GynoFiles

Dermoid Cyst of the Ovary (Benign Cystic Teratoma) Most ovarian cysts come and go. In fact most ovarian cysts never make it to the attention of your health care provider. However, those ovarian cysts that are present on a serial set of ultrasounds become signficantly less likely to ever resolve without your gynecologist intervening. Persistent pelvic masses are not always ovarian cancers, in fact many will be the non-cancerous dermoid cyst shown in this picture.In a review of a study of ovarian masses seen on ultrasound in women over 50 a new study reported in the AJOG in November 2015 has shown that watching and repeating the ultrasound actually did better at determining if an ovarian mass was really cancerous. In this study patients were watched over 3 years. In the past it was thought that a mass of stable size over 6 months would not be a cancer. The theory was that ovarian masses either are cancerous or not cancerous and that masses that are not cancerous cannot evolve into a...

Ovarian Cancer Found Near the Left Fallopian Tube New Studies link ovarian cancer and hormone therapy published in the Lancet by the Collaborative Group on Epidemiological Studies of Ovarian Cancer. Although we know that progesterone is protective against uterine cancer, and estrogen alone may be protective against breast cancer, hormone therapy in menopause has never conclusively been linked to ovarian cancer until this study. In the study over 21,000 women were studied and the risk of ovarian cancer was an increased rate of of only one extra cancer per 1000 women (or less). It is still just an epidemiological study and more facts may come out with other types of studies. If you are taking hormone therapy, or considering hormone therapy we have a few bits of gyno advice:  First you need to establish your baseline risk of ovarian cancer with your gyno. Next you should monitor your risks. After that weigh your risks and benefits of any therapies with how they might impact on...

Our bodies are finely tuned cancer fighting machines. We have many genes that encode for the ability to fight cancer. However, once the gene breaks down (either through aging, exposure to a toxin, or in some unfortunate cases by birth). For ovarian cancer, it is the p53 (now also called the TP53 gene). In over 90% of cases of ovarian cancer studied by the Cancer Genome Atlas they have found this gene is defective.AS they have begun to study the genes further they have discovered another 9 genes that are commonly found in ovarian cancers. Now that we have identified what genes go wrong, the search for being able to hunt for those mutations in patients before they get cancers. To that end they are looking in the blood stream as well as on pap tests. Besides prevention uses, which are still just beyond the horizon, the researchers are trying to apply this gene diagnosis to treatment plans.

Women have about a lifetime  15-20% chance of having a tumor of the ovary.The 15-20% chance includes all the ovarian cysts as well as (the much less common condition of ovarian cancer. How to determine whether a growth on the ovary actually is something that will resolve or not most often is determined by ultrasound and observation. However, some will come to surgery, as shown in this series of pictures.  Ovarian Cyst Found after Pelvic Exam, and Seen on Ultrasound The cyst Then Seen At the Time of Diagnostic Laparoscopy The Cyst Opened, Clear Fluid Was Discarded, and Pathology Showed a Non-Cancerous Cyst Called Serous Cyst Adenoma

Women have about a lifetime  15-20% chance of having a tumor of the ovary.The 15-20% chance includes all the ovarian cysts as well as (the much less common condition of ovarian cancer. How to determine whether a growth on the ovary actually is something that will resolve or not most often is determined by ultrasound and observation. However, some will come to surgery, as shown in this series of pictures.  Ovarian Cyst Found after Pelvic Exam, and Seen on Ultrasound The cyst Then Seen At the Time of Diagnostic Laparoscopy The Cyst Opened, Clear Fluid Was Discarded, and Pathology Showed a Non-Cancerous Cyst Called Serous Cyst Adenoma

If you have a hysterectomy for a cancer of the ovary, the ovaries do need to be removed for the most successful treatment. However, medical teaching has led us to feel one day ovaries are in, and then the next day they are out! But there are some important considerations. At the time of hysterectomy many women need the ovaries removed because of the same medical problem that led them to need a hysterectomy. The removal of both ovaries is called bilateral salpinoophorectomy or BSO But some women are focused on the fact that 1/70 women will get ovarian cancer in their lifetime, and ovarian and tubal removal will reduce this number significantly. Breast cancer patients may do better with ovarian removal and that is another reason that is a good reason to have your ovaries removed at the time of hysterectomy. In the Nurses Health Study , published in Obstetrics and Gynecology April 2013, they have begun to look very closely at what happens to women make a decision to just have thei...

