Live your love, Love your life

As always, we celebrated Christmas at our house. Britt's family and Sandy (Mary's mom) came over and brought their gifts. Kids were so crazy with their gifts and parents, too. Mary loves her gift so much. Britt needs a little tutorial of how his gift would help preserve his wine he..he.. I got my pedicure tools and new slippers from my hubby. I got him a software to convert his vinyl collections into CDs. He really loves it!

Monday, December 15th, my husband and I left the house at 9.05am to Dr. Kavoussi office. I was nervous my hands cold sweated. We'd sat in the waiting room for about 20 minutes before the nurse called my name. We came into the same exam room and waited for the doctor to come in. Dr. Kavoussi came about 15 minutes later. He shook our hands and started explaining the CT scan result and CA-125 result. Everything looks OK. There is no sign of possible cancerous cell in my abdomen and lung cavities. My CA-125 is 31 which is under the permitted rate (35) which means no cancer mark found in my blood. From what I read online, CA-125 is not always acurate, unless done repeatedly. And I did. My CA-125 result 2 months ago turned out negative so did it now.
I gave you a brief of what stated in the result form:
LUNGS : The lung bases are clear
PERITONEAL CAVITY: No ascites
LIVER: Normal
SPLEEN: Normal
GALLBLADDER: Normal
GI TRACT: Normal. Appendix is not seen. No percecal inflammation is identified

RETROPERITONEUM: No adenopathy is seen
PANCREAS: Normal
ADRENAL GLANDS: Normal
KIDNEYS: Normal
AORTA/IVC: The aorta/IVC is normal in caliber

PELVIS
URINARY BLADDER: Compressed by the large cystic mass of the left ovary
UTERUS: Compressed and displaced to the left by the large cystic mass of the left ovary
OVARIES: There is a 12.5 x 12.7 x 11.4 cm predominately cystic mass of the left ovary that does not contain calcifications. The right ovary appears normal deep in the right pelvis
RECTUM AND SIGMOID: Normal
LYMPH NODES: Normal

IMPRESSION:
Enlarging left ovarian cystic mass most likely an ovarian cystadenoma or cystadenomacarcinoma. No evidendence of omental disease or lymphadenopathy present at this time.

Cystadenomas?? This is way far beyond what I expected. Doctor explain there are 2 type of cystadenomas: serous and mucinous. Serous means it filled with watery fluid and about 2-6 cm in size. Mucinous contains sticky, thick gelatinous material and can grow very large. There are rare cases where this tumor can grow up to 40 inches in diameter and weighs 100lbs!

