I think with the multitude of new tools out there to assist with diagnosis it is easy to feel up beat and confident that these will always provide useful information.
However I'm not sure sure. My recent experience disturbed me. After a successful recovery from stage II OC 17yrs ago I got on with my life. During this period other health issues rose up to give me a nip but nothing I couldn't manage. More recently I've felt very unwell so my Gastro Prof organised a CT scan which showed a pelvic cyst.
I was promptly despatched to Gyny oncology and had various discussions with the doc. The concern was that the OC had returned (I had a subtotal hysterectomy and removal of ovaries). Good news was my CA125 was low.
This whole episode was worrying, although I still didn't feel that this cyst was the cause of my symptoms which mainly consisted of total exhaustion. First step now was that I had a trans vag u/sound to view and measure the cyst.
Next stage was to go for an MRI. I couldn't fault the hospital for thoroughness and speed. This showed the cyst, small but possibly involved with the remnant of cervix, bladder and possibly the bowel. Scary stuff. There was talk of a FNA via the vagina with the risk of cancerous cells dropping into the pelvis. I wasn't keen on that! We decided on a wait and see for a couple of weeks with another trans vag to see if the cyst had increased in size. This procedure confirmed the first trans vag but also showed a 2nd cyst in the remnant of cervix though this was felt to be harmless.
There was talk of surgery but with the possibility that the bowel could be involved I was then sent for a sigmoidoscopy to see if this was the case.
Back for a second trans vag u/sound; the good news was there was no real increase in size
but the cyst did look suspicious, had its own blood supply and more alarmingly had solid areas.
Off then to a Centre of Excellence. Shock and awe. What a difference. Not just the smart building, swish colour schemes and overall newness. It was the attitude of staff. From the people on the main doors to the Consultant. Everyone I met was polite, courteous and welcoming.
They were keen to carry out their own trans vag prior to my meeting the Consultant surgeon to discuss options. This was done on the spot by an female doctor who had a very confident manner and felt like a safe pair of hands. She was extremely gentle; carried out the scan very carefully; turned the screen to share the images with me and said that it was looking good, the cyst was fluid and likely to have formed from a small pocket of fluid emerging the remnant of cervix. No blood supply and no solidity. Great news.
Doc then said that she wanted to just run this by the Consultant in the imaging unit so that he was happy with her findings. Along he popped, used the probe and had a look himself; again showed me on the screen and was clear that all was looking good. I did ask whether this type of cyst was a normal occurrence but was told it was not.
I then showed him the report from the trans vag scan that I'd had a week before. And although he didn't say anything negative he reaffirmed that his finding was the opposite.
Although I've scrunched all these event into this post they did of course take place over a period of months. A worrying period for myself and my family. Whilst I am of course pleased that I was investigated thoroughly some sleepless nights and deep discussions were had, based on the original trans vag findings. When I've mentioned to the docs that I felt the cysts were picked up by chance and weren't responsible for how unwell I've been feeling I suspect they felt I was in denial.
It's obviously not practical to go around asking a second opinion for every investigation you have BUT if my original hospital were still carrying out ops I would have had one based on their findings, especially the trans vag scan. It was very lucky for me that they have stopped the OC cancer operations and elected to send patients to the Centre of Excellence or I'd no doubt have my surgery date planned in!
I'm not quite done as the C of Excellence is now requesting my previous CT and MRI scans. They'll review them in one of their group mtgs and I then have a follow up appt to hear their views. Needless to say I feel a lot more positive than I did a week ago.