Irritable Bowel Syndrome Message Boards | GOOD GRIEF: laparoscopy now?

Hi, dear Michelle!

So sorry about this new wrinkle! Having just been down the cancer road myself, very unexpectedly, I can imagine a bit how you feel. Before I go any further, I'd just like to encourage you with this little statistic: as I understand it, fewer than 20% of women who undergo exploratory surgery are diagnosed with ovarian cancer - and most women who have the surgery have more alarming symptoms than you have (fluid in the pelvic region, increased white cell count, etc). Also, we know you have a loving Heavenly Father who is also the One Who is able to heal any disease. One of my dearest friends is an ovarian cancer survivor, against all human odds!

Now, would you mind if I asked a few "mom-like" questions? I've been doing health-care research for about twenty years - a purely altruistic endeavor - I don't have any health-care training - but I've learned a few things and that's part of my motivation for asking you these things - not any intent to alarm you or act like a "know-it-all" but just sincere concern, so here goes:

1) Are you having a laparoscopy or laparotomy? The first is minimally invasive, while the second involves a traditional incision which affords the doctor a greater field of vision, as I understand it. 2) Have you had a transvaginal pelvic ultrasound - sometimes called TVS - (it gives the radiologist the closest look at the ovaries without doing surgery - it's done inside and also outside, on top of the tummy - painless every time I've had one); CT scan? or a CA-125 - blood test (not a fool-proof test but combined with the trans-vag ultrasound or CT scan can sometimes be helpful)? ** please forgive me if you've already posted about these things - I should have looked back to see but I just rushed on to reply to you! all of these tests may be irrelevant, based on your particular set of circumstances ** However, all of these tests can sometimes give an oncologist a better idea of what's going on before s/he even gets you to the OR. 3) This brings me to my next question: have you had a second opinion with a board-certified gynecologic oncologist? Has your ob/gyn suggested this? With no disrespect intended toward your ob/gyn, if cancer is even suspected and exploratory surgery is going to be performed, most cancer organizations, like the National Cancer Institute, would probably advise a person to have the testing and any exploratory surgery performed by a surgical oncologist, if at all possible; in this case, a gyn-oncologist. They will generally have the most experience in the surgery and in knowing what they're looking at while they're in there - and just where to take the tissue sample from - they have a good "eye" for what's healthy, what's not, etc., even before the pathology report. Also, if cancer were to be found, a person would normally be treated and followed by an oncologist (either surgical, medical or radiation). So, it can make sense to begin the whole process with the gyn-onco. At the very least, a second opinion from a board-certified gyn-onco might be prudent. (Depending on where you live, you might have to go to a larger city to see one. I live in Cincinnati and we only have four gyn-oncologists, and we're not exactly a small town).

Just purely FYI - and you may already know this - anyone can call 1-800-4CANCER, which is the PDQ database of the National Cancer Institute (part of the National Institutes of Health) and ask for a cancer information booklet about specific cancers - like ovarian cancer. A person can also request a list of medical centers near them with board-certified oncologists or oncology programs (the NCI has divisions - not exactly ratings - that identify cancer treatment programs by their scope of experience and types of cancer treated). Then, within the medical center, a person would identify the oncologists who diagnose and treat the cancer they're concerned about - in your case and mine, it's a gynecologic oncologist.

I have been so blessed through my ordeal: God had already prepared the way for my diagnosis and treatment - He's the One Who prompted me in that still, small voice to ask for the transvaginal ultrasound - a test my former gynecologist did every year. When that revealed an abnormal thickening, I had to rush and find another gyn (my former gyn had taken a new position in another city), and he was very responsive and immediately did an in-office biopsy. I have been very happy with him but I already knew that my former doc would have immediately sent me to the gyn-onco - and I even knew which of the four gyn-oncos he would have recommended! All this was prepared for me in advance! I didn't waste one minute worrying about offending the regular gyn by choosing a gyn-onco to do my surgery - it's my life on the line. I wanted someone who had spent 20 years studying, diagnosing and treating cancer - IF I had it - which I wouldn't know until after.

If you haven't done this already, you can check out some sites on the web about the diagnostic testing for ovarian cancer. A couple of "user-friendly" articles can be found at: womenshealthchannel.com/ovariancancer/diagnosis and lifetimetv.com/shows/strongmed/fact -- uh-oh, I didn't finish writing down the address, but it's Strong Medicine - Ovarian Cancer fact sheet or something like that once you get to the site. These aren't "scholarly" but they are informative.

Well, with all that said, I hope I haven't added to your burden. Feel free to tell me (gently, though!) to "MYOB", and just toss this into the round file! Also, please remember that I'm not trained in medicine - this is very general information, not intended to take the place of professional medical care from your own physician.

I'll be praying for you and your dear husband and children, that God will give you HIS wisdom and fill you with HIS peace - the peace that passes understanding! Keep us posted. Looking forward to a good report!

In Him,
Kaybee C

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