For many years getting the 'belly button' surgery, or just 'tying the tubes' has been the gold standard for female tubal sterilization. And then there was a trend away from abdominal surgery with the Essure procedure which prevented cutting into the abdomen and thus became popular, and again, we've gone full circle to reconsider a very old procedure called salpingectomy for sterilization .  And the ACOG group is saying that taking out the tubes, but saving the ovaries may be one of the better ovarian cancer prevention strategies.  The American College of Obstetricians and Gynecologists in 2003 said that gynos "should advise patients that the morbidity and mortality of tubal ligation, although low, is higher than that of vasectomy, and the success rates of both procedures are similar". But couples are three times more likely to have the gal cut her tubes than have his cut. And the stand up (or stand down, depending on how you relate to these procedures)...

Cancer awareness increases when it strikes close to home. However, those of us who are fortunate enough to have not had this happen, have been connecting through our favorite shows, characters and actors with this devastating disease. In the final season of the recent incarnation of 90210 had a young main character who was told she had BRCA mutations and was considering removal of her ovaries . And then the ScyFy Channel show Warehouse 13 has the female lead recently diagnosed with ovarian cancer . Last year Pierce Brosnan’s 41-year-old daughter passed away of ovarian cancer on 6/28/2013 and her mother died of the same disease in 1991 at age 43. Knowing a family member had the disease, we urge you to come in to discuss screening. Many good sources of information exist, but an excellent place to find facts about ovarian cancer would be http://www.cdc.gov/cancer/ovarian/index.htm

Endometriosis and ovarian cancer have been linked in several ways": they both are hard to diagnose being internal conditions, they both can produce growths in places the tissue doesn't grow, they both can spread, and they both can cause pain. Yet endometriosis is a condition of hormones, and beyond infertility and pain it has not really been a lethal condition and it most typically resolves in menopause. Endometriosis itself can have malignant transformation, and it is suspected it is the cause of ovarian cancer in rare cases. This however is not normally a reason to routinely screen women with endometriosis for ovarian cancer. There is an ovarian cancer called endometroid cancer and it's look under the microscope appears to be very similar to endometriosis. Peking Union Medical College researchers began evaluating ovarian cancer patients with known ovarian endometriosis as compared to women where no endometriosis was found when they were found to have an ovarian cancer...

Research out of Indiana University School of Medicine states that 30%  of patients treated for ovarian cancer have signs of difficulty thinking and processing after chemotherapy or radiation therapy.  Loss of estrogen, emotional stress, depression due to the diagnosis, loss of sleep, financial worries because of missed work, overall illness, lack of nutrition for brain processing secondary to GI problems from chemotherapy might all contribute to such problems. This study just looked at what aspects of brain function were lacking, and did not yet attempt to understand the fixes. But understanding the stresses and strains mentioned can go a long way to fixing what might have gone wrong, so ask your gyno for advice. 

Women having hysterectomy are often faced with a question: do you keep your ovaries or remove the ovaries, and a further question, do you remove just one? But researchers from the British Columbia Cancer Agency in 2013 have found some research that puts women in a position to keep their ovaries, and still have a surgical solution that will reduce their lifetime chances of ever getting ovarian cancer! Worldwide there are over 200,000 cases of ovarian cancer each year, there are about 14,000 cases in the USA alone. Ovarian cancer is a deadly disease and each year about 140,000 women die of the disease. Of ovarian cancer cases over 10,000 American Women will die of their disease. but getting one's ovaries out is a big decision. Removing both ovaries reduces your chance of ovarian cancer by about 98%. Removing one ovary according to a National Institute of Health study headed by John Chan MD in 2014, did reduce your chances of ovarian cancer by about half. Since we do over 500,000 h...

Only two years of taking a birth control pill will reduce your ovarian cancer risk by 40-80%. This will not work to reduce your chances of ovarian cancer if you only take the pill for a very few months. The reduction of risk starts to accumulate as the years of pill use accumulate since it is related to a reduction of the number of times you ovulate. It's unlikely that this protection will be as great if you begin your pill use in your 40s, the earlier you begin your birth control pills the more efficient the treatment is in preventing ovarian cancer. See your gyno about other strategies to reduce ovarian cancer as well. 

If you caught Dr. Trupin on the Morning Show on WCIA-TV, back in September of 2012, you would have heard that September is Ovarian Cancer Awareness Month, and it is felt that awareness can help conquer ovarian cancer. Each year there are 21,000 women diagnosed and 14,000 women who succumb to ovarian cancer. So seeing your physician to try to reduce your risk of ovarian cancer is an important way to honor Ovarian Cancer Awareness month.  Yet this is what you should not do: ovarian cancer screening if you have no risk factors and no symptoms.  A reported in Ob Gyn News: In the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a randomized, controlled trial of 78,216 women in the United States, there was no significant difference in the number of ovarian cancer cases diagnosed in women randomized to annual screening vs. usual care (212 vs. 176) over 13 years. However, just to be clear those with risk factors do need to be screened; and those with symp...

