large complex mass

[Dino491]

Hello

My sister just had a sonogram and a large compex mass was found on her ovary (15cm.) She is schedualed for a followup with her doctor to discuss the next steps but the radiologist seemed concerned about the size of the mass. He did not see any lymph nodes in the sonogram which seems good. I have read in this forum that 98-99% of masses are benign. Is this also true of complex 15cm ones? She has had irregular period foe the past 2 months. She has always had painful periods. She has recently complained of heaviness  in her abdoment.

Just wanted to know if there is a good chance that it is benign. She is 41 and has never had children.

Thank you all in advance for any insight you may share.

Thanks

[Dino491]

We spoke to the Oncologyst at Sloan on Friday. He said that in clinical trials there was no difference in outcomes when chemo started at 3, 4 , 5 , or 6 weeks after surgery. She is starting Chemo next week.( 6 rounds). He said that a study had found no statistically significant difference in outcomes between 3 and 6 but he thinks that there may be a slight difference that would have been significant had there been more women in the study.

Has there ever been a case where there was no hair loss with chemo?

[ChrisP2236]

Although I haven't had to have chemo, what I have read supports Joanne - it seems that 3-6 weeks is the norm.  I would ask why they are waiting so long as it's so aggressive.  Though I didn't have chemo since I was low grade and it's not very effective for my cancer, my SIL had grade 3 triple negative breast cancer and she was started on chemo almost immediately - I know it's not quite the same but the stage indicated to urgency of treatment her onc.  

If you can ask around through your sister's hospital or gyn/onc or locate a local ovca support group you might get some better direction - go online if need be.  But you are going the right way in seeking treatment at a major cancer center with your sister's grade.  God bless you for being so concerned about your sister.  Keep us informed and we'll all be glad to help as we can.  Chris P

[jlock]

Sorry to hear about your sis,but she does sound like she is in good hands.  I started my chemo 3 weeks after debulking surgery. I don't know if I would wait for Sloan Memorial to get her started on chemo,I would find a Onc now and start chemo as soon as possible.  You can still keep your appt with Sloan Memorial,as they can always pic up her chemo schedule to continue.  I'm not sure if 3 or six is right,there seems to be so many different opinions and every Onc is different.  I have always had 6. I'm not sure if the chemo would be different for the uterine ca..but I have read somewhere that carbo/taxol is given for both ovca and uterine.  My sister is a stage 1c and never had chemo and is still doing great for over 3 years.  I'm stage a 3c and have not been as lucky.  I hope and pray all goes well for your sister~~~~Joanne

[Dino491]

Does anyone know how soon after surgery Chemo can start? Memorial Sloan is scheduling 5 weeks out for an appointment to see the Dr. and I am assuming some time after that chemo can be scheduled. I don't know if I should wait for Sloan or try to have her treated somewhere else. Her surgery was on June 30th so assuming the full 5 week wait, the earliest she would get treatment would be 2 months after surgery that she would get chemo.

Any advice would be appreciated.

Thanks

[Dino491]

Spoke to the doctor this morning. She has stage 1a grade 3 ovarian cancer and a second primary cancer on her uterine. They did not seem concerned about the uterine cancer but they did recommend going to a medical oncologist for chemo since the cells from the ovary were "aggressive". The uterine cells were not aggressive. Does anyone know if the standard chemo regiment (platinum based and taxol) would change b/c of the uterine cancer? Aslo the doctor said that she may only need 3 treatments with chemo instead of 6 that they normally give. Does anyone have any thoughts on opting for six anyway just as a precaution? (I don't know if we will have this option).

Thank you all once again for your previous responses and good wishes.

[ChrisP2236]

I'm sorry about your sister's diagnosis.  The best course is to wait for the path report to know the stage - you can make an educated guess as to stage but there isn't much point as it is what it is.  It sounds like very good news and probably an early stage but wait for the path report to be sure.  I was dx stage 1C and I did not have chemo because it's not thought to be particularly effective with the type of ovca I had since it's typically slow growing and chemo is designed for more aggressive cells.

