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Simple Cysts After Menopause

tnjmom
Posts: 9
Joined: Sep 2006

I am 43 years old. My mother died from Ovarian Cancer at the age of 53 - one week after her diagnosis. She also had two brothers with colon cancer. My doctor does a transvaginal ultrasound on me every year followed by a regular exam and CA-125 six months later.

I have been having some worrisome symptoms for a few weeks now - frequent urination, constipation and weight gain in the abdomen. I knew my regular ultrasound was coming up so I figured I would wait it out. I should also tell you that I haven't had a period since last November and at my regular exam last March, my doctor told me I was probably in early Menopause. I have had perimenopausal symptoms for about 5 years now - very irregular periods, hot flashes, etc.

My ultrasound was yesterday and I'm concerned by the findings. I have a simple cyst on each ovary - they look fairly large to me - at least larger than other cysts I have had. My endometrium is also thicker than it should be. The ultrasound tech was not not concerned. She said it looks like I'm not quite at menopause yet and I'm probably getting ready to have a period.

So, my question is what should I be asking my doctor when she calls me in 2-3 days. I have a feeling that she will want to wait and rescan me in 5-6 weeks - at least that is the approach she has taken in the past. My mother died one week after her diagnosis and I don't want to fool around with this. My understanding is that simple cysts are much more important after menopause - if, in fact, that is what is going on with me.

What sort of tests should I be asking for? I don't want to undergo unnecessary surgery but that is preferable to letting cancer go for another month.

Any suggestions? Thanks!

mopar
Posts: 1948
Joined: May 2003

I feel your concern. We all know our bodies, better than the doctors, and sometimes we just have to perservere if we think something isn't right.

A transvaginal ultrasound should be very telling. If you haven't had a recent CA125 I would ask for one. Comparison should be made to your last one, as it's the upward climb that is an indicator, not just fluctuations that can occur sometimes. As for the thickening of the endometrium, my mother had that and was told it was of no particular consequence. She passed away of colon cancer. I'm not saying these two are related, but I have heard of this 'thickening' being related to cancer, possibly uterine. As for the inconsistent bleeding, I just read the other day that it is often mistaken for perimenopause. I would not necessarily take that for an answer. I just wouldn't feel comfortable 'waiting' for another month or so.

So when I speak to the doctor I would remind her of the family history. Ovarian cancer is pretty quiet until the later stages. So, while this seems subtle, I would expect some solid answers. I would also ask for another CA125. Are you due for another exam? Any changes in the cyst size compared to last year's ultrasound? Have you ever had a colonoscopy? Again, given your family history and current symptoms, it sure wouldn't hurt to have one. They can also do laparascopic procedures for the cysts, and maybe get a biopsy just to be sure. That's minimal surgery.

I will keep you in my prayers and I hope that you will let us know what the doctor says. God bless.

Monika

jamilou's picture
jamilou
Posts: 202
Joined: Mar 2005

I agree with Monika. YOu need to be persistant. If you are not comfortable with the cyst ask him to please do a biopsy. They can as Monika stated do a laproscopy and have the results back before they close you. It is not as invasive and you would not have to wait and worry. I also lost a mother to ovarian cancer and I was fortunate that a doctor was paying attention when I had subtle symptoms at age 40. My doctor knew of my history and was aggressive with finding answers. I hope that you are able to get your answers soon. Please keep us informed and let us know what happens. If you need to talk more you are welcome to email me!
Good luck!
Jami

groundeffect
Posts: 651
Joined: Mar 2003

At a lecture I went to a couple of years ago, the speaker (Dr. Patricia Murphy of the Albany Medical Center), suggested that color doppler imaging of the ovaries as well as a transvaginal ultrasound should be done when ovarian cancer is suspected. I had thickening of the uterus, a transvaginal ultrasound, and a CT scan of the pelvis, none of which showed the uterine and ovarian cancers that I had; a CA-125 wasn't done until after my first chemo.

My gyn did a "mini" biopsy of my uterus and found cancer, after I had extremely heavy bleeding and a host of other symptoms. The ultrasound showed uterine fibroids, so it was easy to blame them for the heavy bleeding.

No one wants to undergo unnecessary surgery, but given the situation with your mother (and the fact that she was relatively young to have had ovarian cancer), all stops should be pulled out to uncover the source of your problems.

Is your doctor a gynecologist?

My family has a history of breast and colon cancer, and my brother was dx with prostate cancer about a month after I was dx with ovarian cancer - he was 52, I was 48, both "young" for those diseases. We're both doing quite well now, after surgery and treatment, but we both had doctors who were probably more aggressive than others might have been.

Please go after whatever it takes to make you comfortable with a dx. I know doctors are reluctant to look for ovarian cancer in someone so young as 43, but it can occur in women with ovaries at ANY age - there are pediatric cases!

Here is an article that talks about color doppler: http://www.macgn.org/newsletter/nl27b.html

The last time I had an ultrasound, I asked the technician what was entailed in doing a color doppler image. She said all that she had to do was flip a switch, so it doesn't really take more effort than a regular one, but I suspect it costs more.

If you're having what you consider to be serious problems, you might want to consider having a hysterectomy/oopherectomy as a preventive measure. With your trouble, an insurance company would surely cover it, and it could save you a host of problems in the future.

tnjmom
Posts: 9
Joined: Sep 2006

Thank you all for your responses. My doctor is a gyn. In past years, they used color doppler during my ultrasound - not sure why they didn't this time.

I heard from my doctor's office this week. The nurse practioner said that my ovaries were fine - a 2 cm simple cyst on each ovary. Then she said they were concerned about the thick, irregular endometrium - and it also appeared to have a polyp. They want me to have a D&C and hysteroscopy and then we'll talk about possible hysterectomy. I asked about what follow up is needed for the ovarian cysts and she said that they would probably want to rescan in a couple of months but that I really need to get this other thing taken care of first.

So, I see the doctor on Oct 31 and the D&C is Nov 2. I have already decided that I will opt for hysterectomy if there is anything at all out of the ordinary in my endometrium. I haven't had a period in 11 months so my ovaries are not doing me any good anymore. It's time to lose them.

Thanks Again - I'll keep you posted.

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