Afraid to stop chemo

It has been a while since I posted!
Sept 2005: Dx. OVCA 3c .
10/05-10/06: Taxol/Carbo Avastin study NED Oct. 2006
2/07: CA 125 started to rise. Femara started. CA cont to rise
7/07: CA cont. to rise. CT Scans clear, PET showed activity in para aortic and iliac nodes, and outer liver. Started
        Doxil.
7/07-4/08: Doxil. Always on decreased dose due to skin. CA 125 up and slight node increase.
4/08- present: Study weekly Taxol and possible AMG 386. CA 125 12/13 x 3 months. CT scan Per RECIST:
        paraaortic node 10 mm, iliac node 6 mm. Dr. is consulting with radiologist to see if these nodes are normal size for me. Is talking about stopping chemo. I,of course, am concerned. What if this is keeping everything at bay? Maybe it is the weekly chemo regime that keeps a steady dose in body? Afraid if stop chemo, cancer will grow again and then I cannot go back on the study AMG 386 drug. I have minimal side-effects, work full time etc. Maybe I could stop Taxol and cont. AMG 386. If cancer grows, then AMG 386 may not be what was working. Then return to Taxol?  Should I have a PET scan? Also BRCA 2 positive. Any insights or suggestions. Fortunately, my Dr. is always open to ideas! As always, thank-you for your wisdom.

[Annekathryn Goodman, M.D.]

Hi There,

You ask a really important question!! When and if to stop therapy when you are living with cancer. It sounds like you are not sick from the cancer and you are tolerating the therapy well.

As far as the study drug, AMG 386, you should ask your doctor about what the rules are. All study drugs have stopping rules. That is required as part of the investigational review board rules.

In general for nonstudy chemo, I usually keep my patients on therapy as long as they are not having side effects and their cancer markers are not changing.
For instance, I have kept a few of my patients on doxil for more than a year when it has worked. Same is true for weekly taxol.  On the other hand if there are changes -increases- on exam, xray,or CA 125 , that is a reason to switch.
best wishes and please let us know how you are doing

[abrite]

Not sure if it would be helpful to know my side-effects:
- mild neuropathy in finger and toes
- mild fatigue
- monthly neulasta has kept my ANC up. Have not missed any chemo'

Thank-you again for your insights. Would also appreciate any questions you think I should ask my gynonc