It sounds like your sister is in very capable hands - she was fortunate to have been referred to a gyn/onc.  A second opinion can't hurt but you might want to check with her gyn/onc - sometimes they are already conferring with major centers to back up their recommended course of treatment.  My gyn/onc had his pathologist verify the diagnosis, then sent it to MD Anderson to triple check it and consulted them on how my case should be treated.  Good luck to your sister and let us know how it goes.  Chris P    

[Dino491]

My sister just got out of the hospital. The full pathology is not back yet but the washings turned out negative. She has an appointment with her Gyn-Onc of Friday who thinks the Pathology report will bew back by then. From what I have read, since the washings were negative and the Dr. saw no signs of cancer anywhere outside the ovary, the staging can now only be Ia, Ib, IIa, IIb, or IIIa. Am I correct in this assumption?

[Dino491]

Thank you both for responding. The Dr. came in this morning and said that it looked like the cancer was contained in the ovary. He said that when he first saw it he did not think it was cancerous but the frozen section said otherwise. He did remove 2 lymph nodes that the CT scan showed enlarged and they were both benign. He took about 30 samples from all over her abdomen to send to the pathologist. I read a little about staging and I believe that if the doctor could not see any visible signs of cancer in the abdomen then the worst it could be is IIIA. Is this correct?

We will see next week.

Again thank you all for your help

[nyc lady]

I was dx'd stage 1A in 2000, I did not need chemo.  Usually stage 1C and above, chemo is standard treatment.

Let us know how everything goes with your sister.

Best of luck.
Pam

[manneca]

My ovarian cancer was stage 1, grade 2 and chemo is optional. As I recall for stage 1, grade 1 chemo is not recommended. My surgeon said I wouldn't need chemo, but I chose it to be on the safe side.

[Dino491]

My sister had surgery today. The doctor said it was definitely cancer but that there was no sign of it anywhere else in her abdomen. He did a hysterectomy. He will be able to stage it when he gets the pathology report.

He said that depending on what the pathology says she may not need Chemo. ( that sounds a little strange). Has anyone been diagnosed with ovarian cancer and not needed Chemo?

I am thinking of sending her Pathology report to another doctor (maybe at Memorial Sloan) for a second opinion on a course of treatment, can anyone recommend a doctor there?

[PPhelps]

Maybe because it looks different. Sonograms and CTs are not exact imageries. Its the radiologist job to raise the red flag and say maybe this needs to be looked into further. I've heard of women getting this referenced on their results that have came back benign.
The gyn/onc will be able to tell you alot more. Get a notebook write all your questions down. When answered make sure you have someone that can write down the answers so you can remember what the doctor said. Or some have taken those mini recorders.
And then come back and let us know how things went. Take care and tell your sister good luck!

[Dino491]

Paula, one more question. What would cause the radiologist to say it was suspicious? Would the radiologist know this?

[PPhelps]

Sound like shes in good care. Come back and let us know how everything goes, and if you need anything else just ask.

[Dino491]

Thank you very much. We were just worried B/C the radiologist said that it looked very suspicious. Her doctor is working on getting her an appointment with a gyn/onc since it needs to be removed either way.

[PPhelps]

Size doesn't matter with cysts. Most masses, tumors, cysts, whatever you want to call it is benign. My advice is tell her to see a gyn/onc anyway. They are the specialist with this area. If any surgery is to be done it needs to be with a gyn/onc. No one can tell you it malignant or not without surgery. But remember 95% percent is benign regardless of size or the wording.

[Dino491]

she has never been diagnosed with anything before. But I do have some more information. When she asked the radiologist if it was a cyst he said it did not look like a cyst. What else could it be?

If it is a complex tumor does the 95% still hold and does it hold if it 15cm?

[silver&gold]

continued  (not sure what happened there!! )

I was only diagnosed with it during surgery.  Has your sister had a ca125 blood test or a ct scan ? . Cysts are very common , malignancy in a cyst is not !!  95% of cysts turn out to be benign , this can only be determined after surgery  with the report from the pathology lab. . Hope everything turn out well for your sister , keep us posted .

Best wishes Angie

[silver&gold]

Hi ,
complex cysts can occur with endometriosis , has your sister been diagnosed with that? I ask because painful heavy periods can be a sign of endo among other things and you say your sister has these symptoms. I was only diagnosed with it during surgery and

[silver&gold]

Hi ,
complex cysts can occur with endometriosis , has your sister been diagnosed with that? I ask because painful heavy periods can be a sign of endo among other things and you say your sister has these symptoms. I was only diagnosed with it during surgery and