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CIS Platin to Gemzar and a CA 125 spike
I am a new arrival at MedHelp. I'm here on behalf of my wife who has recurrent epithelial ovarian cancer in her right lung. She's doing reasonably well, other than the anemia which is a real 'drag' (no pun intended). Jackie's chemo treatment started out with CisPlatin and Docataxol. The latter she couldn't tolerate at all. It gave her the equivalent of anaphylaxis. She was switched to CisPlatin and Paclataxol, but in the 12 intervening years since she had her original bout of ovarian, she grew intolerant of the CisPlatin. Her oncologist switched her to Gemzar and Taxol which she tolerates better and her CA125 levels were decreasing up until this last treatment.
She receives her chemo in 1/3 doses; over 3 weeks and then one week off. This last time her CA 125 marker went from 172 to 213. We were wondering why the spike after weeks of descending numbers. Does anyone have any insights to share with us on why this might be? Thank you.
She receives her chemo in 1/3 doses; over 3 weeks and then one week off. This last time her CA 125 marker went from 172 to 213. We were wondering why the spike after weeks of descending numbers. Does anyone have any insights to share with us on why this might be? Thank you.
A related discussion, Latest news on Jackie's chemo voyage was started.
MEDICAL PROFESSIONAL
Dear tato,
I am so sorry to miss your question.
You have been through alot. Your doctor has taken great care of you. Taxotere is a fine drug. It can be used any time, not just at the start of therapy.
Other drugs that your doctor may consider include:
topotecan
cytoxan
avastin (bevacizumab) in combination with other chemo such as taxol or cytoxan has been used. This is still experimental and very expensive. I do not know if it is available in Russia.
Please keep in touch
take care
I am so sorry to miss your question.
You have been through alot. Your doctor has taken great care of you. Taxotere is a fine drug. It can be used any time, not just at the start of therapy.
Other drugs that your doctor may consider include:
topotecan
cytoxan
avastin (bevacizumab) in combination with other chemo such as taxol or cytoxan has been used. This is still experimental and very expensive. I do not know if it is available in Russia.
Please keep in touch
take care
Dear Doctor Goodman,
My case is quite similar to the one of Mr. AndrewBL's wife Jackie, except for 12 years free of cancer.
I had an operation in November 2004, then followed with 2 separate periods between cancer returns lasted approx.8 months each.During all these time I was getting Oxaliplatin+toptecan (as 1st line before and after the operation), Taxol+Carpboplatin, Doxirubicine+Cisplatine+smthing followed with the second chemofree periods. Then after new cancer reccurrence I had 10 courses of Doxil, which was stopped in September last year when CA125 went up from 187 to 360. At this time the CT has shown liquid in the right lung pleura (like in Jackie's case) which was taken away and a a pleural effusion was made. Since then I received 6 courses of Gemzar+Carboplatin. After 3 courses the CA 125 went down to 217, CT shown stabilization bowel and little improvement in lungs (lymph nodes disappeared and metastazis became slightly smaller). But after 3 more courses the CA 123 went up to 500 (though there is liquid in pleural capsules created by effusion) and 2 more metastatic nodes in right lung. My doctor decided to start Taxotere next week. But I read everywhere that this is a drug for either initial treatment or for the 2nd line treatment. Am I on the right way of treatment? What drug would you recommend in my case? I'd be very grateful for your reply
My case is quite similar to the one of Mr. AndrewBL's wife Jackie, except for 12 years free of cancer.
I had an operation in November 2004, then followed with 2 separate periods between cancer returns lasted approx.8 months each.During all these time I was getting Oxaliplatin+toptecan (as 1st line before and after the operation), Taxol+Carpboplatin, Doxirubicine+Cisplatine+smthing followed with the second chemofree periods. Then after new cancer reccurrence I had 10 courses of Doxil, which was stopped in September last year when CA125 went up from 187 to 360. At this time the CT has shown liquid in the right lung pleura (like in Jackie's case) which was taken away and a a pleural effusion was made. Since then I received 6 courses of Gemzar+Carboplatin. After 3 courses the CA 125 went down to 217, CT shown stabilization bowel and little improvement in lungs (lymph nodes disappeared and metastazis became slightly smaller). But after 3 more courses the CA 123 went up to 500 (though there is liquid in pleural capsules created by effusion) and 2 more metastatic nodes in right lung. My doctor decided to start Taxotere next week. But I read everywhere that this is a drug for either initial treatment or for the 2nd line treatment. Am I on the right way of treatment? What drug would you recommend in my case? I'd be very grateful for your reply
The last CA 125 report went from 213 to 348. Jackie's oncologist wants to finish the last two (now one) session with the Gemzar, and then do a reevaluation using a CT Scan. Since Jackie reacted favorably to a combination of Cisplatin and Taxol 12 years ago, as well as the first three treatments late last year, he is thinking of returning to a combination of Cisplatin and Taxol for further chemotherapy.
We stopped the Cisplatin in December because Jackie's kidney function started to fail and we were afraid that continued use might be deleterious to her kidney function. It took several weeks to stabilize her kidneys, hence the Gemzar. Anyway, that's the short of it. We're a bit confused/unsure at this point regarding a best course of action. Thanks for the support...it helps.
