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Old 04-23-2011, 10:22 AM   #1
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Pregnant, complex ovarian cyst

I'm almost 9 weeks pregnant. Just went to dr yesterday for my first check-up.
The baby is fine: good size, good heartbeat.
But on doing the ultrasound, they found 2 cysts on my left ovary- one simple and one complex.
The complex one is 2 cm. So, not very big.
I'm assuming the simple one is small too.

The doctor didn't seem terribly worried about any of it (then again, it's the first time I've ever seen him, so why should he even care? He's not exactly emotionally invested in me, right?). He just said we'd check it at the next appointment to see if it's grown any. He didn't give me a very good explanation for it, just sort of mumbled something about it being fairly common in early pregnancy, blah blah blah (a lie, it turns out! Complex ovarian cysts aren't common any time. Simple cysts are).

Because of his lack of concern, I wasn't very worried either... until I got home and looked up "complex ovarian cyst".
Good God!! I'm reading that there's an 15-20% chance that it could be malignant! And we're talking about ovarian cancer here! That's not one of the "good" cancers; it doesn't have the high cure rate of, say, uterine cancer, or even cervical cancer. Statistically, most people don't survive ovarian cancer.

So, of course, I'm freaking out.
Instead of being happy that my baby is doing well, all I can think about is that I'm going to die of ovarian cancer.
My research on line is turning up nothing but terrible news.
It's saying that I should be seeing a gyn-oncologist, that I should probably have the complex cyst surgically removed as soon as possible, even though that would endanger my pregnancy. I'm reading that even if the cyst isn't malignant, it can grow gigantic, twist up my ovary, rupture, and kill me.
(I'm assuming this wouldn't be too healthy for my fetus, either).

I have zero symptoms. I never in a million years would've guessed anything was wrong with my ovary. I mean, that's just not something I've ever worried about (and I am a hypochondriac. I just always assumed that ovarian cancer was mostly a disease of menopausal women, so i shouldn't worry about it yet).

Weirdly, I had a bunch of ultrasounds and stuff back in December, in the course of investigating some abnormal bleeding I was having (turned out to be an endometrial polyp, subsequently removed).
The ultrasound tech told me back in December that I had a "deflating cyst" on my left ovary. When I asked my doctor about it, she said it was normal, and was related to ovulation.
NOBODY mentioned any "complex cyst", so I'm assuming it wasn't there three months ago. Either that, or they missed it (but I doubt it, because they saw the simple cyst).

I'm FREAKING OUT! Someone give me some encouraging news (and yes, I've already read how "99% of ovarian cysts are benign", but that's a bit of a trick, I think. Nearly all simple cysts are benign, and most ovarian cysts are simple. Complex cysts are rare, and they're 15-20% malignant, from what I've read. So lumping them together with simple cyst statistics and telling me they're 99% benign isn't going to make me feel better. The type of cyst I have ISN'T "99% benign".)
I'm a realist. I want to deal with the reality of the situation, not skewed statistics.

Somebody talk to me.

 
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Old 04-23-2011, 12:40 PM   #2
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Re: Pregnant, complex ovarian cyst

Why is it so hard to get reasonable information on complex ovarian cysts?
I'm a health researcher extraordinaire (comes from being such a hypochondriac), yet I can't find a speck of sensible information regarding complex ovarian cysts.
Most of it is ignorant fearmongering rife with misspellings- which primarily appears on commercial sites trying to sell some herbal remedy for complex cysts.

Then there are the sites which appear to be written entirely in gibberish; I believe they may be poorly translated from another language, possibly Martian.

Then there are the threads by members on this and other health-related forums, which tend to be optimistic and upbeat, and to quote that "99% are benign" statistic a lot, which is comforting yet clearly inaccurate when discussing complex cysts.

I've found a few semi-reasonable sounding (but not medical-sounding) "women's health advice" sites that discuss how to deal with symptoms of ovarian cysts, such as pain... but they don't even specify whether they're talking about simple or complex cysts, and besides, I have no symptoms, so that's not of any help to me.


