Carbo/Taxol and CA-125

My sister, 45 years old, has started Chemotherapy and developed a recto/vaginal fistula after one week. After surgery she had scattered disease left on sigmoid colon and in pelvis peritoneum cul-de-sac. 14 days after first chemo Carb/Tax her CA-125 came down from 195 to 95. Does the chemo keep working for three weeks and dropping CA-125? We didn't get it checked prior to 2nd Chemo so I was just wondering if it goes up or down the third week. They may do surgery for fistula after 3 or 4 rounds if chemo removes all cancer, clear scan. Her cancer is aggressive originally clear cell, grade 3, stage 2C but after being sent to an expert changed to endometroid, high grade tumor, same stage. Is that a good thing? Is there anything to do if tumors don't completely dissappear in pelvis cul-de-sac? Thanks.

[Annekathryn Goodman, M.D.]

Hi There
Chemo is metabolized and is usually out of the body by one week.
It sounds like your sister's doctor has a good plan. A fistula can occur if there is some cancer in the intestine that shrinks with the chemotherapy. A fistula means a connection between two body regions such as the rectum and vagina.
endometrioid and clear cell cancers are different subtypes of ovarian cancer. The most important prognostic factor is being able to remove as much  of the cancer at surgery.
If the cancer does not completely disappear after surgery and chemotherapy, that is called persistent disease. That would be a worrisome situation because it means part of the cancer was not sensitive to chemotherapy. If that happens, we try different chemotherapy
take care

[Kapapa]

My questions is to the "fistula" and the Chemo.  My wife has ovarian cancer and has had the tumor removed, 6 session of Chemo or the last 6 months...5 with Carbo/dixol  and then changed cux of slow numbers to cardo/taxol...her second session is today...first seesion with taxol took slowily lower numbers from 134 to 96...biggest jump down yet...maybe this chagne was good idea.  my actual question is during the first 3 months she developed some sort of "cyst" (never confirmed)it seems to have drained thru her vagina cavity and she has been having clear discharge ever since.....at first it was green and vile....doctors say do not know...hole in vagina is not life threathening...cancer is...keep up chemo now and worry about hole and daily drainage later....I saw comments on a "fistula" and wonder if this could be what it is....  she had a colonostomy and has a stoma done at the time of the tumor remove...suppose to be temporary and reversed after chemo has "worked"??/  my wife hates the stoma more then the chemo and the cancer....

[akg]

Hi Kapapa,
It does not sound like your wife has an intestinal fistula. If she did, the drainage would be more like stool. She could have a fistula just to the abdominal cavity. I agree with just leaving it alone. You should ask her doctors about getting a CT scan to evaluate for a fluid collection. Yes, colostomies are very hard to deal with. You should ask if she has a reversible kind or a permanent kind. There are some very good support groups for people with colostomies. For instance look up the Unites Ostomy Association
www.uoaa.org

best wishes