Weird! So, the cyst is NOT in my right ovary, as 3 doctors thought before. Also, it is not endometroid nor dermoid as the previous diagnoses. This confirms the transvaginal USG result before where doctor found that my cyst consists of two components: solid and fluid. In my case, doctor said, it looks like this cyst grow from germ cell outside the ovary in my peritoneal cavity and as it grow large it intermingled (somehow maybe even connected) with my left ovary. When I asked him, how does this cyst appear, doctor said there are many ways (read my previous article http://arisan-loveandlife.blogspot.com/2008/12/my-strugle-with-cyst.html). In my case, he thinks, it is something that "suddenly" or "spontaneously" happen and there is no way to prevent it. Genetical factor may add odd to this. It reminds me of my best friend who suffers from "spontaneous pneumothorax". It is a condition where the lung(s) could suddenly collapse without any early symptom. Esther would probably says,"Welcome to the club, Maria!" he..he..
By the way, Ther, I'm really sorry that I made you so upset for not answering your question straight ahead. I'm sorry that I "play game" with your worryness. I hope I'm still your sister. But, hey, I made you read this blog and call me...he..he.. Thanks for your call and support. It really helps me go through all this.
Back to the clinic, doctor explained the possible scenario of the surgery. Oh, FYI, he's not gonna do the surgery but his father (Dr. Kavoussi Sr.) would since he's been performing this kind of surgery for long time. There is gonna be another doctor during the operation (an oncology specialist) who's gonna perform pathology right after the cyst is taken out.
First, doctor will make horizontal incission on my lower abdomen, just above the pubic line. And, consider the size of my cyst, doctor would probably make vertical incission also to get a better look into my abdomen cavity. I was stunned, the image of having my stomach cut open with the small horizontal incission already made me sick. Now, they are gonna make a criss-cross cut. Oh Lord! This is not fun at all! I grabbed Loel's hand and he rounded his arm around my shoulder.
Next, doctor will take the cyst out and works at his best to preserve my left ovary. But, if the ovary is too damaged, then doctor will have to take it out. "Your health is our priority here, Maria." Another scenario: "If they find out there are some cancerous cell in the cyst, we will check on the other usually gonna take organs or parts that might be affected. At the very worst scenario, we will go ahead with histerectomy." Wait a minute! That means they are gonna take all my female organ out of my body?? No way! I'm still young, and we haven't started our family, yet. Doctor calmed me down,"We're talking about any possible situation that might happen during the surgery. That is why we are here now, I provide you with all possible scenario, even the worst one, and I want to know what would you like us to do. Loel said,"We want to keep her fertility organs as far as we could. So, please do your best to preserve them."
At the end, we told doctor that we need to discuss about this and will let him know in a few days. We left his office and went back home.
I almost forgot that I had another appointment with my dentist. My dentist needed to extract my lower left wisdom tooth. So, it will be like a little surgery. The tooth was badly decayed, has a big cavity on the side and from x-ray dentist said there is no way to save it and I had to let it go. Oh well... So, I dropped Loel home, I told him I'd be fine and I can drive back home after the procedure.
At the clinic, my dentist gave me oral and injected sedation and the process began. It took him about an hour to extract that damn tooth. He had to cut the tooth into two pieces to ease the extraction. After cleaning the canal area, he made few stiches to close the incission. He then asked if I want to see what my tooth looked like. It was nasty!
Then nurse gave me pain killer medicine, some gauze to stop bleeding and a list of things NOT to do after the surgery. Some of them are: do not drinking from the straw, do not drink soda/any kind of carbonated beverage, and do not smoke because any of these would create a dry air socket that cause a blood clot that may be fatal. She told me to comeback in a week to take the sutures out and to check up the wound.
I tell you guys, today was not one of my best days in life. Hey, but I learn my lesson: take care of yourself, or you'll be sorry. Second lesson, do not play game with Esther or she's gonna find and get you...he..he..

I had no idea what is the "prep" for the CT (Computed Tomography) scan. Stupid me I did not ask, I guess because I was too shock to learn that the cyst is still growing. Once again, thanks to internet, I searched online what to expect on CT scan so I can get myself ready.
Wednesday, December 10th, I had my breakfast early. When the clock hit 10am, I stop eating anything, only drank water. 11.30am I drove to Austin Regional Clinic at Quarry Lake which is near Costco, where I work. I gave the test form to the nurse in the front desk and sat in the waiting room. 10 minutes later, the other nurse called my name and she asked if I fast today. Then she lead me to another sitting room inside and gave me about 24oz of barium to drink. Barium is a chemical salt that works as a dye in our body so that the scanner could give a good impression of the targeted organ. Nurse told me to drink it up and she said there's gonna be another 12oz to drink just before the procedure. I asked whether it will make me urinate later on, she said no, because barium will go to my digestive system not to my bladder. Hm, interesting! So, I drank it up, it's banana flavor...yuck... I should've asked if they have strawberry flavor. I gave the empty cup back to the nurse which surprised her of how fast I drank. She then told me to wait for 2 hours to give barium enough time to fill up my abdomen cavity.
So, I spent my time working on my laptop. I had a calendar project with Photoshop to finish. I was thinking to chat with Loel but, to my surprise, there is no internet connection detected. Weird! Oh well, at least I have something to work to kill the time.
Two hours later, another nurse called my name and asked me to undress and wear the hospital gown, I have to remove all jewelry and other metal stuff that might intefere with the scanner. Then she lead me to the CT scan room. I sat there and she gave me another cup of barium to drink. Then she asked me to lay down. She put a pillow under my legs, spreaded blanket on me, and said that she's gonna give me some IVs for a contrast scanning. She inserted the needle in my right arm as the IV (intravenous) line and put my arms above my head. She said the whole process would take about 15 minutes.
Then there I went under the scanner. The machine told me to hold breath and to breath in. After series of scans, about 7 minutes later, the nurse came in and told me that she'd gonna give me the contrast injection (it's an iodine based solution). A bottle of saline solution and a bottle of contrast run through a tubing into a power-assisted injector then into the IV line that was placed in my arm. She explained that this contrast will give me funny feeling like flushing sensation, a salty or metallic taste in the mouth, urinating like feeling, and a brief headache, or nausea and/or vomiting. "If you have difficulties of breathing, numbness, sweatness, or heart palpitation, let us know. OK? That means you are allergic to this contrast." And just when the contrast entered my blood vessel, I felt all those sensations.
About 5 minutes later, the nurse came back in. "OK. You are done, sweety." She removed my IV and asked if I feel alright. I was a bit dizzy, other than that I was fine. I went out, change to my dress, and put all my project into my bag. Nurse gave me a piece of paper to give to the check out desk staff outside. I checked my cell there was 2 misscalls from Loel. I called him back told him that everything was fine and that I was ready to drive back home.
An hour later, I started to have gurgling in my stomach and a bit dizziness. I got diarrhea until the next day, which was expected as an after-effect of barium. Later that day, a nurse from Dr. Kavoussi office called me. She said doctor wanted to discuss with me about the CT result. I said I cannot do it tomorrow nor Friday. So I decided to go on Monday, December 15th.