Why is it that I cannot find a single reputable medical site which discusses the risks of complex ovarian cysts and malignancy?
I've never in my life had this much trouble finding basic health information/ statistics.

Are complex cysts that rare??


Last edited by Kali333; 04-23-2011 at 12:42 PM.

 
Old 04-23-2011, 05:01 PM   #3
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Re: Pregnant, complex ovarian cyst

Wow. 84 views, not a single comment?
Not even a "sorry this is happening to you"...?



Why the heck is ovarian cancer combined with cervical cancer on a single board, anyway? The two really don't have anything to do with one another.

Last edited by Kali333; 04-23-2011 at 05:03 PM.

 
Old 04-25-2011, 07:59 PM   #4
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Re: Pregnant, complex ovarian cyst

I know nothing about complex ovarian cysts, so I am sorry I can't help you there. I do know that doctors are not usually hesitant to advise action, even when waiting is a good and safe option. And if the situation warrants, I have seen them recommend termination of a pregnancy to treat the mother. As long as your doctor is knowledgable with your condition, complex ovarian cysts, I would try to take some comfort from his willingness to wait and see. I know that is asking a lot, I am waiting on cervical biopsy results myself right now, but it is something to hang on to.

That said, call your doctor and get the answers you need. If you can't get them from him, keep asking! Listen to your instincts and keep searching and researching until you are satisfied. But try not to listen to your fears. FEAR = False Evidence Appearing Real (Said the person whose fears are getting the better of her no matter how much I say these things to myself!)

I'm sorry you are going through this, pregnancy should be a time of joy! I will keep you and your baby in my thoughts!

 
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Old 04-26-2011, 12:23 PM   #5
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Re: Pregnant, complex ovarian cyst

Kali,

Hello, I am a fellow cyster sister who was in a somewhat similiar position (though not exactly). In 2007 I started to have irregular menstrual bleeding which freaked the heck out of me. After an endometrial biopsy which was somewhat inconclusive (a lot of blood in the sample but the few cells present were normal) I began to have abdominal pain (which turned out to be ovulation pain .. I had just gone off the pill after 20 years so was unfamiliar with this). I was sent for an ultrasound which uncovered an 8 cm simple ovarian cyst on my left ovary. No cause for worry, I was told, we watch it and it will go away with time. Well, it did not go away and it began to develop solid components. When it got to around 9 cms, my doctor recommended removal and I had surgery to get rid of it.

During the 18 months that I watched my cyst, I read everything that I could get my hands on about ovarian cysts and some of the things you mention that are contributing to your anxiety do not concur at all with my sources so perhaps my mentioning these might help.

Ovarian cancer is not common at any age, but when it does occur, it is women 60 years of age and over who are most at risk. This means that if you are premenopausal (which you are since you are pregnant), it is highly unlikely for you to have ovarian cancer. Of course highly unlikely does not mean impossible but it does mean highly unlikely.

Ovarian cysts, EVEN COMPLEX ONES, are extremely common. I am not sure where you read that complex cysts are rare. They are not. Yes the most common cysts are simple ovarian cysts, which are usually just ovarian follicles, but not all simple cysts are ovarian follicles (mine wasn't) that go away with time. I had an abnormal simple ovarian cyst which is not your run of the mill cyst that comes and goes with the cycle. Some simple cysts persist and get larger (like mine did). Also, when cysts get very large, even simple ones, all bets are off and they must be removed ... this leads me to the next point ...

Size matters. Cysts that are 5 cms or less in diametre are extremely common and most often not worrisome. Simple cysts that are less than 5 cms are usually just follicles or corpus luteal cysts. Complex cysts that are less than 5 cms can be follicles or corpus luteal cysts that have bled into themselves or that have persisted for a long period of time. You are right in saying that usually complex cysts are removed in order to be on the safe side but 90% of complex cysts are benign (don't know where you saw the 20% malignant figure).

