Now, here's the big question.
That's again the cancer fear that all women have. The answer, I'd say is no. This has been looked at pretty, pretty extensively. There was a much large study I think it was in Sweden. They looked at something like 90,000 – they've got a very sophisticated system of registry in Sweden where they can look at data. And something like ninety thousand women were paired with 90,000 normal ones and the various kinds of cysts, endometriomas, the functional cyst, the non-functional cyst. And they said "Well what's the likelihood of any of these women come back for ovary cancer"? And there was no difference. If you had an ovary cyst that was benign you had no increased incidence of having cancer later. The only difference in this was endometrioma which had a slight increase difference. And possibly the reason for that is something to do with estrogen sensitivity around the ovary. But again it's, it was something more common but it's nothing to say "My gosh, I've got endometrioma, by now I've got to have cancer." That should be the farthest thing from a persons mind. So I'd say without your question –
The fact that one has a cyst it is not going to develop to, you do not have an increased cancer risk. Now certainly the cystadinomas it's felt that some of these, these are the benign tumors. Can these cystadinomas develop into cystoadnocarsonoma? The answer is, yes probably. But, once you've removed it, the cystadinoma, as well as removing the dermoid cyst, which are very rarely cancer you've eliminated that risk. If a woman is going to have a cancerous cyst it's going to be there from a cancerous cyst per say. She most likely is over the age of fifty and their, in general the reproductive years do not have, a woman does not have to be concerned that a cyst is going to transgress, develop into a cancer.
There was something else I wanted to mention. I'm sure we've got several questions, yet I do want to go through these. I think that's pretty much my overview on cysts and the various diagnoses of cysts, the types of cysts. The treatment we can summarize that at the end.
What happens when a cyst is likely to rupture?
This is probably the number one life threatening complication that New York OB / GYN Christopher Freville has to deal with on an almost basis. A cyst can rupture be it a, most likely it's a follicular cyst or a corpus luteum cyst. These are the so-called functional cysts, or the functional cyst with pregnancy. When they rupture generally nothing happens. In fact, there's usually a pressure relief.
Because any distracted cyst is often what gives, as a cyst's nerves are increased by the distension, by the fluid, that's often what causes the pain. The relief of the pain comes whenever it ruptures. Often like, unfortunately a ruptured appendix. Sometimes when a patient feels an appendix ballooning up and brings him to the doctors the fact that the appendix becomes distended. Immediately after that there's a rupture and they do not feel the pain. Unfortunately what causes the problems with ruptured cysts is if the cyst has a very rich blood supply and that blood supply, the arteries start pumping blood and do not seal off and the abdomen can fill up with blood. And I've dealt with many cases both as an ectopic pregnancy, but the conditions typically much worse, but also, as a, rarely as a ruptured cyst that's bleeding off a cystic pregnancy. And often times the abdomen can literally become distracted. In a severe case woman can go into shock meaning their blood pressure falls out, it's an emergency, life threatening situation that if undiagnosed can be fatal. Fortunately, with emergency rooms being equipped the way they are, doctors being as smart as we are – we rarely miss this. But once in a great while this is a complication. And when the cyst ruptures it does not, you can usually reserve the ovary. Usually it can be sutured over, quarterized. The ovary stays in tact and even in a rare case if it had to be removed, again that does not affect fertility.