It has been 2 months and 2 weeks since my visit to the second obgyn. Well, actually I went to the third obgyn for second opinion. But he has the same diagnose: ovarian cyst in my right ovary and need a surgical removal. Anyhow, I'm still doing my mostly-raw diet and taking herbs, vitamins, and supplements. The good thing about this diet is I lost weights but at the same time I feel more energized. I lost about 12lbs (about 5.5kgs) now I only weigh 103lbs (about 47kgs). Maybe because I cut a lot of fat that comes mostly from dairy products. (FYI: even though I was a vegetarian, I loved to eat cheese (especially cheddar cheese) and ice cream (Ben&Jerry is my favorite...oh God...they are heavenly good!).
My diet now includes more greens and whole grains. Drink plenty of water, orange or lemon juice (citrus fruits are among the alkaline foods, which are good for you), and almond or rice milk to substitute cow milk. My husband made fresh sun flower sprouts and almond milk every 2-3 days. Wholefood market and Sun Harvest become our favorite shopping destinations for organic foods. One thing you should know about fresh produce, always try to get one that is locally-grown. It means less time for transportation, which means less gasoline used, which means less carbon in the air and less contamination.
My period cycle is also becoming more regular (between 28-29 days) and I experience no pain that used to come with the period. Some of you may be familiar with that feeling, it's like having your lower abdomen twisted and squeezed. For some women, it may be accompanied with nausea, vomiting, cold sweat, light headed, even faint. I'm so happy that I no longer have to use my Midol to ease my pain.
Above all, I feel great and positive that this diet would work and I am ready to get another check up. So, I set up another appointment with yet another obgyn my friend, Ati, refered me to. I searched his profile online and he has a pretty good reviews from his patients. With my previous obgyns, I felt like a hopeless experimental mouse. They left me with limited information about what I'm going through. Thanks to internet technology, I'm able to search any kind of info I need and digest it.
The appointment was scheduled on Monday, December 8th. My husband was my companion. We came 10 minutes before to give me time filling out some paperworks. After about 30 minutes later, nurse called me and I went in. She checked my vital status: height, weight, blood pressure and pulse. Then I waited for another 15 minutes before doctor went in my room. Oh, and by the way, I did not tell him about my cyst problem. I wanted him to find it out himself and give me an updated result.
He reviewed my medical history and we talked about the possible fertility program that we might be doing. Then, came that moment when he put his hand on me and felt the bump on my abdomen. "What is this? Would you mind if we do some USG today?" I said, not a problem. Then, nurse took me to USG room and asked me to take my clothings waist down and laid on examine table. Doctor came in and did transvaginal usg to get a better look inside my reproduction organs. OK. I said to myself and pray, 'everything is gonna be alright... the cyst is shrinking now.. Oh God, please...it's going away..."
Doctor was surprised, but not as much as I was, "Wow, it looks like you have a really big cyst in your right ovary. The size is about 11cm by..." I felt my heart was about to jump with jolly. But then, he continued,"...ok...it's about 11cm by 12cm." I felt just like a balloon being popped out by an arrow. That damn cyst is growing. After all this diet and efforts and prayers, the cyst is still growing. Even bigger. I was stunned, did not know what to say. My tears ran through my cheeks. Doctor patted my hand to comfort me and asked if I want my husband to come in. I said yes. Then I dressed up, Loel came in, and we talked about the new finding.
Bassically, he recommended the same thing: open surgery. But, not like the other doctors I met before, he explained the details about what he found and step by step procedure that I might go through next. I was so devastated and frustrated, for sure. I felt that this holistic program only gave me false healthier feeling. But the way the doctor talked to us with such an empathy approach made me feel comfortable and he reassured me that things might not be as bad as they look like.
He then requested for a CA-125 blood test and CT scan. CA-125 is short for cancer antigen, is a test to mark any sign of cancerous cell in ovary and other reproduction organs. I did the blood test the same day but the CT scan must be done in certain hospitals which has the facility. I picked one that is close to us. Nurse made an appointment via phone and wrote notes for me. I have to do 4 hours fasting prior to the procedure. The appointment was set up for December 10th at 2pm. I can only drink water, or plain tea or coffee after 10am and I have to be at the clinic at noon to do some prep.

