Ovarian cyst?

Hi everyone


Im a 29 year old female with a 8cm complex cyst on my left ovary. I have had a CA-125 test done 4 weeks ago and that came up with a reading of 73. I have also had a CA-19.9 test done and that come up with a reading of 44. I have read that a patient with a CA-125 of 65 and above that has a pelvic mass has a 90% chance of it being malignant. Is this true? I know that other factors can contribute to a raised cancer antigen reading however it's still feaking me out a little. My gyno has done the tests again a few days ago and said that if it is the same or higher a oncologist/gyno will be removing the cyst.


Has anybody had a raised level of cancer antigen with a complex cyst before? and if so what were the levels ? I have a strong family history of cancer and am very concerned.

Ovarian cyst?
I think we must approach to each patient as an individual subject , so with "copy / past" , we can not match everything with everybody ! .


You are 29yr , ok !? ; so , your doctor must check another marker named as HCG , in combination with CA-125 , Ca19-9 and CEA . Because in ages around you ; there are two major group of malignant neoplasm , that could affects the ovaries ( your marker profile only check Epithelial OvCa , so the Germ cell tumors will be missed ) .


Approach to a ovarian cyst with complex nature plus 8 cm size (more than 5cm) , is equivalent to surgical resection with frozen section (FS) analysis and then regarding to the FS results ; it may be necessary to proceed with a radical operation in the same time .


So , plz follow your complain as soon as you can . I hope it's a benign one , but it must be certified with pathology analysis , not tumor marker assay! .
Reply:To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called CA-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough CA-125 to be detected by the test. There are also non-cancerous diseases that increase the levels of CA-125, like uterine fibroids and endometriosis. These non-cancerous causes of increased CA-125 are more common in women under 35, while ovarian cancer is very uncommon in this age group. For this reason, the CA-125 test is recommended mostly for women over age 35, who are at high risk for the disease and have a cyst that is partially solid.





How are cysts treated?


Watchful waiting. The patient waits and gets re-examined in one to three months to see if the cyst has changed in size. This is a common treatment option for women who are in their childbearing years, have no symptoms, and have a fluid-filled cyst. It also might be an option for postmenopausal women.





Surgery. If the cyst doesn’t go away after several menstrual periods, has gotten larger, looks unusual on the ultrasound, causes pain, or you’re postmenopausal, the doctor may want to remove it. There are two main surgical procedures:





Laparoscopy—if the cyst is small and looks benign on the ultrasound, your doctor may perform a laparoscopy. This procedure is done under general anesthesia. A very small incision is made above or below the navel, and a small instrument that acts like a telescope is inserted into the abdomen. If the cyst is small and looks benign, it can be removed.


Laparotomy—if the cyst is large and looks suspicious, the doctor may perform a procedure called a laparotomy. This procedure involves making bigger incisions in the stomach to remove the cyst. While you are under general anesthesia, the doctor is able to have the cyst tested to find out if the tissue is cancerous. If it is cancerous, the doctor may need to remove the ovary and other tissues that may be affected, like the uterus or lymph nodes.


Birth control pills. If you frequently develop cysts, your doctor may prescribe birth control pills to prevent you from ovulating. This will lower the chances of forming new cysts.





Can ovarian cysts be prevented?


Ovarian cysts cannot be prevented. Fortunately, the vast majority of cysts don’t cause any symptoms, are not related to cancer, and go away on their own. Talk to your doctor or nurse if you notice any changes in your period, pain in the pelvic area, or any of the major symptoms listed above. A pelvic exam, possibly with an ultrasound, can help determine if a cyst is causing the problem. If a woman is not seeking pregnancy and develops functional cysts, frequently, future cysts may be prevented by taking oral contraceptives, Depo-Provera, or Norplant.





When are women most likely to have ovarian cysts?


Functional ovarian cysts usually occur during the childbearing years. Most often, cysts in women of this age group are not cancerous. Women who are past menopause (ages 50-70) with ovarian cysts have a higher risk of ovarian cancer. At any age, if you think you have a cyst, it’s important to tell your doctor.








An ovarian cyst is a fluid-filled sac usually found on the surface of an ovary. There are many types of ovarian cysts, each with a different underlying cause. Many women will have them at some point during their childbearing years. Most are completely without symptoms. However, some types can cause serious health problems.





