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Suggest Treatment For An Ovarian Cyst

Posted on Sat, 13 Aug 2016

Question: I have had a partial hysterectomy in1993. Allergic reactions /side effects to hormone replacement so these stopped. I was diagnosed with ovarian cyst approx. 4 years ago, on cancerous. Treatment not good so declined follow up after a year. Few months ago GP sent me for a scan ovarian- which I thought I was going for IBS scan and it was not. Size not changed and is size of a golf ball. I do not want further blood teats, follow up treatment etc. Gp is ignoring this. Hospital say it will not burst. I feel confused and afraid they wont let it go. I had endrimitroisis and that was also around bladder and bowel-both scrapped in 3 hour operation. The endrimetriosis pain has returned foe about 2 years approx. GP says cant be the case. Please advise

Answered by Dr. Vjollce Mbiarra (1 hour later)

Brief Answer:
NEED MORE DETAILED INVESTGATION

Detailed Answer:
Hi dear.
I understand your concern and I will try to help you.

First don't worry for your ovarian cyst because chances to be malignant is very very less,but you should do a follow up very four months with trans-vaginal ultrasound and CA 125 ( tumor marker)(Both are very sensitive and specific for ovarian cyst).
Hence in my opinion don't hesitate to do blood test for CA 125.

Simple, unilateral, unilocular ovarian cysts, less than 5 cm in diameter, have a low risk of malignancy.
It is recommended that, in the presence of a normal serum CA125 levels, they be managed conservatively.

Hence please upload your CT scan and I can see what kind of cyst is yours and what you should do.

Secondly, Endometriosis in postmenopausal women without HRT. Although a rare disease, it should be considered in postmenopausal and women who have undergone hysterectomy with classical symptoms of endometriosis, mostly pain.

Hence ,please tell me your symptoms.
Do you have cyclic pain?
Is your abdominal pain relive by using any pill?

Hence upload your CT scan and give me some details of your symptoms you have.

Best regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Vjollce Mbiarra (20 minutes later)

I have not got access to my scans or notes despite requests for one year. I have severe pain more or less constantly in lower left ovary. Pain same as when I had original endometriosis in lower back radiating inwards around bladder and bowel area which is very painful. I have abdominal swelling not relieved by pills but my IBS particularly mid right side painful, Buscopan helps IBS. Twisted feeling from left to right front below bust line feels twisted at times especially when bending and very painful for short periods. Bloating and swelling with wind as well comes and goes for long periods, No pill relief. Not sure why and looks literally 9 month pregnant which I clearly am not. Have sliding hernia and a pain in area of stomach that feels like a punch, which is not. Treated with ranitidine which is useless. Thank you for helping me, it has been worrying me. I am not afraid of cancer but would like no treatment if I have cancer. Seen too many family members die of various cancers to want treatment.

Answered by Dr. Vjollce Mbiarra (21 hours later)

Brief Answer:
Should take into consideration both endometriosis and IBS

Detailed Answer:
Hi dear again and apologize for late replay.

If the pain is persistent and you have had endometriosis and for more you have an ovarian cyst( there is no explanation what type of cyst is),doctor should take into consideration both IBS and endometriosis.

Hence in my opinion go and make a CA125 because it is very useful to determine a proper diagnosis for ovarian cyst ,if it is endometrioma or other type and for a proper management.

If it will be an endometriosis there are some non hormonal treatment that can help you to manage your abdominal pain.

While for IBS you should manage stress you may have and use probiotics ,three times per day.

If you have any further question don't hesitate because I will be ready to help you.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Vjollce Mbiarra (22 minutes later)

Thank you a million, my doctor does not discuss it with me nor my gynaecologist. I have no idea what type of cyst, I have lost all faith in the medical staff here. I would like to know what non hormonal treatment you were suggesting. I have so many allergies and bad side effects to medication so the hormone treatment after partial hysterectomy was stopped after two types were tried.
Mnay thanks for all your help and advice. xxxxxx

Answered by Dr. Vjollce Mbiarra (17 hours later)

Brief Answer:
NON-HORMONAL IS AROMATASE INHIBITOR

Detailed Answer:
Hi dear again and is my pleasure to help you.

The aromatase inhibitors used for endometriosis include letrozole and anastrozole.
In postmenopausal women, an aromatase inhibitor is used in combination with calcium, vitamin D and a bisphosphonate to prevent osteoporosis of the bones.

For this type of treatment you should contact with a gynecologist.

Best regards

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj