WOMENS-HEALTH Messages for May, 1997: Re: laparoscopy

Re: laparoscopy

From: Kelly (anonymous@obgyn.net)
Wed, 14 May 1997 00:22:08 -0500 (CDT)

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At Tue, 13 May 1997, Kathy wrote: >
>I am 45 and had a hysterectomy last year due to fibroid tumors. I have
>a history of breast cancer in my family so I requested to keep my
>ovaries. I was able to keep my right ovary, but needed estrogen anyway.
>My bladder has fallen and I have scheduled surgery (laparoscopy). I was
>stricken with severe pain in my left side recently and saw my family
>doctor. He thought that it was an irritated bowel but the pain
>persisted for days. My blood tests were normal. He sent me for a CAT
>scan where they discovered a mass, about 3cm, on my ovary. I was sent
>to my OBGYN. He thinks it is viral and says that he will check in 3
>weeks during surgery. Is it safe to remove a cancerous tumor during
>laparoscopic surgery? If it is cancer is it safe to cut it into pieces
>in order to remove it from a small opening or will it spread? Should I
>request the surgery be done the old way with a larger incision? My
>stomach is enlarged more than usual and I have been very tired.

It's important to know whether the 3cm mass is solid or cystic, simple or complex. Did either of your doctors do a blood test called a CA-125?

If on CT scan or ultrasound, the mass *appears* benign, and your CA-125 is normal, a laparoscopy is reasonable. There are ways of removing ovaries without spilling the contents into the abdominal cavity (basically dunking the ovary into a baggie). You should ask your doctor about doing a frozen section while you are in the OR (the pathologist freezes the tissue and looks at it under the microscope right away to see if it's most likely benign or malignant). You should discuss what would be done if cancer was found -- would you be opened up for full cancer staging right then, or referred elsewhere for further workup.

If you are uncomfortable with what your doctor is telling you, please get a second opinion.

--
Kelly Shanahan, MD, FACOG
S. Lake Tahoe, CA

Next message: Kelly: "Re: new treatment for fibroids"
Previous message: Kelly: "Re: Clomid... uh, what is it and what are the risks???"
In reply to: Kathy: "laparoscopy"
Next in thread: Kathy: "Re: laparoscopy"
Reply: Kathy: "Re: laparoscopy"

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