You have two walnut-sized ovaries. These are located on either side of the uterus, nestled under the fringed ends of the fallopian or uterine tubes. These tubes create a pathway for a released egg to reach the center of the uterus. During the menstrual cycle, one ovary will develop and mature an egg. The egg is encased in a sac called a follicle. About day 14 of the menstrual cycle, ovulation occurs and the egg is released from the ovary.








Are They Dangerous?


Symptoms


Types of Ovarian Cysts


How They Are Diagnosed


How They Are Treated


Can They Be Prevented?


Diet and Ovarian Cysts














Picture of Ovarian Cyst








Are Ovarian Cysts Dangerous?


Most are harmless "functional” or "physiologic" cysts. Between 4% and 10% of women of childbearing age develop a potentially serious metabolic dysfunction, known as polycystic ovarian syndrome (PCOS). Multiple cysts are one hallmark of PCOS. PCOS also includes hormonal disruptions that can result in persistent acne, excessive body hair, thinning scalp hair, infertility, obesity, and increased risk of diabetes, cardiovascular disease, and uterine or breast cancer.





Ovarian cysts can cause discomfort during intercourse. They may bleed, rupture, or twist the ovary, causing significant pelvic pain. Sudden or severe pelvic pain, especially with vomiting or a fever, should be treated as a medical emergency.





Some ovarian cysts can become cancerous. These are all rare cancers and are most common in women in their fifties. Cancerous ovaries are usually not painful unless they grow very large before they are discovered. Annual pelvic exams are the best preventative method for detecting gynecologic cancers in the early, most treatable stages.








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Ovarian Cyst Symptoms


It’s not easy to know whether you have ovarian cysts. You can have cysts without any symptoms at all, or you may have vague abdominal symptoms that could suggest a number of health problems that are completely unrelated to ovarian cysts.





Some abdominal conditions with symptoms similar to painful ovarian cysts are: appendicitis, diverticulitis, intestinal inflammation or obstruction, gall bladder disease, kidney stone, or bladder infection. Gynecologic problems with symptoms similar to ovarian cysts are: pelvic inflammatory disease, endometriosis, ectopic or tubal pregnancy, or mittleschmirtz, the pain some women feel at mid-cycle, after normal ovulation.





In general, one or more of the following symptoms could be related to ovarian cysts:





Menstrual irregularities.


Pelvic pain – a dull ache, either constant or intermittent, possibly radiating to the low back or thighs.


Pelvic pain during intercourse.


Pelvic pain just before your period begins or just after it ends.


A fullness or heaviness in your abdomen.


Feeling of pressure on your bladder or rectum.


Nausea or breast tenderness similar to when you’re pregnant.


Continuous, creamy or clear-like-eggwhite vaginal discharge that persists unchanged for a month or more.


Any of these symptoms are sufficient cause to consult with your health professional.





If you have sudden, severe or spasmodic pain in your lower abdomen, especially if accompanied by fever, vomiting, or signs of shock (cold, clammy skin, rapid breathing, weakness), go immediately to the emergency room of the nearest hospital.








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Healthy Diet Book


for PCOS, Infertility


and Ovarian Cysts











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Types of Benign Ovarian Cysts


1) Functional (physiologic) cysts. The most common type of ovarian cyst is the functional cyst, also called a physiologic cyst. "Physiologic" means the cyst is non-pathogenic. It develops from tissue that changes during the process of ovulation. Your ovaries normally grow cystic structures called follicles each month. Typically, these resolve back to normal ovarian tissue after ovulation. But sometimes there is a glitch and the fluid-filled cyst stays on for a while.





Functional cysts fall into two categories; follicular cyst, and corpus luteum cyst.








Follicular cyst. The pituitary gland in your brain sends a message, by increasing luteinizing hormone (LH), to the follicle holding the ripening egg. This is called a “LH surge”. Normally, the egg is released from the follicle and starts down the fallopian tube where it may then become fertilized by a sperm cell. If the LH surge does not occur, the follicle doesn’t rupture or release its egg. Instead, it grows until it becomes a cyst. These cysts seldom cause pain, are usually harmless, and may disappear within two or three menstrual cycles.





Corpus luteum cyst. When there is a successful LH surge and the egg is released, the follicle responds by becoming a new, temporarily little secretory gland called the corpus luteum. The corpus luteum produces large amounts of progesterone and a little bit of estrogen, to prepare the uterus for conception.


