Cysts

So you have a benign cyst that requires treatment. Does it REALLY require taking the ovaries as well? So you have uterine fibroids along with your cyst. Do either or both of these conditions REALLY require taking your uterus, ovaries, and cervix too? How about simply taking care of the cysts and removing the fibroids instead? Makes more sense to me.

To determine whether a cyst requires treatment, wait a cycle or two for it to disappear. If it persists, a medical practitioner may use ultrasound to augment the pelvic exam. Usually, a pathological cyst, such as a dermoid cyst, a cyst of endometriosis, or cancer will be removed. Such pathological cysts should be removed. Practitioners disagree about the necessity of removing benign cysts, but small functional cysts do not usually cause problems and may be left alone. A large cyst is more of a health risk because it can rupture, causing severe abdominal pain and sometimes bleeding. A large cyst may also twist and damage the blood supply to the ovary. These two uncommon situations require prompt surgery.

If your physician advises removal of the ovary along with the benign cyst, get a second opinion. Removal of the ovary, though a conventional practice, is in many cases unnecessary. Ovaries perform many functions, even after menopause.

A few words on Cancer

Consider this. My younger sister has had two brain tumors in her lifetime. Serious stuff. Am I at higher risk for these types of tumors than the general population? Yes. Probably. Am I going to have surgery to remove part of my brain as a preventive measure to treat what might or might not occur in the future? What do you think?

To my knowledge, gynecologists are alone in how they recommend the removal of ovaries, uterus, and the cervix as preventive measures for cancer. In how many other surgical cases or medical circumstances do doctors, systematically, recommend removal of organs as a preventive measure for something that might or might not occur? How many do this without asking appropriate questions and calculating risk factors? How many do this with full knowledge that the course of treatment for prevention has a very high morbidity rate?

Finally, how many men would readily allow the removal of their testicles simply because they are at risk for prostate cancer? According the National Cancer Institute, the lifetime diagnosis risk of prostate cancer for a man is nearly 16%. Compare that to 1.8% for ovarian cancer and .7% for cervical cancer...

You know -- I really don't understand the recommendations that flow so freely from gynecologists in regard to the removal of ovaries, uterus and cervix for benign conditions. So far, no gynecologist has been able to explain it to my satisfaction either.

What I do know is that cancer is a very scary word. Only gynecologists let it float out so freely in consults, however. Most other doctors want to avoid the use of the word until some definitive proof is in their hands. Why is that?

Questions to Consider

Before recommending the removal of ovaries for cancer prevention as part of the process of treating benign cysts, did the doctor bother to do a risk assessment of ovarian cancer? Did the doctor bother to share with you any of the following information?

The lifetime risk of acquiring ovarian cancer is less than 1.8%.
Ovarian cancer can occur in the pelvic region even without the presence of the ovaries -- if you're destined to get this type of cancer, removing the ovaries does not, necessarily, protect you.
Removal of the ovaries means instant surgical menopause and a need for hormone replacement therapy (HRT) for the remainder of a woman's life. Without HRT, a woman's overall risk of acquiring heart disease and osteoporosis increases significantly. Heart disease is the number one killer of women in this nation.

Ovarian Cancer Risk Factors

Do you have a family history (mother, grandmother, sister) of ovarian or breast cancer? If so, you are at INCREASED risk of acquiring ovarian cancer.

Have you ever taken birth control pills? If so, your risk is DECREASED.

Have you ever been pregnant? If so, your risk is DECREASED.

Have you breastfed your children? If so, your risk is DECREASED.

Have you had a tubal ligation? If so, your risk is DECREASED.

These are the few areas that have been studied with thousands of women and across different countries and are commonly agreed upon -- in fact recently reaffirmed by doctors -- as being the only indicators of risk currently known to have statistical significance. If these factors were not discussed and considered between you and your gynecologist prior to a recommendation for ovary removal (due to cysts or fibroids or a chosen hysterectomy), you might want to consider returning for a long chat with him/her before the surgery -- or looking for another gynecologist for a second opinion.

