Scared about dermoid surgery

[em69]

Hello all,

I'm so grateful to everyone who's written about their experiences with dermoids. I've been reading and rereading this forum for several months - it's one of the only things that gives me comfort.

I wanted to ask for some advice. I'm in a tough place, caught between my terror of cancer and my terror of surgery, and I wanted to ask for some input from anyone who's been through this.

I'm 44 and have had clockwork-regular periods since I started menstruating at 14. I've always been healthy and energetic - I don't even get colds, though I've always had a sensitive stomach. In March I had an irregular period (late and longer than usual), so I went to the doctor. Pap was normal but she ordered an ultrasound that showed a c. 6 cm cyst on my right ovary, which is probably a dermoid. (I'd been to the ER two years ago with excruciating abdominal pain, but they only did an abdominal ultrasound and found nothing. In retrospect, I wonder if it was the cyst.) I was completely terrified, and over the past six months I've been living a nightmare of anxiety, but at least educating myself by reading a lot about dermoids, cysts, cancer, etc.

After they found the cyst I started experiencing intermittent pinching pains in my abdomen and generally feeling unwell. I'm often tired, I've gained weight, and my stomach sometimes poofs out like a balloon (returns to normal the next day - it seems to be related to certain foods). The pain is very real, but I can't tell if I'm feeling it because now I'm aware there's a cyst in there. I wasn't feeling anything before I learned of the cyst. I've been incredibly stressed by the whole experience, and I often tend towards anxiety, so I wouldn't be surprised if stress were causing these symptoms. But I also wonder if the cyst was asymptomatic before, but when it reached a certain size it caused the irregular period that led to my going to the doctor in the first place, and then, because it had reached that size, it started causing pain.

Because of my symptoms and because I've been so frightened, I had a pelvic MRI which also said it was most likely a dermoid; I asked for another ultrasound two months later which showed that the cyst hadn't changed or grown; and I had another ultrasound a few weeks ago that also showed no change. There is no free fluid detected. I've had blood tests and checkups that all look good.

My periods have been normal since the diagnosis, except this month I've had an irregular period again - a week late, then two weeks of brown spotting, then alternating heavy and light bleeding with some clots and mucus. I've seen three very well respected gynecologists and none of them is worried. They all think it's 'just' a dermoid cyst. One of them even showed me the ultrasound pictures and pointed out the regular border and the lines indicating hair within the cyst. They've all said there's no urgency but that they'd recommend laparoscopic surgery to remove it because of the risk of torsion/rupture and also because it's the only way to know for sure what type of cyst it is. They assume the irregular periods are simply the beginning of perimenopause. I alternate between taking comfort in what they say and terrifying myself with thinking they don't really know. There is no real history of ovarian or breast cancer in my family. (My mother's father's mother unfortunately died of ovarian cancer, but there has been no other cancer in my family that I know of.) I am married, don't take birth control pills or any other prescription drugs, but have never been pregnant.

I've scheduled and cancelled the surgery multiple times because I'm so scared - scared about the outcome and scared about having surgery. I've put it off six months already, but I know I won't ever rest easy if I don't know for sure. I know others have written about their anxiety. Can anyone help me ease my mind? Any encouragement to have the surgery, and any comments about the ultrasound/MRI/doctors' reports, would be so welcome. I've been going over all these things in my mind for so long and would love to hear what others have to say.

Thanks, friends!

[em69]

Thank you, ladies. Your responses were very helpful. Salvic, I also had a doctor tell me that no growth of the cyst basically meant no cancer.

I initially had an irregular period - the first in my life - which is what took me to the doctor and led to the discovery of the cyst. The doctor said the irregular period was probably not related to the cyst but to perimenopause (I'm 44).

For a month after they saw the cyst on ultrasound I was beside myself with fear. But then my periods were normal and I felt OK, so I started feeling more peaceful about it: the fear of cancer diminished.

But this month I've been having a very irregular period again (basically two weeks of spotting and now two weeks of extremely heavy bleeding with clots), so I'm terrified all over again. It's hard to talk myself into believing that it's just perimenopause, even though irregular and heavy periods are common in women my age.

You might not be as prone to anxiety as I am - I suffer badly from it even not related to gynecological issues - but can you tell me how you overcame your fear and made peace with just keeping an eye on things? I would not be able to fully let go of what the first doctor said. (The first doctor I saw also said they couldn't rule out cancer, but every specialist I've seen since - and there have been many - have not bee concerned at all.) Any advice on terror-reduction? I am seriously lacking courage right now.

Thank you both so much!

[salvic]

Hi I have had my 6cm dermoid 2 yrs the first consultant terrified me said had to have out spoke about cancer etc so I see another who was a top gyn and she said has not changed put me on pill I have it checked every 6 months she said when you have them out they are likely to come bk leave it there and keep having scan 6 monthly I am glad I left it as when I stopped stressing it all calm down

[Bhupinder Kaur, MD]

Hello,
Dermoid cysts are growths that can develop in a woman during her reproductive years. Mostly they are symptomless But Ovarian cysts can, however, cause problems if they twist, bleed, or rupture. Since there was no change after repeated ultrasounds, there is nothing much to worry.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.