But occasionally, after the egg is released, the escape hatch seals off prematurely and tissue accumulates inside, causing the corpus luteum to enlarge. This type of cyst will usually disappear after a few weeks. Rarely, a corpus luteum cyst can grow to 3"-4" in diameter and potentially bleed into itself, or twist your ovary, thus causing pelvic or abdominal pain.





2) Dermoid cyst. A dermoid cyst is mainly fat but can also contain a mix of different tissues. They are often small and usually don’t cause symptoms. Very rarely, they become large and rupture, causing bleeding into the abdomen, which is a medical emergency.





3) Endometrioma or "chocolate cyst". These are cysts that form when endometrial tissue (the type that lines the inside of the uterus) invades an ovary. It is responsive to monthly hormonal changes, which causes the cyst to fill with blood. It’s called a “chocolate cyst” because the blood is a dark, reddish-brown color. Multiple endometriomas are found in the condition called "endometriosis". Although often asymptomatic, chocolate cysts can be painful, especially during your period or during intercourse.





4) Cystadenoma. Cystadenomas are cysts that develop from cells on the surface of your ovary. They are usually benign. Occasionally, they can become quite large and thus interfere with abdominal organs and cause pain.





5) Multiple cysts – the polycystic ovary. Women who don’t ovulate on a regular basis can develop multiple cysts. The ovaries are often enlarged and contain many small cysts clustered under a thickened, outer capsule. There are many factors causing a woman to not ovulate and develop polycystic ovaries. Polycystic ovarian syndrome is a complex condition that involves multiple hormonal and organ system dysfunction. Multiple ovarian cysts are just one facet of this disorder.








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How Ovarian Cysts are Diagnosed


Pelvic Exam. An ovarian cyst may be discovered by your doctor during a pelvic exam, while she is palpating your ovaries. If a cyst is suspected, an ultrasound is usually the next step.





Pelvic Ultrasound. Ultrasound is a painless procedure where sound waves are transmitted through your pelvic area and an image of your ovaries and uterus is shown on a video screen. The image is analyzed to determine the nature of the cyst.





Laparoscopy. Laparoscopy is a surgical procedure performed when your doctor wants to see the cyst. A thin, lighted telescope, called a laparoscope, is inserted through a small incision into your abdomen. Laparoscopy may be used for treatment as well as diagnosis.








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How Ovarian Cysts are Usually Treated


Watchful Waiting. If you have no symptoms and ultrasound shows a small, fluid-filled cyst, your doctor may simply schedule another pelvic exam and ultrasound in six weeks. The concept behind watchful waiting is to not actively treat the cyst until does not go away as your hormones change. An unchanging or growing cystic ovary needs further investigation.





Birth Control Pills. If you have a functional cyst that is larger in size and causing some symptoms, birth control pills may be prescribed. The purpose of birth control pills is to alter your hormone levels so the cyst will shrink. Birth control pills will reduce the probability of other cysts growing.





Surgery. Your cyst may be surgically removed if it is large, solid or filled with debris, persistently growing, irregularly shaped, or causing pain or other symptoms. If the cyst is not cancerous, it can be surgically removed without also removing the ovary. This is called a cystectomy. In some cases, the doctor may want to remove the affected ovary, while leaving the other intact in order to maintain your ability to have a normal hormone cycle.








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Can Ovarian Cysts Be Prevented?


It may not be possible to completely eliminate ovarian cysts. However, you can minimize the probability that they will form and grow.





You can do this in several fundamental ways:





Improve the quality of your diet.


Increase your exercise.


Control chronic stress.


Use bio-identical hormones, supplements and herbs to help balance your hormonal system.


Improve your overall health.





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Diet and Ovarian Cysts


A recent study from the Institute of Research Pharmacology in Italy analyzed the diet over a ten-year span of 225 women with benign ovarian cysts and 450 women who did not have ovarian cysts.





The researchers discovered that the type of food eaten influenced the development of cysts. For example, they said that women who consumed the most beef and cheese developed the most ovarian cysts. In contrast, consumption of green vegetables provided a strong protective effect. This study makes it clear that what you eat will influence whether or not you develop ovarian cysts.





We have written an in-depth diet book for women with PCOS. But the dietary recommendations in the book are the same for ovarian cysts. If you have this problem, consider purchasing The Natural Diet Solution to PCOS and Infertility book.





