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Having pain around rib cage. Early sign of ovarian cancer?

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Practicing since : 1999
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I may be worrying about nothing but I would really appreciate some advice. I was recently refered to a urologist who performed a CT scan and cystoscopy because of microscopic blood found in my urine and flank pain. The tests came back clear and he said the blood was probably due to a thin kidney membrane. However he said that the CT scan showed a minor abnormality on one of my ovaries it was surrounded by fluid? As this was not his field he discussed this with his gyne colleague who thought it was due to ovulation and that the scan had caught that particular point in my cycle. He said it was nothing to worry about and that I would be called for re-scan by ultrasound in six weeks time. Im currently waiting for my follow up appointment in two weeks time. I still have the flank pain that goes from my back right round to the front just below my rib cage on the righthand side. The pain comes and goes and worsens throughout the day, easing off at night time. I did have an episode of this type of pain about 6 years ago and nothing was found, eventually after about 5 months it went away. I have tried to put this out of my mind until the ultrasound, but have read that flank pain could be an early sign of ovarian cancer, that coupled with the fact that I'm not really sure what they saw on the CT scan has sent me in to a bit of a panic. I'm 38 years old and my sister has recently been diagnosed with cancer (not ovarian or breast related), which has made me worry even more. Are you able to provide any idea of what this could be?
Many thanks in advance for any info you can provide.
Posted Sun, 9 Jun 2013 in Women's Health
Answered by Dr. Timothy Raichle 54 minutes later
Hello, I would be happy to help you with your question.

I will assume that the flank pain is on the same side as the ovary seen on CT scan - please correct me if I am wrong.

First of all, ovarian cancer is incredibly unlikely. The symptoms are usually very gradual in their onset, and most women will describe bloating, distension of their belly, clothes not fitting right, and feeling 'full' when they have not completely finished a meal. Also, they are usually in the 50-60's age. By the time that they have symptoms, the CT scan would show extensive fluid in the belly and likely some sort of complex pelvic mass. You story does not fit this picture at all.

The GYN was probably right - you probably ovulated and this may have caused the pain. Ovulation involves a cyst that gets large quickly and resolves somewhat slowly. Sometimes this cyst can even bleed a little into the pelvis causing pain. The only thing I might have done differently is to get the ultrasound right after the CT scan, NOT wait 6 weeks. In fact, they could probably do the ultrasound now give the persistence of your pain and 4 weeks already passed. Hopefully, at some point, someone checked a pregnancy test!!

I hope that this helps - please ask if you have any followup questions!
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