[SMS89]

Hi, I'm posting on behalf of my girlfriend. If this is in the wrong place, please excuse it.

She had experienced some very acute abdominal pain about a month ago, along with abnormal menstrual bleeding. Her doctor took an ultrasound and found that she had a growth on one of her ovaries. A biopsy was taken, but the results were inconclusive, and larger sample needs to be taken. Her doctor gave her 3 options.

A complete uterine ablation,
Major surgery to remove the affected ovary, which we can't afford,
Some type of "chemo tablets" that, according to him, would neutralize the ovary, and most of the uterine tissue,
A complete radical hysterectomy,
Or leave it untreated.

Suffice to say, she's having an extremely hard time with the decision. She wants to bear a child one day and is having difficulties dealing with the fact that she may never be able to conceive. The only option that would give her even a slim chance of carrying a child is the ovary extraction. It's a non-issue to me as I do not care for her because of her child-carrying capabilities, but seeing her go through this is doing nothing short of killing me. If at all possible I'd like to prevent her from going through that, and living with it. She said it will make her feel like less of a woman.

So, I come to you, in hopes that someone will be able to offer some insight, possible alternative options, anything. If anyone has experience with a similar situation or any knowledge of any procedures, PLEASE post here or message me. I want to spare her this pain if at all possible.

Thank you for your time.

-S

[Belladonna]

Firstly,I would like to start by saying that I am not a doctor,but I am a student midwife.I guess midwives are considered to be lower on the "scientific chain" than doctors,however I strongly feel that the treatment he has suggested would be ineffective,as I find it to be irrelevant to ovarian growths and very drastic,especially for a woman of a young age(I pressume)who has not had children.It would help me if you could answer these following questions.
-What are the dimensions of the growth?
-What were the results of the ultrasound?
-How would your g/f describe the abnormalities of her menstrual cycle?Have they only recently appeared?
-Does she take any medication?
-Has anyone in her family had ovarian cancer?
-Did her doctor give her a blood test,specifically for CA-125?This is a cancer antigen and when a woman has ovarian cancer the levels of the antigen increase.

An ultrasound is often the first test done if a problem with the ovaries is suspected. Ultrasound can be useful to find an ovarian tumor and see if it is a solid mass (tumor) or a fluid-filled cyst.Using colour Doppler,which is done during an u/s exam will show if there are irregular vessels inside the mass.I do not mean to scare you,an ovarian growth does not necessarilly mean cancer.There are also many types of benign ovarian cysts that occur due to hormonal imbalances/abnormalities.In most cases,monitoring for the next few months(2-3) is suggested and very often some type of contraceptive pill will be prescribed to help the menstrual cycle stabilize.If all the above findings are still inconlcusive,an exploratory laparoscopy may be performed during which another biopsy may be taken.

Endometrial ablation is a medical procedure that is used to remove or destroy the endometrial lining of a uterus.This technique is most often employed for people who suffer from excessive or prolonged bleeding during their menstrual cycle.As you may understand,this will only address her abnormal bleeding and not the ovarian growth.After uterine ablation,nearly 50% of the women never have a period again(!).A hysterectomy is also a very drastic approach especially for a woman in the reproductive phase.Even if a cancer diagnosis is made it is not mandatory for the whole uterus to be removed.

I hope I helped a little..There is more information I can give you but I would like to know the answers to the questions I asked above

[whitedove17]

Thanks for your reply Bella. I'm the gf in question I'm 28 and have had no children, one miscarriage several years ago. I do not know the dimensions of the growth, only can tell you that after having the ultrasound done my doctor determined it not to be a cyst (which I've had several times in the past). I thought it was a cyst for quite a while in fact but the pain didn't go away as it normally does when I have had one in the past, which is what prompted me to see him about it. I've always had issues with my cycle being irregular and very heavy, actually passing what appear to be large clots of blood that are quite painful, and they've become increasingly worse over the past two years or so. They last 5-7 days and literally by the time its over, I'm very weak. I have anemia as well as infrequent heart palpitations which I take Propranalol and an Iron supplement for. The heavy cycles make my anemia much worse and my Gyno recently started me on Medroxyprogesterone as well to help with that. I've only been taking that for a month so I'm not sure how effective that will be yet. I had the CA125 blood test done today so I do not know the results of that yet. Other than my anemia, I'm healthy (lab wise at least). The only cancer in my family is a great aunt with breast cancer, no ovarian that I'm aware of although many of the women in my family suffer from endometriosis which I have as well. Thanks again for any information or hope you can offer. -J

[Belladonna]

It is mentioned in your first post that he performed a biopsy.I presume it was done through the abdomen wall with a needle,much like an amniocentesis.The results of the biopsy and the fact that he determined via ultrasound the growth not to be a cyst means that more “exploration” needs to be done in order to rule out cancer.Endometriosis can also cause ovarian cysts known as endometriomas,but I guess the biopsy ruled that out too.The abnormalities in your menstrual cycle are a result of endometriosis.The drug medroxyprogesterone that has been prescribed to you mimics the natural hormone progesterone and will help relieve your endometriosis symptoms(heavy & long periods,pain during intercourse,pain in your pelvic region etc).
Some of the risk factors for ovarian cancer that may concern you are:
-Endometriosis
-Family history of breast cancer,ovarian cancer or large intestine cancer.
At this point,I think you should wait for the CA-125 results and see what the doctor will suggest.An MRI might also be helpful and as I mentioned before,an exploratory laparoscopy during which a biopsy can be taken or the growth may be removed.According to its size and whether or not it is “entangled” with the ovary may lead to a partial or total removal of the affected ovary.But don’t worry,even if you have one ovary you can still get pregnant.
All the information that I have shared with you I have done so with a sense of timidness as I am not a doctor.I do not presume to know better than your physician,as I lack in knowledge and experience,but I thought I could give you my opinion.Please use this information with caution and perhaps get a second opinion from a different doctor before going forward with any potentially life altering procedures.I would like to get an update from you,if you too wish to share it.Best of luck..