It was a nice autumn afternoon on September 26th, my husband and I decided to go to obgyn to have us checked for fertility. We've been married for 4 years and been trying to conceived since our first nite with no luck. I did search online and bought some fertility test strips and ovulite test. I check my BBT (Basal Body Temperature) every morning toward my estimated fertile days. We are both vegetarian, non-smokers and live a healthy life style. I feel like I did everything and think that it is time to seek for some expert's help. My husband agreed with me.
At the clinic, obgyn reviewed our medical hystories then he was ready to refer us to a fertility doctor. But, when he examined me, he found a lump in my abdomen. USG result showed a large mass in my right ovary with the size of 9cm by 13cm. My obgyn requested for a blood test and recommended a surgery. Since the mass is large, as he explained to me, the cyst must be removed through laparotomy, means it'll be an invasive major surgery with estimated 7-9 inches incission. I was shock to learn that the "small complex cyst" I have since 2 years ago keeps growing. I know the previous obgyn told me to come back in few months to close-monitor the cyst which, back then it's size was only 2cm by 3cm. But, as I experience no pain whatsoever and my period comes regularly, plus doctor said it may dissolved in few months, I did not have it checked.
We went back home feeling upset. We did search online to find more infos about this cyst and I stumbled into this website http://www.ovariancystsnomore.com/. It offers an e-book that contains diet and holistic way to get free of ovarian cyst. I was so frustrated and the image of having my abdomen cut open really frightened me out. So, I bought this e-book and started to buy all the supplements needed for the treatment soon after. As suggested, I changed my diet to mostly-raw, means 70% of what I eat should be raw, uncooked. We eat only organic food whereever possible. And I should avoid 3 "evil" things: dairy products, soy, and gluten grains. We started to grow our own sprouts, mung bean, amaranth, sun flower, lentils, etc. I made smoothies with wheat grass and spirulina. We replace cow milk and cheese with almond milk and cheese. I limit consumption of egg and white rice. Drink lots of water mixed with apple cider vinegar in the morning to cleanse my system, which is followed with drinking Total EFA oil, extra virgin coconut oil, olive oil with lemon juice.
My husband is a really good supporter. I'm so proud of him. He even slow down on coffee and alcohol since we learn that caffein and alcohol are among the list of acid foods. Our environtment has been feminized througout centuries because our diet contains lots of acid food that parts come from using chemical pesticide and cleaning product. Our bodies need to be alkalinized to balance the acidity.
Anyway, the blood test (CA-125) turned out normal. It relieved me a bit. I called my obgyn to put the surgery on hold since I'm going to do this holistic method first. I really hope and pray this diet with supplements would be my gateway to live free without cyst. Diet was a bit hard at the beginning. Sometimes, I was tempted to some tasty potato chips or my favorite cheddar cheese or a cup of Starbucks frapuccino with fluffy cream on top. Yum...! But every time I ate them I felt guilty and wrong and it consumed my mind for the next few days. So, whenever I craved for them, I simply rubbed the bump on my belly and started to visualize this: a good chunk of cheese that is getting smaller and smaller as I was able to control my cravings.
The holistic program takes about 60 days for the cyst to show positive result. But since my cyst is pretty big, it would take longer to dissolve. I plan to follow this program closely and have the cyst checked after 2 months. If there is any sign of shrinkage, I will keep on doing this program. But if the opposite occurs (means the cyst gets bigger or worse) then I have to consider a surgery. For now I just want to focus on this diet and my other visualization: me being pregnant with the baby and as the baby grows it eats the cyst bit by bit until it's gone. Gross...ha..ha..

