Benign or not Benign, That is the question...

Glory_for_the_Lord1

Hello to whom ever is reading this,

I apologize for my terrible grammar ahead of time. I didn't major in English. So, I am seeking advice through the process which will follow these days. I recieved the ultrasound results a day ago, and tadaa my ovaries had friends...large ones...my pelvis is having a party without my permission. I admittedly should have gone in a lot sooner. I noticed symptoms about 6 months back but being only 25 and a newly wed I chalked it up to stress and new found food triggers. My mother had passed away also in the beginning of the year from colon cancer and I was more focused on not becoming a hypochondriac. All in all, the result is the same, two tumors and 17CCs of free fluid. I took a deep breath and just made a follow up appointment to get a gyno referral. All the what if's started FLYING, I mean really crashing and bombarding, around my mind. I work in the medical field so I realize what these things mean.

So at 26, I have a great husband and no children, so the stresses that will follow at least will not affect too many. I can be quite a worry wart. I don't know if these things are meant to rant so I am sorry if it is long.

What are the situations I should expect to follow? CT scans, most likely, but how often are these things malignant? Should I prepare for the worst or is that the unhealthy way to go about this? My family has the worst genetics and my mother was diagnoised with stage 3 at 40, and skin cancer at 38, and my grandma as well had colon cancer at 50. I don't want to be a control freak, and I am staying away from WebMD which tells me I am going to die of a stroke within the hour...morbid humor I apologize for as well.

If anyone can shed some light and advice, I'd be very grateful.

Samantha

Yari29199

I know how you feel!

I know how you feel... I had a CT Scan done 2 weeks ago for a back pain and the radiologist discovered a 10cm mass on my left ovary. I was sent to see my Gynecologist and she did a vaginal and pelvic ultrasound a couple of days later and the mass was bigger(13cm now) with some malignant characteristic.  I've been referred to a Gynecologic Oncologist. My Dr said there is no way to tell if it's cancer until they remove the mass and the pathologist check it. She said she is hoping the mass is an endometrioma and no cancer is found. I know the waiting it's horrible and the not knowing really sucks... But you gotta stay positive and hope for the best outcome. I see the oncologist next Thursday and will have the date for surgery. My gyn said the oncologist is planning on removing both ovaries, but she'll discuss with me on my appt.

I've done some research and this kind of masses are not usually malignants. So we have hope that everything turns out to be ok. Stay positive and hang in there. 

Good luck to you on your appt. Make sure you ask questions and don't stop until you feel they have been answered. 

NoTimeForCancer

Yari29199 said:

I know how you feel!

I know how you feel... I had a CT Scan done 2 weeks ago for a back pain and the radiologist discovered a 10cm mass on my left ovary. I was sent to see my Gynecologist and she did a vaginal and pelvic ultrasound a couple of days later and the mass was bigger(13cm now) with some malignant characteristic.  I've been referred to a Gynecologic Oncologist. My Dr said there is no way to tell if it's cancer until they remove the mass and the pathologist check it. She said she is hoping the mass is an endometrioma and no cancer is found. I know the waiting it's horrible and the not knowing really sucks... But you gotta stay positive and hope for the best outcome. I see the oncologist next Thursday and will have the date for surgery. My gyn said the oncologist is planning on removing both ovaries, but she'll discuss with me on my appt.

I've done some research and this kind of masses are not usually malignants. So we have hope that everything turns out to be ok. Stay positive and hang in there. 

Good luck to you on your appt. Make sure you ask questions and don't stop until you feel they have been answered. 

yari, please let us know what

yari, please let us know what happens,  I applaud your approach.  It is hard to do, staying positive, but it is a great goal.

LorettaMarshall

Samantha & Yari-Fallopian tubes R highly suspect as origin of OC

Dear Samantha & Yari29199

This is a reply to your letter addressed to “Whomever is reading this”.  I note Yari29199’s response as well, and so what I have to say is intended for both of you to read and consider.

 I have answered some other ladies that have their stories posted on either the Ovarian or Peritoneal Cancer links.  You might like to read them to know more about my own diagnosis.  They say a lady that will tell her age will tell anything, so I will tell you that I am almost 77 years old, and presently am bald because my last chemotherapy treatments that ended September 25, 2015 took my hair by the second week out.  My chemo was Carboplatin & Taxol.  If you read my “about me page” you will also know more.  So here are two places on this site that I have written to someone about Peritoneal Carcinomatosis and/or Ovarian Cancer.  When you read my comments, you will see that I was first diagnosed with Peritoneal Carcinomatosis.  That was already Stage IV.  A second opinion and exploratory surgery at the University of Pittsburgh Medical Center at Christmas of 2012 also revealed that the cancer was in my ovaries as well.

