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What Questions Should I Ask The Oncologist?

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Posted on Mon, 27 Jan 2014
Question: Dr. Kannepallii, You answered a question of mine a couple of weeks back. I had a vaginal ultrasound that should my left ovary double the side of my right and a lesion on the left that was the same size as my right ovary. My uterus is also "enlarged". I have a very strong family history of both breast and ovarian cancer. I have an appointment with the GYN oncologist on Monday. I want to be sure that I ask the right questions. Could you suggest a few questions that I should be sure to have on my list?
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Answered by Dr. Krishna Kiran Kannepalli (48 hours later)
Brief Answer: The following suggestions might be of help. Detailed Answer: Hi. Thanks for the query. as I have suggested in my previous answer, you need to focus and enquire regarding the following. 1) Is a biopsy of the ovary needed? The answer is no. Biopsy will not serve any purpose in your case as you have a very strong family history. You need to get both the ovaries and uterus removed along with removal of the omentum, lymph nodes in the pelvis and peritoneal biopsies. This procedure is known as staging laparotomy and is indicated for you. 2)Another option is to remove the ovaries and uterus and send them for frozen section. Though this method is not universally practiced for ovarian tumors, it can probably be done in your case. If the ovaries and uterus do not have cancer, you can avoid lymphadenectomy and omentectomy. You can therefore ask your doctor if frozen section can be performed during surgery. 3) You can also request for a meeting with a genetic counsellor in view of your strong family history. 4) You can ask for a CA-125 test. The purpose of the test is not to prove or disprove the presence of cancer but to serve as a baseline study for future comparison, if it is elevated. 5) In view of previous abdominal surgeries, laparoscopy is going to be difficult (almost impossible). You can mention it but safe and complete surgery should take precedence over the choice of approach. 6)You can also ask for a CT scan of the abdomen and pelvis. It will help plan the surgery and also give information about the extent of the disease. It is however not mandatory in your case and is best left to the discretion of your treating doctor. I hope I have answered your query. Please feel free to write to us in case of any further query.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Krishna Kiran Kannepalli

Oncologist, Surgical

Practicing since :2004

Answered : 59 Questions

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What Questions Should I Ask The Oncologist?

Brief Answer: The following suggestions might be of help. Detailed Answer: Hi. Thanks for the query. as I have suggested in my previous answer, you need to focus and enquire regarding the following. 1) Is a biopsy of the ovary needed? The answer is no. Biopsy will not serve any purpose in your case as you have a very strong family history. You need to get both the ovaries and uterus removed along with removal of the omentum, lymph nodes in the pelvis and peritoneal biopsies. This procedure is known as staging laparotomy and is indicated for you. 2)Another option is to remove the ovaries and uterus and send them for frozen section. Though this method is not universally practiced for ovarian tumors, it can probably be done in your case. If the ovaries and uterus do not have cancer, you can avoid lymphadenectomy and omentectomy. You can therefore ask your doctor if frozen section can be performed during surgery. 3) You can also request for a meeting with a genetic counsellor in view of your strong family history. 4) You can ask for a CA-125 test. The purpose of the test is not to prove or disprove the presence of cancer but to serve as a baseline study for future comparison, if it is elevated. 5) In view of previous abdominal surgeries, laparoscopy is going to be difficult (almost impossible). You can mention it but safe and complete surgery should take precedence over the choice of approach. 6)You can also ask for a CT scan of the abdomen and pelvis. It will help plan the surgery and also give information about the extent of the disease. It is however not mandatory in your case and is best left to the discretion of your treating doctor. I hope I have answered your query. Please feel free to write to us in case of any further query.