Question: I am a 39-year-old female with a 5-cm complex ovarian mass on my sole remaining ovary. The mass was discovered incidentally on a CT during a recent trip to the ER for severe abdominal pain and cramping that began and has progressively worsened over a month's time. It started out as mild discomfort about 10-20 minutes after eating, but now it is severe pain shortly after eating and serious discomfort in my abdomen and lower back all of the time. I've lost about 25 pounds in 2 months--some of that was intentional, but I'm now losing about 1 pound/day and am severely malnourished due to my inability to eat very much without pain. My GYN wants to surgically remove the mass and my ovary, but warned that I have an extremely high risk of incurring damage to my colon or kidneys due to my numerous previous abdominal surgeries (2 C-sections, right ovary removal, hysterectomy, gall bladder, appendectomy) and being overweight. Although I am BRCA1-, my mother and sister are positive (maternal grandfather's line carries the gene mutation), and my mother is dying of Stage IV ovarian cancer--her mother was not a carrier, but also died of ovarian cancer. A GI specialist wanted to do a colonoscopy today, but canceled because I was too weak and ill to undergo the procedure. My questions are: Given my family history of ovarian cancer, should I proceed with the surgery despite the high risk of damaging my colon and/or kidneys? Should I see a gynecological oncologist even though malignancy can't be confirmed before a biopsy? Do my symptoms sound consistent with either ovarian or colon cancer (most important question). Thank you so much for your response!

Thank you! My follow-up question is about the biopsy you mentioned. How would the doctor obtain a biopsy from the ovarian mass without performing surgery? Could the surgeon biopsy a piece of the mass in the OR to help make the decision to remove the entire ovary or will the entire ovary need removed anyway, given the size of the mass? Thank you.