Also, I would not worry too much about the cyst becoming gigantic and rupturing or twisting your ovary. This is not a common occurence and your cyst is rather small. I walked around with an 8 cm cyst for a year and a half and this cyst was much heavier. Usually they become concerned around the 10 cm mark as this is starting to get large and the risks that you mention become more worrisome. A cyst rupturing is extremely painful but the risks of dying from this event are very very small if not practically non existent (I have spoken to a number of very good doctors, including gynecological oncologists who have told me so). A cyst twisting your ovary, on the other hand, is an emergency situation that requires immediate surgery or your ovary will die from a lack of bloodflow. This is also incredibly painful as you can imagine.

Having said all of this, these cysts cause a tremendous amount of anxiety because when one has something that risks even 1% being malignant, we worry. There are some things which you can do to control your situation which may help.

1. You may want to inquire about the CA-125 test. This tests for a cancer antigen that is normally present in great numbers when ovarian cancer is present (a reading of 35 or less is normal). However, this test is notoriously unreliable and may show a high reading when there is no ovarian cancer. It also misses some stage I ovarian cancers (ie. a false negative). Ask your doctor about this test and see if it is right for you.

2. You can ask for more frequent ultrasounds in order to "keep an eye" on the cyst. Then if you see that it is growing at a fast rate, you can react quickly in order to control the situation. You may find that the cyst will start to regress and then go away completely and this would be wonderful news indeed.

Talk to your doctor about these two things as they may help to keep things under control while you are waiting for your baby to develop. They will also help keep your anxiety under control as this is also not good for the baby. If you can keep an eye on the cyst and know exactly what you are dealing with, it will help immensely. Also, talk to your radiologist as these folks are very good at knowing what is and what isn't cancer. They are not 100% accurate but believe it or not, they have a higher accuracy rating than the CA-125 test.

I was faced with waiting on an ovarian cyst and the way I kept my wits is to use both the CA-125 and the ultrasounds as reassurance that it was extremely unlikely that I had cancer. As time went on and my cyst was still there and barely growing, I became more and more certain that the cyst was benign (ovarian cancer usually moves quickly).

Be very careful about internet reading and watch your sources. Use scholarly journals or board certified gynecologists' web-sites. There is a lot of panic generating stuff on the internet so tread very carefully. If you type "headache" on the internet, you will get all sorts of things like brain tumours and brain cancer when most of the time a headache is just a headache.

Hang in there and try to relax. If you are still very anxious, talk to your doctor about the things that I mentioned and perhaps explain that you are very anxious about this situation. They are definitely used to it because we are all anxious about ovarian cancer. Oh and by the way, ovarian cancer can be cured just as endometrial cancer can be cured. The thing about ovarian cancer is that when it is discovered it is often at stage III or IV so it has progressed unchecked for a while. When ovarian cancer is discovered early, it has an over 90% cure rate just like endometrial cancer. The thing that will help is when they finally release an ovarian cancer screening test. They are working seriously on this and hopefully we will have something very soon.

Take good care of yourself and let us know how you are doing.

Best Regards,

Estria

 
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Old 04-28-2011, 05:10 PM   #6
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Re: Pregnant, complex ovarian cyst

Thank you, thank you, Estra.
That does ease my anxiety quite a bit.
I don't remember where I read that 20% malignant figure; it was on some website. Most websites say "15% malignant".
I guess I just assumed complex cysts were rare because ovarian cancer is pretty rare, especially in young women, and if 15% (or even 10%, as you stated) of complex cysts are malignant, they can't be all that common, or there'd be many more young women dying of ovarian cancer.

It's all such a headache.
I'm trying to just put it out of my mind until my next appointment.
The fortunate thing about me being pregnant is that they will be doing frequent- possibly even monthly- ultrasounds, so it should be pretty easy to keep an eye on this thing.
And I did find a reputable medical website that mentioned the chance of a woman my age (under 40) having ovarian cancer is extremely slim, so that made me feel slightly better.

