3rd recurrence of clear cell OVCA

[indrasis123]

My mom was diagones Clear cell OVCA in 2006 underwent total hysterectomy

followed by 6 rounds of
cisplatin + Taxol
and she was under total remission for about 21 month when she got it recurred

in her omentum and infracolic omentectomy done followed by 4 rounds of

doxrubicin +Cyclophophomide and 2 cycles of 5FU.

Now again after 8 moths 1 lymph node 3cmx2.17 cm was detected and doctor

said no treatment is required as her health was exellent and she was totally

asymtomatic. Still She is in exellent health and has no symtoms but now she is

having (after 3 months she was diagonised 1 lymph node) the same Lymphnode

with 4cm x 3.5 cm dimension along with two 2cm x2cm lymph nodes in her para

aortic region)(Co eliac region).

My questionas are
1) What combination of chemotherapy would be suitable for her now?

2) Would surgery (which would be 3rd) be a wise option for her?

3) Doctors are saying disease is not progressing as much as it generally

progresses coz earlier only one small lymph node and now after 3 months only

two very small lymph nodes.But they like to start chemotherapy to arrest it

despite a good health of my Mom. No weightloss, no drop of Bloodcount.

Waiting for your valuable suggestion as I got form you earlier.

[Annekathryn Goodman, M.D.]

Hi There,
thank you for your questions. I am glad to hear that your mother is feeling well and is in good shape. It sounds to me like she has very thoughtful doctors. here are my answers to your questions:


1) What combination of chemotherapy would be suitable for her now?
Usually we recommend single agent therapy such as: carboplatin, weekly taxol, gemzar, doxil

2) Would surgery (which would be 3rd) be a wise option for her?  Sometimes surgery for an isolated recurrence makes sense

3) Doctors are saying disease is not progressing as much as it generally

progresses coz earlier only one small lymph node and now after 3 months only

two very small lymph nodes.But they like to start chemotherapy to arrest it

despite a good health of my Mom.  I agree.

best wishes

[Annekathryn Goodman, M.D.]

Hi There
there are occasions where surgically removing lymph nodes is a good idea. This is when  there is no other sign of disease and the lymph nodes are isolated.

There can be several severe consequences to removing alot of lymph nodes:
swelling in the legs
pain from a neuropathy
increased risk of infection
the development of a fluid collection called a lymphocyst

take care

[indrasis123]

Thank you doctor for your reply. Is RPLND (Retroperetoneal lymph node dissection)  an option for her?
I came to know that isolated lymphnode recurrences are very good prognosys factor and she has  a better chance for long term remission. Is that true?

Though her CA 125 has become 536 from 128 in this 4 months.

Regards