Ovarian Cancer Found Near the Left Fallopian Tube Often ovarian cancer is so small it doesn't produce any symptoms at all. But looking internally can reveal ovarian cancer. In this picture, taken at the time of a laparoscopic surgery, a patient with mild symptoms was found to have ovarian cancer sitting right near her left ovary.

Are you planning to stop at one child? Two? More? Concerned about world population growth? Will your decision revolve around your job? What age should you start? When you want the baby to have a birthday? When the right time is to have a baby is a whole different discussion, and one that is likely to be more social than gynecologic! Many patients don't want to have children at all, and so the answer for them may be: zero is the right number of children. Are their physical concerns with birthing more than one child? We've touched on this topic in lots of posts! Have more babies and you have less chance of breast cancer,  and if you breastfeed your children you are even less likely to have breast cancer. On the other hand, for each child you breastfeed you may decrease your total bone mass (at least during the feeding, some research says if you give it long enough you can recover!) More babies also means less uterine and less ovarian cancer. But the bladder probably suffers, mor...

One of the most interesting of the contraceptive benefits of the birth control pill that was listed in the Gyno Gab Top Ten Things Your Birth Control Pills Can Do For You  is the fact that birth control pills protect against ovarian cancer. And as soon as Dr. Oz talked about the fact that taking the pill after age 40 could cut your risk of ovarian cancer by half  we got an immediate phone call from  a woman over the age of 65 wondering if she could get going on this terrific treatment. But alas it has only been shown as a protective factor over the age of 40 in women who are still ovulatory. t is the quiet of the ovary that is why it works, less ovulations lead to more protection, which is why longer use is associated with more ovarian cancer protection. At age 65 your cannot decrease your risk of ovarian cancer with birth control pills or with hormone therapy. In fact, some studies (although not all) of who have taken estrogen hormone therapy for over ten ye...

Generally speaking we have been telling women that endometriosis is no a cancer, will not turn into cancer, and that pain of endometriosis is part of their disease and not a sign of cancer. A new report has gotten a lot of media attention that states endometriosis raises a woman's risk of certain types of cancer. The reports in the Lancet Oncology inf Feb 2012 showed that endometriosis is associated with clear cell, endometrioid and low-grade serous ovarian cancers . This conclusion was drawn from analysis of many studies. There is a theory that a certain gene defect in the ARIDIA gene might be the reason that some women might suffer from both endometriosis and ovarian cancer. It is too soon to do special gene screening of this nature, but it's another example of how gene screening may help us know as your gyno how to direct your care in the future. So women with endometriosis should take the following steps: 1. Continue to get routine gynecologic care, do not skip yearly c...

Ovaries of women in menopause do still have some eggs, do still have some hormone production, and can still get ovarian cysts. One study showed that almost 1/5 women in menopause will be found to have an ovarian cyst. And its also important to note that while the worry of ovarian cancer is high in the women who do have cysts in menopause, the likelihood of a simple cyst in menopause being cancerous is very low. Your gyno will likely look at the size of the cyst and decide if it is something that is serious and needs surgery or needs to be just watched. Blood tests, other symptoms, sometimes other imagining tests, like CAT scans can help determine this as well, although hands down the ultrasound is the most efficient and accurate and actually the least expensive way to determine what the significance of the cyst is.Then the next issue is how fast they can resolve without needing surgical removal. In the University of Kentucky Ovarian Cancer Screening Program that watched women from 1...

Most women harboring an ovarian cancer will not recognize the fact that a cancer is developing in their ovary. Eventually the cancer becomes more advanced, symptoms may then be pronounced and then the disease is recognized. Some women are taught to recognize signs of ovarian cancer because they are at greater risk of developing ovarian tumors.  Women with BRCA 1 or 2 mutations, those with strong family history of breast or ovarian cancers, women who have never had children, women who have never breastfed, and women who have spent greater portions of their life ovulating because they never used birth control pills are all a bit more likely to get ovarian cancer. These women have been targeted for more careful watching in some studies looking at ways to diagnose ovarian cancer early. If effective screening could be performed, we can identify who these women are who have an ovarian cancer at an earlier stage when it is much more treatable. A screening test is a test for women with n...

As the number one gynecologic deadly cancer ovarian cancer is a very serious disease. Treatments are more successful than they used to be but it is sill, best to avoid, if this would be possible. All the standard anti-cancer strategies are important: don't smoke for starters. Specific advices to avoid ovarian cancer by: taking birth control pills, having babies, breast feeding your babies, normalizing your weight, having the right genetics, or even have your ovaries removed. None of these strategies is perfect, but many cases can be avoided all together. Now there's another possible protective factor: some soy consumption. There is some reason to believe this is more than just a quirk of a type of diet studied.New studies tells us that there is basis for believing soy foods can protect as against ovarian cancer.