Chemo Treatment options

[Mobydick]

History: Diagn 2001 Stage2 OvC 6 sessions taxol/carb. 2.5yrs remission, April 2004 started 9 sessions taxol/carb. 9 mth remission, ca 500 lypth nodes through out body shown on PET, started taxotare 3 sessions, CA dropped, but now up to 700, CAT showed orig areas gone, but new areas showing, 6 session Gemzar. CA down to 50-60, but never steady. Dr suggested break to exaluate, CA slowly rising since April 2006 to 200. Any suggestions of what treatment to try now. Happy, healthy and strong in mind. Tks

[Annekathryn Goodman, M.D.]

Hello Tks, You sure have been through a lot of therapy. I am glad to know that you are doing well. There are many other options for you and your oncologist to consider. As long as your blood counts are good, your kidney and liver function are normal, and you are not having any trouble with bowel obstructions, I do recommend other therapy. There are no wrong answers. I completely agree with the choices of treatment that you have received so far. In general, our approach is to choose an agent. As long as the CA 125 is stable or dropping, that particular agent is continued. If the CA 125 rises or there is other evidence based on x-ray or physical examination that the cancer is growing, then one would make a switch. I am going to just list possibilities below. Please take them to your oncologist to discuss which one feels like a reasonable choice right for you. There are also clinical trials looking at new agents (phase 1 and 2 drug trials). You should ask you oncologist what is available at your institution.
Best wishes

Hormonal agents                
-tamoxifen                            
-arimidex   (anastrozole)      
-megace   (Megestrol acetate)                                                      

                                                                                                    
Oral chemotherapy      
-cyclophosphamide                      
-hexamethylmelamine                  
                                                                                                            
Intravenous chemotherapy
doxil    
-topotecan
-weekly taxol
weekly carboplatin
-weekly cisplatin

[kathy o]

Thanks so much for this info.....