Thank you so much for your kind words and reassurance.
It really does help.

Last edited by Kali333; 04-28-2011 at 05:11 PM.

 
Old 06-29-2011, 05:39 PM   #7
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Re: Pregnant, complex ovarian cyst

I am completely confused right now, just had a pelvic ultrasound, I still have my right simple ovarian cyst, it was 3.9cm in January 2011 and now it is 4.9 cm and I have a 2.3cm left ovarian complex cyst, wasnt there in January...yikes, and the report made mention of a 47.0mm gest sac....what the heck, does that mean I am pregnant and have cysts??? OH my word, I am so scared, will see my MD tomorrow for follow up to todays pelvic ultrasound, in the meantime, any info preferred.
kali---how are you doing now? Better I hope

 
Old 06-29-2011, 06:52 PM   #8
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Re: Pregnant, complex ovarian cyst

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Originally Posted by purity dee View Post
I am completely confused right now, just had a pelvic ultrasound, I still have my right simple ovarian cyst, it was 3.9cm in January 2011 and now it is 4.9 cm and I have a 2.3cm left ovarian complex cyst, wasnt there in January...yikes, and the report made mention of a 47.0mm gest sac....what the heck, does that mean I am pregnant and have cysts??? OH my word, I am so scared, will see my MD tomorrow for follow up to todays pelvic ultrasound, in the meantime, any info preferred.
kali---how are you doing now? Better I hope
I'm not sure what it means... I'm sure if you were pregnant they'd TELL you (I hope??).

I'm fine; I'm 18 weeks pregnant now. No complications, all of my doctor's visits have been normal. We've listened to the baby's heartbeat with a Doppler at each visit.

I have not had another ultrasound since the first one (at 8 weeks, when the cyst was discovered).
My doctor seems unconcerned about the cyst. Like, completely.

My next appointment is not until July 28th, and at that appointment I will have an ultrasound: it is the "anatomy scan" one where they determine the baby's gender.
So I'm trying to stay excited and optimistic about that, and not focus too much on this cyst.
If it's still there, I'm sure they'll see it. And will decide what- if anything- to do about it at that time.

 
Old 06-30-2011, 10:01 AM   #9
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Re: Pregnant, complex ovarian cyst

Great, Im happy you and your baby are doing great!!! I had my US yesterday at an imaging center, I will see my OB today to discuss the findings. I am scared....I will let you know how I turn out. Please give us an update after your next visit

 
Old 06-30-2011, 12:50 PM   #10
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Re: Pregnant, complex ovarian cyst

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Originally Posted by estria View Post
Kali,

Ovarian cysts, EVEN COMPLEX ONES, are extremely common. I am not sure where you read that complex cysts are rare. They are not. Yes the most common cysts are simple ovarian cysts, which are usually just ovarian follicles, but not all simple cysts are ovarian follicles (mine wasn't) that go away with time. I had an abnormal simple ovarian cyst which is not your run of the mill cyst that comes and goes with the cycle. Some simple cysts persist and get larger (like mine did). Also, when cysts get very large, even simple ones, all bets are off and they must be removed ... this leads me to the next point ...

Size matters. Cysts that are 5 cms or less in diametre are extremely common and most often not worrisome. Simple cysts that are less than 5 cms are usually just follicles or corpus luteal cysts. Complex cysts that are less than 5 cms can be follicles or corpus luteal cysts that have bled into themselves or that have persisted for a long period of time. You are right in saying that usually complex cysts are removed in order to be on the safe side but 90% of complex cysts are benign (don't know where you saw the 20% malignant figure).


Estria

This is relieving to hear since I have also read online of all places that complex cysts are RARE!!! Way to scare the hell out of us all, right!!!
Thanks for your post, how are you doing?