GENERAL INFORMATION:





What is it? An ovarian cyst is a sac (like a blister) that may grow on an ovary. The sac usually contains fluid, but may sometimes have blood or tissue in it. Most ovarian cysts are harmless and go away without treatment in a few months. However, some cysts can grow large and cause problems. The cyst may even rupture (break open). Ovarian cysts are usually not a form of cancer.





What are ovaries? The ovaries are two small organs in your lower abdomen (belly). Each ovary contains female sex cells, or eggs. During child-bearing years, your ovaries make and release an egg each month. This is called ovulation (ov-u-LAY-shun). Right before ovulation, your ovary forms a follicle, or fluid-filled blister that has an egg inside. During ovulation, the follicle breaks open and allows the egg to go down the fallopian tube and into the uterus. If the egg is fertilized (mixes) with a man's sperm, you may become pregnant. If it is not fertilized, you will have your monthly period.





What causes ovarian cysts? Most ovarian cysts form during or after ovulation. A cyst may form if the follicle does not break open to release the egg. A cyst may form if the follicle opens to release the egg, but then closes and collects fluid. Other cysts are caused by endometriosis (tissue from the uterus grows in your ovaries). Cysts may also form if your hormones are out of balance. Other cysts form for unknown reasons.





What are the signs and symptoms of ovarian cysts? Most cysts are found during a regular pelvic (internal) checkup by your caregiver. You may not feel anything or know that you have a cyst. You may have one or more of the following signs and symptoms:





Bad pain in your lower abdomen and pelvic area. The pain may be sharp and sudden or a dull ache.








Fullness and swelling in your lower abdomen or back.








Infertility (not able to get pregnant).








Late or painful periods. You may also have small amounts of bleeding between your periods, called spotting.








Lower abdominal or pelvic pain during intercourse (sex).








Nausea (sick to your stomach) or vomiting (throwing up).





How are ovarian cysts diagnosed and treated? Your caregiver may do an ultrasound (test using sound waves) to look at your ovaries. You may need to have blood drawn for tests. Blood tests may include hormone levels, CA-125 (cancer test), and a pregnancy test. Your treatment will depend on things such as your age, test results, and the kind of cyst. Your caregiver may wait to see if your ovarian cyst will go away without treatment. You may be given hormone medicine, such as birth control pills. This medicine may help to control your periods, shrink a cyst, and prevent new cysts from forming. You may need surgery to have the cyst removed.
Reply:Benign ovarian masses include functional cysts and tumors; most are asymptomatic. Functional cysts develop from Graafian follicles (follicular cysts) or the corpus luteum (corpus luteum cysts). Most functional cysts are %26lt; 1.5 cm in diameter; few exceed 8 cm, although a very few reach 15 cm. Functional cysts usually resolve spontaneously over days to weeks. Corpus luteum cysts may hemorrhage into the cyst cavity, distending the ovarian capsule or rupturing into the peritoneum.


Benign ovarian tumors usually grow slowly and rarely undergo malignant transformation. Benign cystic teratomas are the most common benign ovarian tumor. They are also called dermoid cysts because, although derived from all 3 germ cell layers, they consist mainly of ectodermal tissue. Fibromas, the most common solid benign ovarian tumors, are slow-growing and usually %26lt; 7 cm in diameter. Cystadenomas may be serous or mucinous.


Ovarian cancer is often fatal because it is usually advanced when diagnosed. Symptoms are usually absent in early stage and nonspecific in advanced stage. Evaluation usually includes ultrasonography, CT or MRI, and measurement of tumor markers (eg, cancer antigen 125). Diagnosis is by histologic analysis. Staging is surgical. Treatment requires hysterectomy, bilateral salpingo-oophorectomy, excision of as much involved tissue as possible, and, unless cancer is localized, chemotherapy.


CA-125 is a protein that is more prevalent in ovarian cancer cells than in other cells. This protein enters the blood stream and can be measured by a blood test. There are two CA-125 tests, a first and second generation test. The second generation test is now more widely used and is generally more accurate.


C-125. Normal values range from 0 to 35. CA 125 is clinically useful for diagnosing and monitoring therapy for ovarian cancer, although any peritoneal inflammatory process can increase levels.


CA 19-9 was originally developed to detect colorectal cancer but proved more sensitive for pancreatic cancer. It is primarily used to judge the response to treatment in patients with advanced pancreatic cancers. CA 19-9 can also be elevated in other GI cancers, particularly cancer of the bile ducts.


Please note that I am not a medical professional.

camellia