ovarian cyst or cancer?

My 14 year old daughter has had 3 episodes in the past 8 months and the doctors have decided they are ovarian cysts.  She had another episode last night and it was longer and more painful this time.  I am wondering what are the differences between cancer and a basic ovarian cyst that eventually goes away?  I am worried we are going to beat around the bush for too long with out getting a diagnosis.  The doctor put her on birth control a month and a half ago, but apparently that hasn't worked to stop the cyst from bursting.  She has had 2 ultra sounds and blood tests in the hospital twice.  She has also had another ultra sound at the OBGYN.  This is very abnormal to me.  Her symptoms are sudden weight gain, intense pain during episodes, difficulty urinating, blood in her urine, and nausea, but no vomiting.  I am sick to my stomache that this could be cancer.  She has an identical twin who has always been a little smaller and has not had any episodes. This discussion is related to Do doctors consider ovarian cancer in teens?.
Answers:

I am so sorry to hear about your daughter. But, ovarian cancer is very rare in her age group and most cysts are benign. Ovarian cancer would present with a complex adnexal mass that does not resolve. There are many types of cysts and some women have chronic problems with them. I had many cysts in my lifetime before being diagnosed with ovarian cancer at the age of 37. I had my first surgery to remove a peristent cyst when I was only 15 years old. Cysts cuase a lot of pain and it is hard to get rid of them. In my case, I believe endometriosis was the underlying contributor to my cysts. Some of your daughters other symptoms seem like she may have PCOS. You should ask her doctor for a complete check. You may want to take her to an endocrinologist who is familiar with this condition. Medications are very helpful at regulating the PCOS and she may be given a special diet to help with the condition. I think you should keep pressing for answers and be sure to get her a complete gastrointestinal work up if no answers are found in the gyn checks. It sounds like she is miserable. It think since her gyn has not mentioned surgical removal, it is a good sign that he does not think her cysts are worrisome for malignancy. But, you should ask him and be sure. Get a copy of her scan reports. If her cysts are complex, she should consult with a gynecologic oncologist. Persistent complex cysts with symptoms may require surgical removal. You would want that type of cyst to be removed with the help of a gynecologic oncologist. Good luck in finding answers! Shelly


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