About 3 years ago, I was diagnosed with complex cyst in my left ovary. The size was 2cm by 3cm. Doctor recommended pap smear test and blood test. Unaware about this, I searched online, through many health sites and found some facts that I did not get from my doctor. I'd like to write here so that you, my fellow ladies, would become aware of your own bodies and take a good care of them.

Description of Ovarian Cyst
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two cm is considered an ovarian cyst. An ovarian cyst can be as small as a pea, or larger than a cantaloupe.
Most ovarian cysts are functional in nature (some say "simple cyst"), as they are parts of menstruation cycles and have nothing to do with disease. We start puberty with about 400,000 egg-producing follicles in our ovaries. Each month hundreds of these follicles attempt to develop, fail to do so and (sadly) die. Only one (rarely several) succeeds in it’s developmental effort and continues the process that allows it to produce a mature egg. It enlarges, produces estrogen and secretes fluid that surrounds the egg, then breaks open and releases the egg into the fallopian tube during ovulation. Once its egg is extruded, the follicle continues to function for the next two weeks as a corpus luteum secreting both estrogen and progesterone; hormones that prepare the uterine lining to receive and nourish a possible pregnancy. In the absence of a pregnancy, the corpus luteum collapses and disappears. Hence, each month that a woman ovulates, a small ovarian cyst is formed; this usually measures 1.5 to 2 centimeters. Subsequent to the release of the egg, this cyst or corpus luteum may collect a small amount of blood prior to its degeneration.
the egg is not released during a woman's cycle, the ovary can fill up with fluid. Usually these types of cysts will go away after a few period cycles.
Most of ovarian cysts are benign (harmless, noncancerous). Ovarian cysts affect women of all ages. They occur most often, however, during a woman's childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove cysts larger than 5 centimeters in diameter.


Types of Cyst

1. Graafian follicle cyst
One type of simple cyst, which is the most common type of ovarian cyst, is the graafian follicle cyst, follicular cyst, or dentigerous cyst. This type can form when ovulation doesn't occur, and a follicle doesn't rupture or release its egg but instead grows until it becomes a cyst, or when a mature follicle involutes (collapses on itself). It usually forms during ovulation, and can grow to about 6cm (2.3 inches) in diameter. It is thin-walled, lined by one or more layers of granulosa cell, and filled with clear fluid. Its rupture can create sharp, severe pain on the side of the ovary on which the cyst appears. This sharp pain (sometimes called mittelschmerz) occurs in the middle of the menstrual cycle, during ovulation. About a fourth of women with this type of cyst experience pain. Usually, these cysts produce no symptoms and disappear by themselves within a few months. Ultrasound is the primary tool used to document the follicular cyst. A pelvic exam will also aid in the diagnosis if the cyst is large enough to be seen. A doctor monitors these to make sure they disappear, and looks at treatment options if they do not.

2. Corpus luteum cyst
Another is a corpus luteum cyst (which may rupture about the time of menstruation, and take up to three months to disappear entirely). This type of functional cyst occurs after an egg has been released from a follicle. The follicle then becomes a secretory gland that is known as the corpus luteum. The ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. If a pregnancy doesn't occur, the corpus luteum usually breaks down and disappears. It may, however, fill with fluid or blood, causing the corpus luteum to expand into a cyst, and stay on the ovary. Usually, this cyst is on only one side, and does not produce any symptoms.
It can however grow to almost 10cm (4 inches) in diameter and has the potential to bleed into itself or twist the ovary, causing pelvic or abdominal pain. If it fills with blood, the cyst may rupture, causing internal bleeding and sudden, sharp pain. The fertility drug clomiphene citrate (Clomid, Serophene), used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation. These cysts don't prevent or threaten a resulting pregnancy. Women on birth control pills usually do not form these cysts; in fact, preventing these cysts is one way the combined pill works. In contrast, the progesterone-only pill can cause increased frequency of these cysts.

