Why weight loss from a benign tumor?

October 13, 2017 7:28 PM

My wife has been losing about a pound a month since last January. She had an ultrasound and they found a golf-ball sized "mass" in an ovary. The family doctor said that since the report on the ultrasound didn't mention fluids or any other structures, this was a good sign. The CA-125 blood test came back with good numbers.

The oncologist performed a hands-on examination and the mass moved. She implied that this was a good sign and said, "The vast majority of these cases are not cancerous." An MRI is scheduled for October 20 and a visit with the oncologist for Nov. 1.
Until that time, please help us put our minds at rest, provisionally and theoretically. I can find lots of reasons why a malignant tumor would cause weight loss, but none why a benign tumor of this kind would.
Any ideas?
Thanks.

posted by feelinggood to Health & Fitness (10 answers total)

For many women, weight is so hugely complicatedly tied to hormones that any disruption could alter the system. Onset of perimenopause, for me, came with a pretty much effortless 12-14-pound drop. Mostly I think that because I'm not having so much PMS, I'm not having so much fluid retention fluctuation or hangry cravings.

Because there's no identifiable money in it (yet), there's not a lot of research into the ballet of estrogen, progesterone, androgens, insulin, and all other kinds of brain-body juices.
posted by Lyn Never at 7:37 PM on October 13, 2017 [1 favorite]

Response by poster: I should add: My wife is going to turn 70 in January. Many years since menopause.
posted by feelinggood at 7:48 PM on October 13, 2017 [1 favorite]

Still having a mass on your ovary can cause hormone fluctuations.

Also, depending on size it can impact the stomach, intestines, or other structures. Pain fiddles with appetite as well.

Tumors benign or not divert nutrition and nutrients .

Or it could be entirely unrelated.
posted by AlexiaSky at 8:27 PM on October 13, 2017

Stress? 2017's been a rough year.
posted by Iris Gambol at 8:38 PM on October 13, 2017 [1 favorite]

Yeah, people (men in particular, with OBGYNs just behind them) seem to think this is all cut and dried, but if you are a woman and still alive you still have hormones and they can do stuff, and if you have ovaries they can do stuff there specifically.

But also being elderly is a fragile state and losing 10 pounds in a year is not that dramatic. In women, appetite and metabolism fluctuate with every possible variable.
posted by Lyn Never at 9:28 PM on October 13, 2017

A pound a month is not a lot, especially over a long period. Before my father's diagnosis the weight loss was very dramatic (20 or 30 pounds) in a short amount of time (two or three months I believe, possibly shorter).
posted by saucysault at 9:29 PM on October 13, 2017 [1 favorite]

Best answer: A loss of a pound a month is basically a 117-calorie shortfall per day, or the equivalent of a slice of bread. It adds up over time, but it doesn’t mean your wife’s habits have changed significantly. People gain weight over time the same way—they don’t just suddenly start gorging, they just eat a little more than they burn off.
posted by Autumnheart at 4:16 AM on October 14, 2017 [1 favorite]

Unintentional weight loss is pretty common in elderly people, and often not associated with any particular diagnosis. It may have something to do with reduced sense of smell and taste, or changes in lifestyle, or any number of things that are not necessarily bad or dangerous in their own right.

Just because it’s common doesn’t mean it’s not important though! Although losing 20 pounds over two years is obviously not as big a deal as losing it in two months it’s definitely something to be concerned about, because low body weight is associated with all kinds of bad outcomes in older patients.

I’m surprised your wife’s doctors aren’t concerned about the weight loss on its own and that they haven’t suggested dietary changes to turn this around. She should make it clear to them that this weight loss was not intentional and that it’s a concern for her.
posted by mskyle at 4:17 AM on October 14, 2017 [1 favorite]

AlexiaSky is completely right. Tumors often cause weight loss because they require energy to sustain themselves and grow; because they represent disordered growth, their growth is much less energy efficient than normal tissues, and often causes a greater metabolic burden than you would expect based on their size (e.g. something the size of a golf ball). These things are all true of both benign and malignant masses.

Another common way that ovarian masses cause weight loss is due to decreased appetite -- either feeling full much more quickly, or because of abdominal pain worsened by eating. Although a golf ball sounds small, the human pelvis is also pretty small, and having anything "extra" in there can certainly cause real but subtle changes in eating behavior (as well as bowel and bladder function, which are other symptoms frequently associated with ovarian masses).

Ultimately your wife's oncologist is the expert who has seen the imaging and the blood work, as well as performed a physical exam, and feels reassured that "the vast majority of these cases are not cancerous." I would hold on to that, and I wish you both the best.
posted by telegraph at 4:32 AM on October 14, 2017 [3 favorites]

Response by poster: November update:
The MRI last month showed the mass is not, in fact, in her ovary. She has been referred to a doctor who specializes in peripheral nerve surgery, since the theory so far is that it is somehow spinal or neurological. We have not yet seen this neurosurgeon to hear his opinion in person. The tumor is not considered cancerous at this point, since 99% of peripheral nerve tumors are benign.
We wonder what the gynecological oncologist was feeling when she did her hands-on, if it wasn't in the ovary all along. Oh well . . . .
Thank you all for your comments. Very helpful.
posted by feelinggood at 6:22 AM on November 14, 2017 [2 favorites]