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Chemo before surgery
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Chemo before surgery

I was diagnised with Stage3 OVCA in June. The only sign was ascites which made my abdomen so bloated that I had to be taken to hospital by ambulance. I had not felt in any way unwell and it was a complete shock to get the result. I had the fluid - which was malignant - drained off several times and was put on a course of chemotherapy - Taxol and Carboplatin the first time but then just Carboplatin as I reacted badly to the Taxol the second time and had to miss a treatment. The last ascites drain I had was at the end of October - just a small amount.
On Monday I have surgery for a complete hysterectomy and removal of omentum plus anything else the surgeon can safely take that is affected.  The chemo seems to have worked well as my abdomen is almost back to normal and I feel really well. At the pre-op medical I was told that I was in good health except for the one 'blip' meaning the cancer!  Some blip :(  
It feels quite unreal to be going into hospital well and come out feeling rotten!  Has anyone followed the same treatment pattern of chemo first and did the ascites return? I am scheduled for more chemo after surgery.  Wish me luck!
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Hello there - I'm in the UK too - in Herts, treated in London.  Yes, its' quite common to have some chemo first before surgery especially when they want to shrink the tumour to have more successful surgical outcomes.  I had surgery first, then chemo but halfway through the course had a second lot of surgery to get my omentum which hadn't been possible the first time.  I then completed the chemo course afterwards.  I also had bad ascites at the outset which was drained during the first surgery and it didn't come back afterwards, so here's hoping yours will do the same after your surgery.  It should do as the main source of the fluid expression, the tumour(s), will have been removed.  Where are you located?  I hope your surgery goes well - I was surprised how quickly I recovered although it took several months for me to feel fully OK.  I also didn't have much pain - they did a really good spinal epidural as well as a general and it worked great.  Good luck, Jenny
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Hello Jenny,

How nice to have such a quick reply!  I haven't come across anyone on the forum who has had chemo first - it seems in the US that they mainly do surgery first. I am in Shropshire and being treated at the Royal Shrewsbury Hospital.  No-one has mentioned an epidural - just a general anesthetic.
Also they don't do enemas which seems to be a part of the US format. Apparently they stopped doing that some time ago I am rather glad to say.
Can't say I am looking forward to Monday but I just want it over now.
How long ago did you have your operation? I haven't actually met anyone so far who has OC - not that I know of anyway - so it is nice to be able to communicate with someone in the UK who has the same problem - or shall we call it a 'blip' like the nurse did!
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As an "old" surgery nurse, the enemas are simply done to prevent contamination. Many people are so relaxed with anesthetic that the bowels move and this makes the surgery field a little messy to deal with. Besides it usually made me sick.   ha ha ha
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I've heard so much about how advanced the medical field is there...I'm from the US.  I have relatives in Switzerland & keep up w/ them.  Would it be okay if I put a post out to you "UK Ladies" after the 1st wk. of Feb, for some helpful advice.  I'm looking at a possible stage III Ovarian Cancer (derived from Ovarian Remnants).  I go in for a CT on the 2nd, then to a gen. surg. to preform the paracentesis (only if they're able to).  My OBGYN cautioned me that since I've had several operations (3 minor, 3 major, no repro. organs left), they may not be able to needle aspirate the fluid.  Have any of you had that problem & if so, how did you proceed?  I have a colonoscopy & laparotomy coming soon after.  Any suggestions on what to watch for (given they confirm malignant cells in cytology)?  I'm getting a little anxious...the fluid has been in there for over 9 months now & I have a tumor (confirmed by ultrasound over 11 months ago).  I'll be praying for you all & hope to hear from ya.  Peace.
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I'm from the UK as well and had a tumour removed from an old scar last July.  It was a recurrance of a tumour removed 16 years ago.  It was felt that chemo would be of no clinical value to me, even though it was a recurrance.  I'd been having symptoms beforehand and was glad to have the op.

I was 29 when I had my first laparotomy and the whole event came as quite a shock to me.  But then I felt quite alone with no support groups like this.  I ended up feeling extremely ill after and had to have a further op because of complications.  I was off work for 3 months and it took a year to bounce back.  

I wish you all the best for Monday.  I would say take your time for recovery, especially in the first three weeks and then gradually build up from there.  

So Lisa three weeks from now is the big day.  I wish you too all the very best.
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Hi,
I'm from the UK too. I started out as possible stage 3-4 OVCA last August, so followed that pathway until appendix cancer and pseudomyxoma peritonei was found during surgery.

Pre-surgery I discussed the options, at the time there was a huge European research trial going on into whether chemo should be given before or after surgery (for stage 3 only I think), or before and after for best effect, apparently there are mixed opinions but no conclusive evidence of best practice. There was a possibility of me going on the trial where it would be luck of the draw whether I got it before or after or both. I asked the McMillan Nurse her preference and she felt chemo before or before and after was looking better, however it often depended on the tumor grade,stage, size and other factors. As it turned out I was side-stepped from the trial as my CT scans and other results were very odd(showing extensive involvement across the whole of my abdomen and ascites, but I was relatively well - I went to my GP with a chest infection and mentioned stomach discomfort as a second thought. Once I knew the symptoms I was supposed to have I did start noticing them though!)

As regarding going into hospital well and coming out poorly. It happened in August, when I had ovaries, 24cm cyst, appendix and omentum out and bowel and diaphragm scraped of tumor. I'm now completely recovered from that episode, feel absolutely great and as my cancer is very slow growing (proberbly been there 2-3 years)didn't even realise I felt awful beforehand until I felt so well afterwards!

I'm due to go back in about 3 weeks to have the full cytoreduction and heated interperitoneal chemo (including large bowel resection, splenectomy, gallbladder out, hysterectomy, liver stripped and maybe resection, stomach stripped, peritoneal membranes and any remaining omentum removed, tumor stripped off small bowel/possible but hopefully not resection, with heated chemo directly into the abdomen during surgery, will take somewhere between 10 and 20 hours - eek!) Which will with a bit of luck get rid of the cancer for good, there's a 50-80% success rate, but it's got harder to imagine I'm going in there with nothing apparent wrong with me now, knowing that I'll have about 6 months before I feel anywhere near as well as I do now and with the possibility of some pretty rotten complications - it's plain weird!

I had an epidural for pain control - it was scarey going through the possible complications and consent, but even though I got most of mine down one side and nothing down the other it was pretty good. I'll be having this time too.

Lots of luck for Monday!!!!

Lisa
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Hi Echo,
I'm not too far from you,I'm in Staffordshire-your just over the border from me.I was diagnosed 3c in Feb 05.Had my chemo after surgery though.I've been on a few chemo treatments now,the last one (Gemcitabine/Treosulfan)has given me a very rough time.Its been stopped now as my tumors have continued to grow.The one tumour has damaged my kidney and I go in for surgery next Sunday to have a stent put in to try and save it.Then its chemo again after my 'kidney break' probably Etoposide.I've seen two surgeons now and they both decided the tumors are inoperable,but I'm talking to the surgeon again after my kidney op-see if I can change his mind! I keep in touch with Barney22-up above,regularly.Its lovely to meet you.
Keep your chin up and good luck with your op.
Sue x
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Just a quick note to thank you all for your good wishes.  I am hiding from everyone now as one of the family has developed a sore throat. Fortunately she only arrived home last night so I am hoping I don't get it or my op will be off!
I hope to be home next Friday all being well.
My very best wishes to all of you whatever stage of treatment you are,

Echo x
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