Oma's Appt with the Gynecological Oncologist

Today Oma met with the Gynecological Oncologist.  He had reviewed all of Oma's scans to date and still wasn't sure exactly what the mass was on her ovary.  He indicated that it was a cyst about the size of a golf ball.  Cysts of this size on women Oma's age have a less than 5% chance of being cancerous.  It admitted that the cyst was not normal and most likely benign, but the only way to know for sure was to remove it and send it to pathology.

The Gynecological Oncologist explained that Oma had two options:

        Option #1 ... The "watch and see" approach.  Oma would be monitored with ultrasounds every six weeks for a period of time, then every three months, then every six months to eventually once a year (so long as the cyst did not change).  When asked if the cyst could transform into the cancer, the doctor stated that the answer was unknown.  He did state that most cases of ovarian cancer are already at a Stage 3 by the time they are found.

        Option #2 ... Surgery.  Oma would have a laparoscopic surgery to remove both ovaries and the mass.  Like any surgery, there are risks of complications.  The mass would go through a freezing process and several sections of it would be examined under the microscope.  If everything is benign, Oma may stay in the hospital overnight and could expect a couple weeks of recovery.  If anything was malignant, a more invasive surgery would be completed and the lining and lymph nodes would be removed.  This would require a hospital stay of 7 to 10 days and recovery could be expected to take 6 to 8 weeks.

The cyst could have been there a long time.  There is no way of knowing.  In post-menopausal women like Oma, the cyst is unlikely to shrink.  Although Oma's tumor marker test (the CA-125) came back normal, the doctor didn't give that a lot of weight.  He indicated that of all Stage 1 ovarian cancer diagnoses, 50% of them had a normal CA-125.  Furthermore, 25% of Stage 3 ovarian cancer patients also had a normal CA-125.

Oma didn't hesitate to say that she preferred to have the surgery.  She doesn't want to take any chances.  I don't blame her.  I think I would have done the same thing.  There is still a chance that the pancreatic surgeon will want to "check out the pancreas" while the Gynecological Oncologist is in there doing his thing.

Oma has an appointment with the pancreatic surgeon on January 15th.  The day before that, she'll get another CT scan of the abdomen and pelvis, which will provide current information and give the doctor something to compare.  Then, finally, surgery will be scheduled.