3. Hemorrhagic cyst
A third type of functional cyst, which is common, is a Hemorrhagic cyst, which is also called a blood cyst, hematocele, and hematocyst. It occurs when a very small blood vessel in the wall of the cyst breaks, and the blood enters the cyst. Abdominal pain on one side of the body, often the right side, may be present. The bleeding may occur quickly, and rapidly stretch the covering of the ovary, causing pain. As the blood collects within the ovary, clots form which can be seen on a sonogram. Occasionally hemorrhagic cysts can rupture, with blood entering the abdominal cavity. No blood is seen out of the vagina. If a cyst ruptures, it is usually very painful. Hemorrhagic cysts that rupture are less common. Most hemorrhagic cysts are self-limiting; some need surgical intervention. Even if a hemorrhagic cyst ruptures, in many cases it resolves without surgery. Patients who don't require surgery will experience pain for 4 - 10 days after, and may require several days rest. Studies have found that women on tetracycline antibiotics recover 25% earlier than the majority of patients, a surprising correlation found in 2004. Sometimes surgery is necessary, such as a laparoscopy ("belly-button surgery" that uses small tools inserted through one or more tiny slits in the abdomen).

4. Dermoid cyst
Dermoid cysts (also called benign cystic teratoma) are the most common form of benign ovarian tumors in young women. These develop from germ cells which are primitive cells that are capable of producing eggs and all human tissues. A dermoid cyst is formed if the germ cells multiply bizarrely without fertilization, forming an encapsulated tumor that contains hair, sebaceous or oil materials, cartilage, bone, neural tissue and teeth. Dermoid cysts are most commonly diagnosed in women between the ages of 20 and 40. They range in size from one to 45 centimeters. Up to 15 percent of dermoid cysts occur on both ovaries. The good news is that 98 percent of these tumors are benign. Only on rare occasions do the overactive germ cells form malignant tumors (malignant teratomas).

5. Endometrioid cyst
An endometrioma, endometrioid cyst, endometrial cyst, or chocolate cyst is caused by endometriosis, and formed when a tiny patch of endometrial tissue (the mucous membrane that makes up the inner layer of the uterine wall) bleeds, sloughs off, becomes transplanted, and grows and enlarges inside the ovaries. As the blood builds up over months and years, it turns brown. When it ruptures, the material spills over into the pelvis and onto the surface of the uterus, bladder, bowel, and the corresponding spaces between. Treatment for endometriosis can be medical or surgical. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used first in patients with pelvic pain, particularly if the diagnosis of endometriosis has not been definitively established. The goal of directed medical treatment is to achieve an anovulatory state. Typically, this is achieved initially using hormonal contraception. This can also be accomplished with progestational agents (i.e., medroxyprogesterone), danazol, gestrinone, or gonadotropin-releasing hormone agonists (GnRH), as well as other less well-known agents. These agents are generally used if oral contraceptives and NSAIDs are ineffective. GnRH can be combined with estrogen and progestogen (add-back therapy) without loss of efficacy but with fewer hypoestrogenic symptoms. Laparoscopic surgical approaches include ablation of implants, lysis of adhesions, removal of endometriomas, uterosacral nerve ablation, and presacral neurectomy. They frequently require surgical removal. Conservative surgery can be performed to preserve fertility in young patients. Laparoscopic surgery provides pain relief and improved fertility over diagnostic laparoscopy without surgery. Definitive surgery is a hysterectomy and bilateral oophorectomy.

6. Cystadenomas
This is a type of cyst that arise from benign tumors and are more likely to occur in older women. These arise from cells on the outer surface of the ovary that secrete a watery or jelly-like fluid. Cystadenomas can become quite large and cause pain. The most worrisome (and largest) are mucinous cystadenomas. They are filled with a sticky, thick, gelatinous material which can seed onto other pelvic and abdominal surfaces causing multiple growths and collections of mucinous fluid. These tend to recur and may ultimately be fatal.

