Resubmit Question to Dr Elaine Brown

Dr Brown I am resubmiting my follow up question to your Forum as requested by you. You had read my scan results in November 2008   showing a large Complex Cyst with solid and cystic components and  Papilliary Inclusions. 148x89x128mm.  You advised me strongly to have this checked I underwent TAH/BSO/Omentectomy this was done in the UK although I live in Cyprus..  I then endured  a second Laparotomy to restage the disease.within the Paraortic Nodes thankfully no further disease was present and I therefore did not require Chemotherapy. My Follow up is Local Policy 3/4 monthly pelvic exam and Ca125 monitoring.   My query to you all that time back Jan 10 was what is the protocol in the USA for a Patient with my diagnosis how would they be monitored would Chemotherapy be given or just regular checks.  Thankyou and Kind Regards April

[Elaine Brown, MD]

Hi again!
I hope this will asnwer your question:
Here in the States, if the disease is confined to one or both ovaries with no spread to the capsule, and negative nodes, pelvic washings, and biopsies, we don't give chemo.  The stage would be Ia.
For anything other than Ia chemotherapy would be advised.  I think the current regimen is taxol and cisplatinum.
I certainly hope you have stage 1a disease, as that would be considered surgically cured, and we would do the follow up exams quarterly with ca125 levels.  Most oncologists would throw a CT scan or two in there, although that varies.  Many oncologists are using PET scans now too, to look for metastatic disease/recurrence.

Brigham & Women's Hospital and Massachusetts General Hospital in Boston are two very fine facilities.  Also, MD Anderson in Texas and UC Irvine in California.  They probably have websites with more in depth information too! The specialist you would see in the States would be a Gynecologic Oncologist.
Good luck!
Dr B