QuestionI am a 54 year old very active, in good health female. I was training to run in my 7th marathon and was experiencing some lower back pain (structural) as well as a pulled hip flexor muscle. The sports med chiropractor suggested that I get an MRI of my back and my pelvic area. In the MRI results they noticed an enlarged uterus with some cysts or fibroids. I went to see my ob (woman) who I have been seeing for my yearly for about five years. She ordered an ultrasound and I asked about the CA 125 since our school nurse (I am a teacher) suggested it. She was reluctant at first, but then realized that it would be ok given the rest of the MRI results. In the ultra sound there were small fibroid tumors in the uterus, a slightly enlarged uterus as well as a small cyst on the left ovary.
My CA 125 was 46.4 and high end of normal is 35. she then said that if were her body, she would perform a complete hysterectomy. I was a little taken back, to say the least. I went for a second opionion to an older male doctor (a friend of mine works for him) and his approach would be a DnC, pelvic wash, biopsy (laporscopy?). I went ahead and scheduled with the male
doc because I thought his more conservative approach was the better, but then if there is cancer, I will have to go under anathesia again and have a hysterectomy any way. Should I go ahead with the complete surgery or would you recommend going in the steps to see if there is really any reason to take it all out. I am a little concerned because Ovarian and Uteran cancers are so hard to detect. I have not had a period in a year, but have experienced some in frequent and light spotting. He, the male doc, wondered if the CA 125 (which can have false positives) was elevated from my long distance running or the fibroids. He has told me to quit running for a couple of months. This is very hard for me and if it is not really necessary, I do not want to comply to this. I wonder who really has the correct answers. It is very frustrating to hope the experts know what is best. Can you help me?
AnswerDear Mary, I feel that your second opion MALE doctor is more on the right track than the FEMALE doctor who sounds KNIFE happy.....
It is a known fact that just ONE ca-125 test is NOT a good diagnostic tool... A sequence of these tests are really required (called a serial ca-125).... I think your MALE doctor, IF he makes sure he biopsies everything removed from you with the D&C and the laproscopic surgery, has the right idea.... However, I have never heard of running causing an elivated ca-125... But, other things like benign cysts, fibroids etc CAN cause an elevated ca-125....
Here is a web site I want you to look at and there are others out there as well....
http://pathology2.jhu.edu/ovca/ca125qa.cfm
Just remember, if this D&C and the laproscopy biopsies come back cancer, going under anetheria again is not a big deal unless you have a heart condition etc that requires closer monitoring.... Also, if all is NOT cancer, then you would have had a hysterectomy for nothing...
thank you, karen