We stopped the Cisplatin in December because Jackie's kidney function started to fail and we were afraid that continued use might be deleterious to her kidney function. It took several weeks to stabilize her kidneys, hence the Gemzar. Anyway, that's the short of it. We're a bit confused/unsure at this point regarding a best course of action. Thanks for the support...it helps.
MEDICAL PROFESSIONAL
Dear Andrew
thank you for the follow up information. Wow, what a rough year! It sounds like Jackie is getting wonderful and appropriate care.
please keep in touch
thank you for the follow up information. Wow, what a rough year! It sounds like Jackie is getting wonderful and appropriate care.
please keep in touch
My wife hasn't lived with Ovarian for 12 years. She was staged, at that time, at 3c. There was a complete hysterectomy and she has 6 lbs of tumor taken out (each ovary was approx. 3 pounds) but they were intact and metastasis had not occurred. The pathology lab at Johns Hopkins found a small measure of aggressive cells and the decision was to do 6 chemotherapy treatments (a phased (3) clinical study at NIH) using cis-platin and paclataxol. Jackie remained cancer-free (after the chemo therapy) for 12 years.
This past summer (June) Jackie came down with a minor case of Shingles. Following that she had pneumonia in her left lung, which was treated. Shortly, thereafter they discovered fluid in the lining surrounding the right lung; the lung filled rapidly and collapsed. She was treated by a thoracic surgeon for removal of the fluid (which was biopsied and found to have cells consistent with epithelial ovarian cancer). The lung lining received a pleural effusion to adhere it to the lung cavity wall to prevent further fluid build-up.
Post this treatment, Jackie was started on a 6 course chemotherapy initally with cis-platin and docetaxol. This was because she responded so well to this course 12 years ago. Not this time. She couldn't tolerate the docetaxol (anaphylactic reaction), so they switcher her to pacletaxol and cis-platin. By the 3rd course, her kidneys started to shutdown. After restoring kidney function, she was switched to a 3 week course of Gemzar and Pacletaxol (3 weeks on, 1 week off) which she's tolerating much better.
After her 4th course, the CA marker spiked from 172 to 213 (hence my last question to this forum). What was interesting is that we found that if my wife received her IV using a saline drip that she has a nasty reaction to the saline. When her oncologist switched the IV solution to Dextrose, Jackie tolerated it much better. Her oncologist was on vacation during the 4th course and the back-up physician used a saline (not dextrose) drip. It was after that that her CA marker spiked. That's the only correlating factor we could think of since there has been no fluid build-up in her lungs.
Now we're completing the 5th course (one week off next week) and then the (hoped for) 6th and last course. We'll see. Thank you very much for your evaluation, it was very helpful. Glad I found this forum.
This past summer (June) Jackie came down with a minor case of Shingles. Following that she had pneumonia in her left lung, which was treated. Shortly, thereafter they discovered fluid in the lining surrounding the right lung; the lung filled rapidly and collapsed. She was treated by a thoracic surgeon for removal of the fluid (which was biopsied and found to have cells consistent with epithelial ovarian cancer). The lung lining received a pleural effusion to adhere it to the lung cavity wall to prevent further fluid build-up.
Post this treatment, Jackie was started on a 6 course chemotherapy initally with cis-platin and docetaxol. This was because she responded so well to this course 12 years ago. Not this time. She couldn't tolerate the docetaxol (anaphylactic reaction), so they switcher her to pacletaxol and cis-platin. By the 3rd course, her kidneys started to shutdown. After restoring kidney function, she was switched to a 3 week course of Gemzar and Pacletaxol (3 weeks on, 1 week off) which she's tolerating much better.
After her 4th course, the CA marker spiked from 172 to 213 (hence my last question to this forum). What was interesting is that we found that if my wife received her IV using a saline drip that she has a nasty reaction to the saline. When her oncologist switched the IV solution to Dextrose, Jackie tolerated it much better. Her oncologist was on vacation during the 4th course and the back-up physician used a saline (not dextrose) drip. It was after that that her CA marker spiked. That's the only correlating factor we could think of since there has been no fluid build-up in her lungs.
Now we're completing the 5th course (one week off next week) and then the (hoped for) 6th and last course. We'll see. Thank you very much for your evaluation, it was very helpful. Glad I found this forum.
MEDICAL PROFESSIONAL
Dear Andrew,
thank you for your question.
I just wanted to clarify- has your wife lived with ovarian cancer for 12 years?
As far as the CA 125 values. it is always so frightening waiting for the results.
It is possible that the 213 value is a lab error, or is from some concurrent inflammation or irritation.
When the lung is involved, any fluid build up that irritates the lung lining (the pleura) can elevate the CA 125.
It is also possible that the elevation represents a plateauing of response to this chemotherapy.
At this point, one usually would repeat the CA 125 and consider continuing with gemzar for another month.
please let us know what happens
best wishes
thank you for your question.
I just wanted to clarify- has your wife lived with ovarian cancer for 12 years?
As far as the CA 125 values. it is always so frightening waiting for the results.
It is possible that the 213 value is a lab error, or is from some concurrent inflammation or irritation.
When the lung is involved, any fluid build up that irritates the lung lining (the pleura) can elevate the CA 125.
It is also possible that the elevation represents a plateauing of response to this chemotherapy.
At this point, one usually would repeat the CA 125 and consider continuing with gemzar for another month.
please let us know what happens
best wishes
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