 
Old 07-01-2011, 04:59 AM   #11
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Re: Pregnant, complex ovarian cyst

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This is relieving to hear since I have also read online of all places that complex cysts are RARE!!! Way to scare the hell out of us all, right!!!
Thanks for your post, how are you doing?
Yep, that's what I've read. That they're RARE, and that there's a 10-20% chance they're cancer, depending upon which website you read.
However, the number of young women I've spoken to who have (or have had) complex cysts is so high that they can't be that rare, and the statistics show that ovarian cancer in young (under 40) women is so incredibly rare... that those statistics simply can't be correct. Two other young women at my work have them, besides me (one currently has one and is being monitored, one had hers removed last year. It was benign) and that's just out of the women i know well enough to talk to about such things.
Besides, my doctor seems utterly unconcerned about the whole situation, and if there was a high risk I could have cancer, I'm sure he'd be more concerned. He's not a heartless monster.

 
Old 07-11-2011, 02:29 PM   #12
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Re: Pregnant, complex ovarian cyst

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Yep, that's what I've read. That they're RARE, and that there's a 10-20% chance they're cancer, depending upon which website you read.
However, the number of young women I've spoken to who have (or have had) complex cysts is so high that they can't be that rare, and the statistics show that ovarian cancer in young (under 40) women is so incredibly rare... that those statistics simply can't be correct. Two other young women at my work have them, besides me (one currently has one and is being monitored, one had hers removed last year. It was benign) and that's just out of the women i know well enough to talk to about such things.
Besides, my doctor seems utterly unconcerned about the whole situation, and if there was a high risk I could have cancer, I'm sure he'd be more concerned. He's not a heartless monster.
Everything online is so contradictory....I wish you luck, keep us updated on yur cysts

 
Old 07-15-2011, 01:13 PM   #13
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Re: Pregnant, complex ovarian cyst

Update, had a CT two days aog, I have a unilocular lumen cyst with one area of septation, my OB wants me to go on birth control pills for a few months to see if it shrinks or dissolves!!! I DONT WANT TO.....my partner and I had baby plans.......it is currently 4.7cm.....I just want to cry now, why should any of us go through this???? WHY?

Kali, how are yu and your baby doing?

 
Old 07-15-2011, 02:50 PM   #14
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Re: Pregnant, complex ovarian cyst

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Update, had a CT two days aog, I have a unilocular lumen cyst with one area of septation, my OB wants me to go on birth control pills for a few months to see if it shrinks or dissolves!!! I DONT WANT TO.....my partner and I had baby plans.......it is currently 4.7cm.....I just want to cry now, why should any of us go through this???? WHY?

Kali, how are yu and your baby doing?
We're doing awesome; I'm almost 21 weeks now. I have an ultrasound scheduled on the 28th, to determine the sex of the baby.
Baby is moving and kicking a lot; everything seems fine.

Purity, why don't you just insist to your doc that you do not want to put your baby plans on hold, and would prefer to have this cyst removed laproscopically?
And if your doctor refuses, perhaps seek another doctor.
I think this has gone on long enough, and 4.7 cm is not small... I don't blame you for wanting that thing out, and I think you should insist on it.

Best of luck, hun!

Last edited by Kali333; 07-15-2011 at 02:51 PM.

 
Old 07-15-2011, 03:22 PM   #15
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Re: Pregnant, complex ovarian cyst

How Fantastic Kali about you and your baby! Makes me happy for you.

I am seeing a new OB on July 27th for a second opinion on this matter, I will not start on the BC pills this Sunday as he suggessted as I just finished with my menstrual cycle a few days ago, I will wait to see what this new MD advises me and move forward from there

Thank you for your words of supporet, and let me know how your appt on the 28th turns out.....Ill be thinking of you and sending positive vibes your way and hope that cyst you have has shrunk

Dee

Last edited by purity dee; 07-15-2011 at 03:23 PM.

 
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