Cancer of the Ovary
What is an ovarian cyst? An ovarian cyst is a hollow swelling containing fluid which grows in the region of the ovary.
Is an ovarian cyst often cancerous?
Most ovarian cysts especially in younger women are found to be benign. Cancer of the ovary is infrequent in patients under the age of 35; it is most frequent between ages 50 and 59. However, ovarian cancer develops silently, with no symptoms until it is often so far advanced that it is difficult to remove it successfully. The risk ofhaving ovarian cancer is higher if close relatives have had it.
How can the doctor tell there is a cyst on the ovary?
Most ovarian cysts are first found by the doctor during a routine pelvic examination and this is a very good reason for having a routine internal examination each year.
What symptoms make the doctor suspect an ovarian cyst?
Cysts of the ovary are quite common. The majority of them are benign, but some are cancerous. Cysts appear to grow quickly and often cause the abdomen to become distended. The patient may notice that she needs to urinate frequently or may complain of constipation or swelling in the legs. Interestingly enough, ovarian cysts often grow to the size of an orange or grapefruit before they are discovered. The ovaries are normally shaped like almonds; they are attached loosely to the undersurface of the fallopian tubes and have space around them, so a benign cyst of a fairly good size can be present for years without the woman being aware of its presence. When it starts to increase in size, it pushes the loose, flexible bowel away and fills in the space around it, causing a sensation of fullness or heaviness in the lower pelvic area.
Do ovarian cysts ever disappear?
Sometimes they do. Called physiological cysts because they are involved with the menstrual cycle, these cysts can sometimes cause the patient to miss a period. Normally, the sac that contains the egg ruptures about halfway between periods. If the sac fails to rupture, it begins to swell and fill with a clear liquid or jellylike material and increase to the size of an egg or even larger. That is why the doctor will sometimes wait for a few weeks before suggesting surgery. If the cyst fails to disappear, then surgery will be recommended.
What if the cyst does not disappear?
If the cyst does not disappear, or is very large and is causing other problems, surgery will be necessary. A benign cyst in a woman under 30 is often treated in a different way than one in a middle aged woman or an older woman. If the cyst has not destroyed the ovary, the doctor can remove the cyst and leave the part of the ovary not affected by the cyst. There are important decisions that need to be made and options that need to be discussed before going into surgery. Studies have shown that there are significant differences in treatment by physicians and hospitals, with gynecologic oncologists and university hospitals more accurately evaluating patients. It is important that appropriate examinations and procedures be carried out to determine the proper staging and treatment of the disease.
Ask these questions of yourself:
• Do I want the doctor to remove the uterus and other ovary if he finds nothing wrong with them?
• Since the operation is being done, do I prefer to have a hysterectomy at this stage in my life even if it is not necessary?
• Do I want the other ovary left if it is healthy so that I can have a normal menopause and avoid the need for taking hormones? (Hysterectomy does not cause you to have instant menopause unless both ovaries have been removed.)
What Can Cause Ovarian Cysts?
What operation is performed if the cyst is cancerous?
If the ovarian cyst is cancerous, regardless of the patient's age, a hysterectomy with removal of one or both ovaries is usually performed. If only one ovary is removed, the second ovary needs to be biopsied to determine whether or not there are any cancer cells. Sometimes radiation therapy or chemotherapy will follow the operation.
Why are ovaries removed?
Ovaries are removed surgically because they are diseased or not functioning properly. Ovaries may also be removed in patients with breast cancer if the cancer has been found to be estrogen dependent. Sometimes the ovaries are treated by radiation as an alternative to surgery. Some physicians remove healthy ovaries as a preventive measure against ovarian cancer while doing hysterectomies if the woman is past menopause.
Ovarian Cyst: Its Symptoms, Diagnosis, Causes and Treatment
What happens when the ovaries are removed?
When the ovaries are destroyed either surgically or by radiation the body no longer produces estrogen. The result is that menopause occurs, bringing with it sudden and severe symptoms, usually more severe than would have happened if menopause occurred naturally. Most premenopausal women who have an oophorectomy (removal of both ovaries) are given estrogen replacement therapy to help avoid severe menopausal symptoms.