Should I get a second opinion?

[moroka]

I had a cyst on my right ovary, a uterine polyp, and heavy bleeding. My initial diagnosis was in June, with a follow up scheduled for six weeks later. I knew my gyn wanted to check for changes in the ovarian cyst. She talked surgery, and made it sound like a done deal due to the heavy bleeding (which I didn't realize wasn't normal until the Dr. visit). The follow-up was with her partner for the ultrasound (he did the first u/s as well). He also sent me to get blood work done. When I returned for the u/s results with my regular gyn, she said both ovaries had cysts, the original one had changed. One of the cysts was complex. I had to ask about the polyp. She wasn't concerned. I mentioned the heavy bleeding, and she handed me a pamphlet for uterine ablation that she could do in the office. I even said, "wow, from surgery to waiting for blood test results (they weren't in yet)." She said she would see me in a year unless the blood tests showed something. Am I wrong in thinking that my condition should be monitored a little closer or that surgery should be a discussion that requires more than a pamphlet?

[pixie16502]

I agree with hopeshell. I would push for more info and at the very least arrange for a follow up in a month or so. I can tell you from my personal experience that I waited for a year after I was diagnosed with a 1cm ovarian cyst and now it has grown to 7 cm and may require a laparotomy instead of the more minimally invasive laparoscopic surgery. I also now have to have my ovary removed since the cyst has damaged it extensively by cutting off the blood supply. I am scheduled for surgery this coming Tuesday and I wish I would have taken care of this much sooner.
  In the past year I have had irregular periods, often for a month at a time, weight gain, pelvic and referred pain, and heavy bleeding. This summer has been rather miserable because of this.
  I hope you have better luck with your cyst,it is always best to know what is going on. Not to mention that it is not worth it to suffer through the symptoms that cyst may cause. Best of luck to you!

[hopeshell]

What were the sizes of your cysts?  Regardless of the size, you are absolutely correct.  Any complex cyst should be monitored sooner than a year.  Any blood test your doctor orders (most likely the CA-125) can't tell you if you have a malignancy. The only way to rule out cancer is to biopsy the mass.  I know women who have had a high CA-125 with a benign condition or a normal CA-125 when they had late stage cancer.  It is a great tool to know your CA-125 if you end up being diagnosed, but it is not a reliable test for ruling out cancer.  That said, most complex cysts under 5cm can be monitored to see if they are growing or reducing in size.  The majority turn out to be benign.  But, once a complex mass reaches 5cm, surgery and biopsy are recommended.  If you are post-menopausal, you have a slight increased risk of malignancy versus pre-menopausal women.

If you find yourself facing surgery, you need to ask for a referral to a gynecologic oncologist before having surgery.  A gyn/onc has more experience and training with ovarian cancers and studies have shown that your overall prognosis is much better than if you have a gyn or general surgeon.

If I were in your shoes, I would be inclined to get a second opinion since it seems your doctor is not familiar with this type of situation.   If you want to stick with her, you should definitely call the office and insist on earlier follow-up.  Have you had a MRI or CT?  Ultrasounds show the ovarian mass but can't identify any other areas of concern in the pelvis.  I would want to know that there were not other masses or enlarged lymph nodes in the pelvis before being put on a watch and wait plan for a complex mass.  It is better to be safe than sorry!  I hope all goes well.  Keep us posted on how you are doing.  

Shelly