that is normally present in high numbers when ovarian cancer is present. This test is notoriously unreliable in premenopausal women and can actually miss stage 1 ovarian cancer or show high for benign reasons. However, in menopausal women it is a much more accurate test and if your results are under 35, this is a normal reading. My CA-125 remained around 6 or 7 throughout my ultrasound followups and this was reassuring. A friend of mine (menopausal) who was diagnosed with ovarian cancer had a reading in the hundreds.

3. Ask your friends and family for gynecologist recommendations and start phoning around to see if anyone can take you sooner. This is to alleviate your stress right away rather than your feeling helpless for a long period of time. Sometimes your friends or family can even phone for you and get you an appointment. This is what I did when my cyst was found and my sister in law got me in to see her own gynecologist while I was waiting for one in my area. Her gynecologist happened to do a full day of internal ultrasounds on anyone who could pay for it so I went in, had the ultrasound (with doppler) and spoke to her at the same time (this cost about $100.00). She did a lot to reassure me that it was not cancer (but she also thought I should have it removed as it was a very large cyst). If you end up having to wait for a gyne, then find a private radiology clinic and go for another ultrasound to keep you reassured (private external ultrasounds usually cost around $80.00). Your G.P. will still need to write you referrals for both the ultrasounds and the gyne but be insistent and he will do it just to get rid of you (who cares, as long as you get the referrals).

You need to keep in mind that you have lived with this cyst for over 10 years now (!) so the likelihood that it is cancerous is practically nil. There is currently no proof that benign ovarian cysts turn into cancer and you have some things that are on your side such as the following:

- Your cyst is smaller than 5 cms ... the size of a cyst makes a big difference ... cysts under 5 cms are more predictable in relation to their morphology than larger ones. In other words, what these smaller cysts look like to a radiologist is a strong determinant of what they actually are (whereas larger cysts are more likely to be dangerous no matter what they look like ... a simple cyst that is 20 cms needs to come out even though it is a simple cyst).

- You have had this thing for over 10 years and it has not caused you any problems. This is a HUGE plus as a cyst that has cancer potential would have shown its true colours by now (you are right in saying that ovarian cancer grows very quickly ... between 3-6 months usually although there are some other types of borderline cancers that grow more slowly). Past behaviour of a cyst is probably the strongest determinant of what it actually is.

- As per my radiologists, cysts that have sat there for a while have a tendency to develop solid components and this does not mean they have turned into cancer. It may have more to do with the concentration of cells. At any rate, a few mms should not be cause for too much concern .. this happened to me and I still remember that my gyne was not worried about this .. also the radiologists still referred to this as a simple cyst.

Try not to worry as this will not help you. The most likely scenario is that you have a simple serous cyst (the most common type) that has begun to develop some solid components. If you feel really anxious then keep a closer eye on it with more frequent ultrasounds and see if the solid components get bigger quickly. If they do not then it is really nothing to worry about. Your gyne may still want you to have it removed (along with your ovary), if anything for your own peace of mind (in addition to your postmenopausal status). These damned things cause so much anxiety in us but ovarian cancer is still a rare disease while ovarian cysts, even in menopausal women, are extremely common (up to 20% of menopausal women have ovarian cysts).

I hope you find a gynecologist soon so that you can take a deep breath. In the meantime, don't keep thinking the most unlikely scenario ... that you have ovarian cancer growing in you .. think rather the most likely scenario .. that you have a common serous cyst that may have to come out in the near future because it has overstayed its welcome and is now causing a lot of unneeded anxiety.

Come back and tell us how you are doing and best of luck finding that gynecologist quickly (I am also from Canada and completely understand what you are saying about the health care system).

Take care.

Estria





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