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Chemo before surgery????
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Chemo before surgery????

I had my gyn/onc appointment today. The doctor said that I definitely have ovarian cancer and probably stage 4. After looking at my the results from my abdominal fluid, biopsy, ct and chest xray the doctor made some suggestions regarding treatment.

He wants to do several rounds of chemo, then debulking surgery and then chemo again.

Is normal to have chemo first??? I thought that the standard procedure was to have surgery and then chemo. He has given me a couple days to think about it and get a second opinion if I want. I am not sure if this is the right way to go. Has anyone else gone this route???

Thank you,
Kimberly
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Hi. My mum has just been diagnosed with ovarian cancer and is having chemotherapy first followed by surgery and then more chemo. My understanding is that the initial chemotherapy is to shrink the mass so that it is easier to operate on.  Unfortunately I can't give you more details as I do not know them yet. Good luck x
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Hello,

Quite a lot of patients have chemo first.  I had six rounds over six months prior to surgery to dry up ascites and shrink the tumour.  I felt really well by the time I had surgery (felt like saying don't bother :-)  ) then I had four more chemo after surgery.

Best wishes,

Ruth in the UK
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I had 6 rounds of chemo after my diagnosis and just 3 weeks ago had my debulking surgery.  I had exploratory for my diagnosis.  When they did the surgery there were no visible signs of cancer although the biopsy showed microscopic still....Depending on where you live is how they do it... chemo first or surgery... Here in Central America it is almost always chemo to  shrink the masses down to make the chemo work better...

Different studies show different things.  My Oncologist just attended a cancer convention at MD Anderson in Texas and said they are doing more of the chemo first.... studies show a better result for stage 4 patients like me.  

Trust in your doctor... I did and I lived my entire life in the United States.  My ca125 is now down to 6  where it went from a high of 380.

I agree with Ruth I felt so good I didn't want them to operate....
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Kimberly - I have no insight to offer you but I just wanted to tell you that I have thought of you often over the last couple of days and I will keep you in my prayers - blessings and best wishes.
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The decision to go with chemo first is not unusual.  They start with the chemo to shrink the tumors and then go in an remove anything that is remaining, as well as a proper staging and removal of the uterus, tubes, ovaries and the omenteum, along with lots of biopsies.  Chemo usually dries up the fluid, so you will feel better.  Good luck to you, this is a scary time with lots of decisions to be made, when your brain wants to leave your body.  We are here.  
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Thank you for your responses. I am seeing the oncologist today. I feel pretty comfortable with him, so I will trust him and the people here who have had positive experiences The thought that my stomach won't be so bloated is very welcomed.

Echo and Vegas what kind of chemo did they put you on? Were there a lot of side effects? I am hoping to get more info today and ask him lots more questions since I have been researching a lt since Monday.
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I was on taxol/ carboplatium which is usually the standard first line... side effects total hair loss  low hemoglobin and hematocrit, and neuropathy in hands and feet.  I must add that I am a type 1 diabetic who suffered from neuropathy BEFORE the chemo and it just made it worse.. some have no side effects of neuropathy at all... I was tired but it only took me about 4 days to come back around.  I did take injections of neupogen to keep my white blood cell count up.

IMPORTANT... for naseau I took emend which is a pill you take 1 before chemo and 1 next day and then one more.. (expensive but worth every dime) and Aloxi which was put into my IV...All in all not bad...

Much good luck and sending you hugs........... Ronni
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I had taxol and carboplatin for the first treatment but after having an adverse reaction to taxol on the second treatment I continued on Carboplatin alone. My hair thinned but didn't all fall out (it grew back curly but that has grown out now - pity - I liked it :-)  )
I had no real side effects apart from some loss of sense of taste and some ringing in my ears but those all cleared up. I did have two units of blood - once part way through the first six treatments and at the finish of the last four as carboplatin can lower the red blood cells.
I didn't go into remission but stabilised with a CA125 of 284 (was 6000 at diagnosis).  I am due to see the oncologist in three weeks - last chemo was May 7th.

Hugs,

Ruth in the UK xx
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I am in the middle of this right now. Dx Stage 4 because of peritoneal carcinomatosis and mets to neck nodes and too much cancer in my abdomen for surgery.  Three rounds of taxol/carbo first, surgery 3 weeks ago and at least 3 more chemo rounds soon.  The first 3 rounds made me much more comfortable and the surgery much easier according to my gyn/onc. I have a bad week after chemo, a so-so week and then a good week before the next round.  I was petrified of nausea, and although I do have a number of days of that, it is manageable with zofran and emend.  I get preventive neulasta injections and lately procrit for anemia. My CA-125 went down over 90% and my ascites dried up after just one round of chemo.  On the Dr-Patient forum I asked the same question about this course of treatment and was told this is exactly what should be done.
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Thank you all so much for the info. At least  I know somewhat what to expect. I begin chemo Monday.... so I will make sure I get something for the nausea since I get sick to my stomach really easy. I was told by the doctor about the possibility of the problems I could experience with my hemoglobin and hematocrit. Thank you for info. Kimberly
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Good luck with your treatment - you should be feeling much better in time for Christmas :-)

Ruth X
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I was dx stage IV in Nov 2005 after getting sick in Aug and not getting better. I gradually got worse and worse to the point that when I was dx they didn'tthink my health was good enough to survive surgery. I went on the normal 56 rounds of carbo/taxol then had a reaction to the carbo on my 6th round. After a CT scan my onc decided on 2 more rounds of chemo (taxol only) to shrink everything as small as possible. When I finally had my surgery in June of 2006 they only found one other small spot on my diaphram an removed it. (I still had tumors in my liver, but they couldn't be taken care of at that time) After recovering from surgery my onc has kept me on chemo (as a maintenance)and I have since had to change regimes twice now. Before they begin with the actual chemo med, you should have what they call a pre med drip which can last anywhere from 1 - 2 hours. But it contains anti-nausea drugs. I was also prescribed Ativan and Compazine in case I needed them at home. (By the way, when it came time for surgery I was feeling great and bounced back in no time) I wish you the best of luck. Chris
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