To ABYPHILE in Texas: Re Ovarian Mass Question

[Guest guest]

Dear Abyphile:

A number of days back, you asked the following question, which I don't

believe has been answered. You wondered:

" 1) Is the doctor correct in that an ovarian mass cannot be

evaluated at the time of surgery? Do the tests take too long? "

**********************************************

Rest assured that a confirmation of ovarian cancer CAN be established DURING

your surgery.

Biopsies can be obtained by your doctor, and results from those biopsies can

be available intraoperatively--i.e., BEFORE they close you up.

Your physician will send any specimens directly to pathology, and he/she can

then act according to findings determined by pathology--DURING your actual

surgery. You do NOT have to have to undergo a subsequent surgery, nor do you

need

to have to have a healthy ovary removed-- if the mass in question proves to

be benign. (Unless, of course the benign mass is of such massive dimensions as

to have already damaged most of the ovary.)

On the subject of ovarian cysts in premenopausal women, once again, I cite

Dr. H. 's words (taken from his book _A GYNECOLOGIST'S SECOND

OPINION_)

Dr. states: " As long as there is healthy ovarian tissue remaining, it

is a good idea to leave the ovary in place and remove just the benign cyst. "

Also note that Dr. mentions:

" We always try to save some of the ovary, if possible, in all premenopausal

women. Some doctors may make more of an effort to do this than others, so it is

a good idea to discuss the possibility of saving the ovary with your doctor

*before* surgery. " (again, asterisks mine, not Dr. 's)

The above comment is Dr. 's diplomatic way of reminding us that many

OTHER GYN doctors " cut first, think later " --being stuck in that old

prophylactic mindset with respect to hypothetical reproductive organ disease:

Their

thinking is: even if the mass is benign--removal of the ovary NOW will prevent

any

potential FUTURE ovarian cancer. I don't share that drastic view, nor do I

think most woman on this list feel that way.

Dr. also reminds us that:

" But no test can flawlessly predict benign or cancerous cysts, and surgery

will be required to remove any QUESTIONABLE [caps are mine, not Dr. 's]

cyst so that a definite diagnosis can be made. "

By test, Dr. is including MRI, CT, Ultrasound, and the CA-125 blood

test. All of them potentially can be misleading.

Your ovarian " mass " is really not huge, but given its suspicious appearance

on ultrasound, surgery is probably indicated. However, if I were you, before

undergoing surgery, I would first have one additional follow-up ultrasound. It's

not unheard of for a cyst of less than 5 cms. to simply disappear on its own,

in a menstrual cycle or two.

Years ago, I, too, had a " complicated cystic mass " within my right ovary,

which didn't change in appearance on ultrasound over the course of a few months.

Surgery was indicated--surgery to remove the ovary, as well as the mass.

I objected to my gyno's plan to remove the ovary, should the cyst prove to

be benign. A friendly debate about preserving that ovary ensued, during one of

my office visits. But in the end, I insisted that MY wishes prevail. And I put

those preferences IN WRITING PRIOR TO MY SURGERY.

Amazingly, my ominous-looking mass turned out to completely benign, and

because I had insisted on it, the doctor removed the benign mass, but did NOT

remove my ovary.

In the years since joining this list, I have other read stories of ovarian

cancer scares, similar to my own, which also proved to be unfounded. Happens

all the time.

If your doctor won't agree with your wishes to leave what could well be a

cancer-free, healthy ovary in place, well, it's probably time for her to become

your EX-doctor.

As we've all learned on this list........Trust, yes--but VERIFY, VERIFY,

VERIFY!!!

As the Ladies of the List (LOL) will tell 'ya--with fibroids and with ovarian

cysts, you almost always have plenty of time to contemplate your next move.

So, pay attention to your instincts, make sure your preferences are honored,

and do take the time to have ALL your questions answered to your satisfaction.

Good luck to you,

Roma