Ahoy, vagineers -
Question first, then backstory.
How concerned should I be about a 5cm ovarian cyst that the doc thinks is fluid-filled? And if he thought there was a possibility it was sketchy, would he advise me to just wait and come back in two months?
Backstory for anyone who's interested:
I've had ovarian cysts for several years. I had one pop (didn't realize it until they saw it on a CT scan for an unrelated problem and they were like "so there's a ruptured cystic mass in there, did you know that?" and I was like OH MY GOD THAT'S WHAT THAT HORRIBLE PAIN WAS! For a hypochondriac I sometimes ignore the strangest things.), and one about this size that caused bladder discomfort that either went away or turned into the mutant megacyst I had removed last summer. It turned out to be endometreosis. I tried a couple of birth control options to attempt to keep it from returning, but it turns out that it doesn't take much to turn me into a creature of violent mood swings, hysterical anxiety, hot flashes and endless diarrhea. My insurance has been giving me trouble since the surgery and I couldn't get back to the GYN until today, when lo and behold, shiny new cyst. I'm having a constant need to urinate again, so I asked to pee in a cup, but he thinks it's probably just the cyst using my bladder as a punching bag. He did take the urine test just in case, and some blood - I didn't ask what that was for outside of the CA125.
While he was doing the ultrasound he got very quiet and worried-looking and spent a good ten minutes looking at the thing from every angle. I asked him if it looked like cancer and his oh so reassuring reply was "not really." He mentioned that it looked fluid-filled. He told me he'd call with my test results and had me schedule an appointment 2 months from now to check on it.
I have intense health anxiety and have for 25 years. I just turned 29 yesterday, so...you can do the math. It's been a thing forever. So I have no idea how it's warping my perceptions of how concerned I should be. On the one hand he acted quite worried when he was looking at it, and his reply to did it look like cancer seemed noncommittal. On the other, if he thought it had any possibility of being something sinister, is this the likely course of action he would take?
So as I mentioned upthread, my questions are basically how worried should I be, and is this standard cyst procedure regardless of malignancy potential? I know that worrying doesn't help anything, and I know that given my history it's likely just another cyst or endometrioma. But I still feel concerned.
Question first, then backstory.
How concerned should I be about a 5cm ovarian cyst that the doc thinks is fluid-filled? And if he thought there was a possibility it was sketchy, would he advise me to just wait and come back in two months?
Backstory for anyone who's interested:
I've had ovarian cysts for several years. I had one pop (didn't realize it until they saw it on a CT scan for an unrelated problem and they were like "so there's a ruptured cystic mass in there, did you know that?" and I was like OH MY GOD THAT'S WHAT THAT HORRIBLE PAIN WAS! For a hypochondriac I sometimes ignore the strangest things.), and one about this size that caused bladder discomfort that either went away or turned into the mutant megacyst I had removed last summer. It turned out to be endometreosis. I tried a couple of birth control options to attempt to keep it from returning, but it turns out that it doesn't take much to turn me into a creature of violent mood swings, hysterical anxiety, hot flashes and endless diarrhea. My insurance has been giving me trouble since the surgery and I couldn't get back to the GYN until today, when lo and behold, shiny new cyst. I'm having a constant need to urinate again, so I asked to pee in a cup, but he thinks it's probably just the cyst using my bladder as a punching bag. He did take the urine test just in case, and some blood - I didn't ask what that was for outside of the CA125.
While he was doing the ultrasound he got very quiet and worried-looking and spent a good ten minutes looking at the thing from every angle. I asked him if it looked like cancer and his oh so reassuring reply was "not really." He mentioned that it looked fluid-filled. He told me he'd call with my test results and had me schedule an appointment 2 months from now to check on it.
I have intense health anxiety and have for 25 years. I just turned 29 yesterday, so...you can do the math. It's been a thing forever. So I have no idea how it's warping my perceptions of how concerned I should be. On the one hand he acted quite worried when he was looking at it, and his reply to did it look like cancer seemed noncommittal. On the other, if he thought it had any possibility of being something sinister, is this the likely course of action he would take?
So as I mentioned upthread, my questions are basically how worried should I be, and is this standard cyst procedure regardless of malignancy potential? I know that worrying doesn't help anything, and I know that given my history it's likely just another cyst or endometrioma. But I still feel concerned.
i'd say dont worry too much. he's scheduled you to look at it again in 2 months. he probably sounded distracted as he was making calculations in his head about "is it big enough to need to aspirate the fluid from it? or should i give it some time and just keep an eye on it?" that's sort of subjective to the person, whether you need it to be aspiratated (have the fluid removed by having it popped in outpatient surgery and the fluid analized) or just watch it.
if he thinks its fluid filled rather than endometria, then waiting is the quite normal more conservative course of action, and the one i'd personally be quite happy with.
Fluid filled cysts often arise from the normal, functional follicular cyst that forms around the developing egg as it is released. Sometimes that sack hangs around too long and gets filled with fluid or blood from a broken blood vessel. Over time that blood can clot, leading to a cyst with "semisolid" contents, either classified as a hemhorragic cyst, or as an endometrioma (the "walls" of an endometrioma are made of endometrium).
Endometriomas can be difficult to distinguish from hemhorragic cysts on ultrasound, but treatment for all functional cysts or endometriomas is roughly the same: wait and see. If you didn't tolerate hormonal birth control pills well you might want to check out the Mirena IUD. It has good results in symptom reduction for people with endometriosis.
A great resource for endometriosis is this community: http://www.endo-resolved.com/messageboa
A friend of mine had a horrible Mirena experience, and I AM concerned with the whole thing where if something goes awry it's not as simple as stopping taking pills...but yeah I think if that's what's up I'll ask about that option.
I figured cancer is generally solid, but the guy could've been a little more committal in his response to my question....still, not his fault I have a wacky brain. But I would hope that if he felt there was any visible possibility of it being sketchy, he'd take a more direct approach to figuring it out. (Though maybe that's not the best course of direction in someone who's otherwise low-risk for ovarian cancer...I don't know; I'm not a doctor...obviously...)
According to the "simple cyst: diagnostic approach" chart gif, a simple, fluid-filled cyst of that size is to be assumed as benign, with follow-up ultrasounds annually until resolved.
The page is interesting and useful because it does outline different kinds of cysts and gives recommended treatment paths for many scenarios. I hope it's helpful for you!
I understand how scary it can be, though. I currently have a 18cm cyst on my left ovary and will be scheduling surgery next week to have it removed (and possibly my ovary). My cyst is complex (fluid and solid mixed) so I'm a little worried, too.