My letter to Mary -  http://csn.cancer.org/node/298633

My letter to Lesli814 - http://csn.cancer.org/node/299108

At age 36, I had my uterus removed but not my fallopian tubes or ovaries.  I did not intend to have any more than 3 children.  Since my menstruation periods were painful with a heavy flow, my gynecologist suggested I might want to have a hysterectomy.  Fast forward to today—much research now indicates that ovarian cancer may well begin in the fallopian tubes.  How I wish I had those removed as well.  My gynecologist that treats me today, called me personally when he saw my records.  He indicated how sorry he was to hear this.  He knew that my husband is a cancer survivor of Esophageal Cancer which most of the time is terminal.  Dr. Hughes said that recent evidence indicates that most likely ovarian cancer can begin in the fallopian tubes and that from now on, he is going to remove the uterus, tubes and ovaries when he performs a hysterectomy.  Had I know that way back then, I would have said, “Take it all out!”  Personally, I would rather cope with “hot flashes” than terminal cancer.  So my advice would be for both of you to continue to research some of the causes of Ovarian cancer.  You will see that fallopian tubes are considered “suspect”.  I have listed only two of many references that points to the tubes as a likely place for the Ovarian cancer to start.  And since you have written here, I felt impressed to share some of the information I’ve found in my own research.

Samantha, you speak of the cancer your family members have had.  There were 20 major cancers on my mother’s side alone.  You ask if you should prepare for the worst.  You say you work in the medical field.  I never worked in the medical field but when I went to the Emergency Room thinking I had a hernia and the CT scan revealed Peritoneal Carcinomatosis and listed tumors in terms of “centimeters”, I knew this meant I was in some serious trouble.  Since I am a realist, I like to prepare for the worst, and hope for the best.  So I began researching this diagnosis, and knew right away it was “terminal." Please don’t think I am diagnosing your case, I am only sharing the facts about my own diagnosis.  So far the Lord has not seen fit to call me home, and I am still here by His grace.   

So I am not telling you “what to do” but as for myself, if I were going to have a hysterectomy, I would want “everything removed.” 

Sincere best wishes to the both of you,

Loretta Marshall,

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV  (Diagnosed Thanksgiving 2012)

_______________________________________________________________________________

References for your consideration are below.

1. http://www.medscape.com/viewarticle/843469

Medscape Medical News > Oncology

Evidence Points to Fallopian-tube Origins of Ovarian Cancer

Veronica Hackethal, MD - | April 21, 2015

“Most cases of high-grade serous cancer (HSGC) ― the most lethal form of ovarian cancer ― arise from the fallopian tubes rather than the ovaries, concludes a literature review published in the April issue of Cancer Prevention Research.

"There has been a major breakthrough in our understanding of the origin of ovarian cancer with the identification of the fallopian tubes as the major source of the cancer," commented first author Mary Daly, MD, head of the Genetics Risk Assessment Division of Fox Chase Cancer Center in Philadelphia, Pennsylvania. She even suggested that in the future, ovarian cancer may be described as fallopian tube cancer.

"This raises the possibility of altering our risk-reducing surgery approach, specifically, by removing the fallopian tubes first, while a woman is still premenopausal, and then removing the ovaries at the time of onset of menopause," Dr. Daly explained. "This would spare women the side effects and long-term health risks associated with early surgical menopause."

For women with hereditary risk for ovarian cancer, such as those with BRCA1/2 mutations, the standard of care has been removal of both ovaries and fallopian tubes (bilateral salpingo- oopherectomy [BSO]). Although this procedure reduces the risk for ovarian cancer, it can affect quality of life, precipitate early menopause, cause sexual dysfunction, and contribute to increased risk for cardiovascular disease, osteoporosis, and all-cause mortality.

Because HSGC constitutes the most common form of ovarian cancer among women with high genetic risk, the new approach (bilateral salpingectomy with ovarian retention [BSOR]) could also have a "large impact" on ovarian cancer mortality, Dr. Daly and colleagues write in the article.

BSOR could also reduce ovarian cancer risk in women at average risk for ovarian cancer who are undergoing hysterectomy for benign conditions, such as fibroids. About 600,000 women undergo hysterectomies in the United States each year. Fifteen percent of women who have had a hysterectomy develop ovarian cancer, according to background information in the article.

However, in a related editorial, Mark Greene, MD, and Phuong Mai, MD, from the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, in Bethesda, Maryland, state, "in our view, BSOR is an investigational procedure that should not be routinely implemented in high-risk women until its risks and benefits are more clearly defined."

The editorialists call for more research on the outcomes of such surgery, including impact on quality of life and on ovarian function. But they are pleased to see research moving the field forward. Recalling that in the past, when ovaries were removed prophylactically, the fallopian tubes were often left behind, they note that the current standard is to remove both ovaries and fallopian tubes. This latest research points to the importance of the fallopian tubes in ovarian carcinogenesis and is providing "invaluable etiologic and clinical leads that promise to refine and improve both the prevention and management of ovarian cancer," they write…”

2.  http://www.cancer.gov/types/ovarian/patient/ovarian-prevention-pdq#section/_4

Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention (PDQ®)

“General Information About Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

Key Points

Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum.

• Ovarian cancer is the leading cause of death from cancer of the female reproductive system.

  Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum.

  The ovaries are a pair of organs in the female reproductive system. They are in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries make eggs and female hormones (chemicals that control the way certain cells or organs work in the body).

  The fallopian tubes are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary.

  The peritoneum is the tissue that lines the abdominal wall and covers organs in the abdomen. Primary peritoneal cancer is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary.

  _______________________End of references________________________________