Advice needed re: wife's Ultrascan and surgery

"Mcpmt" - Dear concerned husband~

You’ve listed the results of an ultrasound conducted for your “young” wife who is only 30 years old.  Now “heavier periods” and “frequent urination” are reasons to consult a gynecologist for sure.  The results that you have posted are reason for concern.  Now understand that I am not pretending to be a medical person, only a Stage IV Ovarian Cancer patient, age 77.

Without medical training, but able to find some good information on the web, I’ve been looking at terms you listed below as well as conversion measurements.  So I’ve computed a few “conversion” facts for you relative to mm and cm to inches, and ml to liters to ounces.  But I’ve also found an informative article on “Ovarian cysts.”  They can be either cancerous or benign.  At this point, I’m sure that more testing will be done to determine the exact makeup of the mass that is described on your wife’s abnormal right ovary.

I would say that you have every right to be concerned, because the mass on your wife’s ovary could be either benign or cancerous, according to the description given for masses on one’s ovary.  It must be that the first gynecologist thinks that this is most likely a benign ovarian cyst, however they haven’t stated that in those terms.  But I never like surprises, so I would just as soon have it said presented to me as “either/or” rather than “most likely not”.  

As traumatic as it is, when I hear the word cancer, I want to have the possibilities explained to me in terms that I can understand.  So if I were your wife, I would be keeping a journal of what medical team examined me, and what were their findings.  I would want them to give me a written report and copies of any scans conducted as soon as possible, after the testing.  When I have a CT or PET/CT I always tell them before the test that I wish to take home a copy of the scan, and want to pick up a copy of the report as soon as it is “read” and defined.  If your wife seeks another opinion, and I would always suggest a SECOND OPINION, she will have to gather copies of all these records for the next medical team. 

So perhaps the definitions I’ve looked up will be of help to you.  When I have a 2^nd opinion, I don’t necessarily depend on whom the first doctor recommends, after all they are cohorts.  But I would want to have them give me their recommendation.   Then I would want to do some research on that doctor as to where they trained, how many years they’ve been in practice, have they written any medical articles that have been accepted for publication by established medical journals.  Now if I’m really impressed with the first doctor, I will be likely to trust his/her judgment. 

There is a web reference called Vitals.com that helps me with information like that.  And of course, personal recommendations from others with similar diagnoses, can be helpful.  Choosing the right medical team, is of utmost importance.  We often see that a patient is being pushed around from “pillar to post” with no real treatment regimen in mind, and that is a waste of valuable time for the patient.  So do your homework as to where you need to go.  And “close proximity” to home should not be the criteria, unless your insurance limits you to a certain network and a certain area.  That sometimes happens.

Then there are always “questions to ask”, but unless you have researched the initial diagnosis, if you’re like most, you won’t necessarily know what questions to ask.

I’ve found that most doctors will only tell you as much as you ask.  So the more you familiarize yourself with the possibilities, the more intelligent answers you will get.  Most doctors aren’t willing to tell you “the good—the bad—the ugly” unless you pin them down and ask direct questions.  My husband takes along his recorder on his smart phone and sometimes his camera.  Our oncologist doesn’t mind if we tape our consultations, so we find that an easy way to “remember what he said” when we leave his office.  And if the doctor objects to taping the conversation, be sure to take notes, the time and date you spoke with him, etc.  Ask him/her to spell the words out for you that you’ve never heard before—I do!  After all, I’m the inquisitive patient with the cancer, and I don’t like “secrets” or a doctor that just wants me to trust them to make all the decisions.  It’s your wife’s life and therefore, it’s your life as well.  So be a good student as you go along.  And another thing, in my opinion, “bedside manner” would be secondary to a smart doctor who “knows his/her stuff”.  I don’t need someone to hold my hand.  My husband will do that.  I need someone to “dig deep inside my body” and find the culprit that’s giving me trouble.  Now if he’s kind besides, then that’s a plus. 

As I looked at one of the sites describing masses on an ovary, they can either be benign or malignant cysts, so it’s best to be prepared for either diagnosis.  You might have asked the doctor why she thought this was most likely “not” a cancerous mass.  It would have been kind of her to go into a bit more detail.  But I would want to know the pros and cons as well.  I’m proud of you for being realistic, but try to keep your fears where they belong until they are well-founded facts.  It’s good to be informed, but don’t let “fear” control your life.

The more you learn about your wife’s condition, the more confident you will be that she is getting the care that she needs.  This will bring the two of you into a closer loving relationship than ever before.  Your love and mutual admiration will grow, and you will feel more secure than ever in your relationship.  Initially, as young people, we’re often first attracted to someone’s looks or personality, but when hard times come, the real person inside will emerge.  So either cancer will pull you together, or pull you apart.  Your expression of love and care for your wife is a good indication that you’ll be an even better husband as you travel this road with your wife.

So I will just wish the two of you all the best.  

Loretta

Ovarian Cancer, Stage IV/Peritoneal Carcinomatosis

P.S.  Incidentally, here are some conversions for some of the sizes mentioned in the Ultrasound report.

http://www.metric-conversions.org/length/centimeters-to-inches.htm

3mm= 0¹⁄₈in

1 cm = 25/64^th of an inch

11 mm = 7/16^th of an inch   X    8 mm = 5/16^th of an inch

Places you might like to visit to learn more about Ovarian cysts and Ovarian Cancer

 1.  http://www.cancer.net/navigating-cancer-care/diagnosing-cancer/questions-ask-your-health-care-team

Questions to ask your healthcare team

 2.  http://www.cancer.net/cancer-types/ovarian-cancer

 Info - Just in case it turns out to be something more than a “benign cyst”

 3.  http://www.cancer.net/navigating-cancer-care/cancer-basics/cancer-care-team/choosing-doctor-your-cancer-care

 4.  http://www.mayoclinic.org/diseases-conditions/ovarian-cysts/basics/symptoms/con-20019937

5.  http://www.mayoclinic.org/tests-procedures/oophorectomy/multimedia/ovarian-cancer/img-20007472

6.  http://medical-dictionary.thefreedictionary.com/echogenic

 “…ech·o·gen·ic - (ek'ō-jen'ik), Pertaining to a structure or medium (for example, tissue) that has internal echoes. Cf. hypoechoic, hyperechoic, and anechoic, which refer, respectively, to paucity, abundance, and absence of echoes displayed in the image of a structure…”

Hello - It's Loretta again - I'm determined to get all of your "homework" assignment posted.  If you review all these sites, you will probably know as much as your wife's first gynecologist.  I would especially pay attention to the Cancer.net references.  They are all-inclusive.  And on your "second go round" choose a gynecological oncologist, and you will have the best of both worlds.  Naturally, we hope everything turns out to be "fixable".  But one can never be too cautious.  And I would offer one piece of advice.  If and when the doctors recommend a hysterectomy, please consider taking out everything.  I had my uterus removed when I was 36, but my ovaries and fallopian tubes were left intact.  Now it's been found that often times, Ovarian cancer begins in the Fallopian tubes.  Too bad doctors didn't know that when I had only the uterus removed.  And it's even possible to have Ovarian cancer after removal of the ovaries.  Cells can "slough off" the ovaries and remain dormant for who knows how long, and then turn into cancer at some later time in life.  In any event, be thorough, and hope it's minor instead of major.

Loretta

Last two references that would not transmit before.

8.  http://www.foundationforwomenscancer.org/find-a-gynecologic-oncologist/ 

  9.  http://www.md-health.com/Complex-Ovarian-Cyst.html

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