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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Lower abdominal pain. Diagnosed as cyst. Elevated CA125 level. Should I get second opinion?

I m not sure if you can help me or not. I ve had lower abdominal pains which have worsened over the past three months. I was in hospital six months ago with an infection which was diagnosed as a sizeable cyst of 4inches on my left ovary but nothing was done and I wasn t given a follow up appointment. Since then, a similar pain has developed but worse on my right side which some days leaves me doubled over and a pain in my lower back started about a month ago. The pain in my left side is more of a dull ache which never goes away but the pain in my right sometimes is a sharp, burning pain. Some days it feels like extreme period pains but I never used to suffer during that time and now I m sometimes bedridden for a couple of days. I m not sure if its linked. I finally plucked up the courage three weeks ago to go and see a doctor who took blood tests. I d been told to go back this morning for my results. Unfortunately, the original lady doctor I d seen has since left the surgery and my appointment this morning was with a male doctor. He told me my levels of CA125 were 67 and although slightly elevated, it was nothing to worry about. He has arranged for a pelvic ultrasound in three weeks. However, he has ruled it out as anything to do with my ovaries and is suggesting that because of the pain in my back, it could be something called Scoliosis . He has also referred me to a musculoskeletal Clinic for an assesment. I ve never had any problems with my back previously. I can t see how this can explain the severe pains I m having and why this wasn t explored further when I was in hospital. I also can t find anything on the internet about what the level of CA125 should be? Should I get a second opinion or just wait for three weeks till my ultrasound? I d refrained from getting worried or reading anything on the internet till just now because what the doctor said, doesn t make sense. Now I m concerned that some of the symptoms of ovarian cancer are symptoms I ve had over the past couple of months. I m 31 yrs old and have never had children. I am asthmatic though and my recent cervical smear came back clear as did the other blood tests they did for thyroids etc. I m sure though that after I d told the doctor how I was feeling he would ve mentioned it as a possibility but he didn t mention it at all. Any advice you can offer me would be greatly appreciated.
Tue, 23 Apr 2013
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General Surgeon 's  Response
Hi and welcome to HCM.
It usually very difficult to determine is ovarian cyst malignant or benign. These cysts are most commonly benign and it is recommended to do frequent check ups and evaliat dynamics of growing. Malignancies grow much faster and infiltrate surroundsing tissues. There is really no better approach then it was recommended in your case. There is a possiblity of laparoscopic biopsy but it is invasive. I suggest to do this ultrasounds and if something suspicous is founds then it can be easily removed. CA125 is confusing many woman. This is a tumour marker, but is also found in endometriosis, benign cysts, PID and some other intraabdominal tumours and disorders. Wish you good health.
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Lower abdominal pain. Diagnosed as cyst. Elevated CA125 level. Should I get second opinion?

Hi and welcome to HCM. It usually very difficult to determine is ovarian cyst malignant or benign. These cysts are most commonly benign and it is recommended to do frequent check ups and evaliat dynamics of growing. Malignancies grow much faster and infiltrate surroundsing tissues. There is really no better approach then it was recommended in your case. There is a possiblity of laparoscopic biopsy but it is invasive. I suggest to do this ultrasounds and if something suspicous is founds then it can be easily removed. CA125 is confusing many woman. This is a tumour marker, but is also found in endometriosis, benign cysts, PID and some other intraabdominal tumours and disorders. Wish you good health.