7. Pathological cysts
The incidence of ovarian carcinoma (malignant cancer) is approximately 15 cases per 100,000 women per year.
Other cysts are pathological, such as those found in polycystic ovary syndrome (PCOS), or those associated with tumors.
A polycystic-appearing ovary is diagnosed based on its enlarged size — usually twice normal —with small cysts present around the outside of the ovary. It can be found in "normal" women, and in women with endocrine disorders. An ultrasound is used to view the ovary in diagnosing the condition. Polycystic-appearing ovary is different from the polycystic ovarian syndrome, which includes other symptoms in addition to the presence of ovarian cysts, and involves metabolic and cardiovascular risks linked to insulin resistance. These risks include increased glucose tolerance, type 2 diabetes, and high blood pressure. Polycystic ovarian syndrome is associated with infertility, abnormal bleeding, increased incidences of pregnancy loss, and pregnancy-related complications. Polycystic ovarian syndrome is extremely common, is thought to occur in 4-7% of women of reproductive age, and is associated with an increased risk for endometrial cancer. More tests than an ultrasound alone are required to diagnose polycystic ovarian syndrome.


Symptoms
Some or all of the following symptoms may be present, though it is possible not to experience any symptoms:
Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent -- this is the most common symptom
Fullness, heaviness, pressure, swelling, or bloating in the abdomen
Breast tenderness
Pain during or shortly after beginning or end of menstrual period.
Irregular periods, or abnormal uterine bleeding or spotting
Change in frequency or ease of urination (such as inability to fully empty the bladder), or difficulty with bowel movements due to pressure on adjacent pelvic anatomy
Weight gain
Nausea or vomiting
Fatigue
Infertility
Increased level of hair growth
Increased facial hair or body hair
Headaches in some cases
Strange ribs pains, which feel muscular
Bloating
Occasionally, strange nodules that feel like bruises under the layer of skin
Feeling of lumps on the lower abdomen


Treatment
Treatment for cysts depends on the size of the cyst and symptoms. For small, asymptomatic cysts, the wait and see approach with regular check-ups will most likely be recommended.
Pain caused by ovarian cysts may be treated with:
pain relievers, including acetaminophen (Tylenol), nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil), or narcotic pain medicine (by prescription) may help reduce pelvic pain. NSAIDs usually work best when taken at the first signs of the pain.
a warm bath, or heating pad, or hot water bottle applied to the lower abdomen near the ovaries can relax tense muscles and relieve cramping, lessen discomfort, and stimulate circulation and healing in the ovaries. Bags of ice covered with towels can be used alternately as cold treatments to increase local circulation.
chamomile herbal tea (Matricaria recutita) can reduce ovarian cyst pain and soothe tense muscles.
urinating as soon as the urge presents itself.
avoiding constipation, which does not cause ovarian cysts but may further increase pelvic discomfort.
in diet, eliminating caffeine and alcohol, reducing sugars, increasing foods rich in vitamin A and carotenoids (e.g., carrots, tomatoes, and salad greens) and B vitamins (e.g., whole grains).
combined methods of hormonal contraception such as the combined oral contraceptive pill -- the hormones in the pills may regulate the menstrual cycle, prevent the formation of follicles that can turn into cysts, and possibly shrink an existing cyst. Also, limiting strenuous activity may reduce the risk of cyst rupture or torsion.
Cysts that persist beyond two or three menstrual cycles, or occur in post-menopausal women, may indicate more serious disease and should be investigated through ultrasonography and laparoscopy, especially in cases where family members have had ovarian cancer. Such cysts may require surgical biopsy. Additionally, a blood test may be taken before surgery to check for elevated CA-125, a tumor marker, which is often found in increased levels in ovarian cancer, although it can also be elevated by other conditions resulting in a large number of false positives.
For more serious cases where cysts are large and persisting, doctors may suggest surgery. Some surgeries can be performed to successfully remove the cyst(s) without hurting the ovaries, while others may require removal of one or both ovaries.
(Sources: Wikipedia health articles, American College of Obstetricians and Gynecologists, 1999c; Mayo Clinic, 2002e, MSNBC Health Today)