Link	Site Name/Author	What You'll Find
www.soulcysters.com	Kat Carney	Polycystic Ovarian Syndrome site. Incredible collection of women's stories along with links, resources, and research.
www.pcosupport.org/	Polycystic Ovarian Syndrome Association, Inc.	Information, support, physician directory, etc. Excellent compendium of resources.
www.healthsquare.com/ pdrfg/wh/chapters/wh1ch09.htm	The PDR® Family Guide to Women's Health	Comprehensive site covering all of the following: Warning Signs of An Ovarian Cyst A Close Look at the Most Common Types When To Seek Medical Attention How Your Doctor Goes About a Diagnosis Treating Ovarian Cysts What to Expect When the Doctor Operates
www.gynsecondopinion.com/ ovarian-cysts.htm	William H. Parker Rachel L. Parker Amy E. Rosenman (Contributor) Ingrid A. Rodi (Contributor)	A Gynecologist's Second Opinion : The Questions and Answers You Need to Take Charge of Your Health -- If you have Ovarian Cysts...
www.goerwitz.com/endo/	Amy and Richard Goerwitz	My Laparotomy: An Experience With First-Time Surgery and an Endometrioma
www.mjbovo.com/OvarianCysts.htm	Dr. MJ Bovo	Ovarian Cysts. Simple presentation of basic description of cysts.
www.bris.ac.uk/Depts/ObsGyn/ pgrad/md/welcome.htm	Julian Michael Jenkins D.M. Thesis (1993) University of Southampton	The development and influence of functional ovarian cysts during in vitro fertilisation cycles.
www.wic.net/waltzark/cysts.htm	Rev. Dr. EarthAngel The Herbal Encyclopedia	Treating Ovarian Cysts and Uterine Fibroids naturally.
www.inciid.org/faq/pcos.html	Rebecca Smith Waddell, E. Scott Sills, M.D. and Samuel Thatcher, M.D., Ph.D.; InterNational Council on Infertility Information Dissemination	PCOS Frequently Asked Questions. Covers it all with over 100 questions/answers.
www.mayoclinic.com/ invoke.cfm?id=DS00129	Mayo Clinic	What are ovarian cysts?
www.medem.com/medlb/ article_detaillb.cfm?article_ ID=ZZZEB8EN97C&sub_cat=9	American College of Obstetricians and Gynecologists	Ovarian cysts. Simple, brochure-type info but nice black and white graphics of ovarian cysts.
kidshealth.org/teen/ sexual_health/girls/pcos.html	The Nemours Foundation: TeensHealth	Coping with polycystic ovary syndrome. Excellent information for women of all ages -- not just teens!
www.emedicine.com/ med/topic1699.htm	C William Helm, MBBCh	Comprehensive paper on ovarian cysts. Terrific photos of removed cysts.
www.emedicine.com/ EMERG/topic352.htm	eMedicine, Amin Antoine Kazzi, MD, Robin Roberts, MD	Ovarian Cysts. Comprehensive medical information on diagnosing and treating ovarian cysts. Written for physicians.
www.gynob.com/cysts.htm	Gerard M. DiLeo, M.D.	Ovarian Cysts--The Good, The Bad, And The Ugly. Covers ovarian Follicles, Cysts, and Malignancies ...and everything in between.
womenshealth.about.com/ library/weekly/aa111998.htm	Womens' Health at About.com, Tracee Cornforth	What You Need to Know About Ovarian Cysts.
www.4woman.gov/faq/ ovarian_cysts.htm	National Women's Health Information Center	OVARIAN CYSTS. What are ovarian cysts? What are the symptoms of ovarian cysts? When are women most likely to have ovarian cysts? How are ovarian cysts diagnosed and treated? What questions should a woman with an ovarian cyst ask her doctor?
www.nlm.nih.gov/medlineplus/ ency/article/001504.htm	MedlinePlus Health Information	Ovarian cysts per Medical Encyclopedia.