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Done with Surgery
My mother has completed 3 cycles of Carbo/Taxol and underwent surgery yesterday. It was a very long one lasted around 11 hrs. The surgeons said that she was optimally debulked. On opening her they found that the tumor had not invaded her rectum and found no bowel involvement. The Scans had shown no spread to the diaphragm but they could see some spots on that which they could trip out. They also found deposits in the peritoneum more at the ascites drain site and had to strip out pretty much the entire area of the peritoneum to get complete clearance.
On the surgical front they where happy with the outcome but said that the 3 chemo cycles she has had should have cleared most of the peritoneum deposits but it has just shrunk it. They have sent the tumors and other stuff they removed for testing to get a better picture. They have also implanted an IP port.
Before treatment her CA125 level was 4700 and pre surgery it was 700.
My questions are:
1> Since she has already had 3 cycles of Taxol/Carbo. Will the next 3 cycles via IP be of any help. What ever research i do on the net they give stats for 6 cycles via IP?
2> The surgeons were concerned that the cancer spread to the ascites drain site during chemo which is not a very good sign. However the PET did not show any activity.
3> Is her Cancer Chemo resistant, since it did not clear up the peritoneum after 3 cycles. The surgeon has scheduled a meeting with the medical Onco to see what needs to be done next?
4> Are there any sites in the US where we can send her tumor for culture to see how her cancer will respond to different chemo agents to plan her further treatment?
Thanks
On the surgical front they where happy with the outcome but said that the 3 chemo cycles she has had should have cleared most of the peritoneum deposits but it has just shrunk it. They have sent the tumors and other stuff they removed for testing to get a better picture. They have also implanted an IP port.
Before treatment her CA125 level was 4700 and pre surgery it was 700.
My questions are:
1> Since she has already had 3 cycles of Taxol/Carbo. Will the next 3 cycles via IP be of any help. What ever research i do on the net they give stats for 6 cycles via IP?
2> The surgeons were concerned that the cancer spread to the ascites drain site during chemo which is not a very good sign. However the PET did not show any activity.
3> Is her Cancer Chemo resistant, since it did not clear up the peritoneum after 3 cycles. The surgeon has scheduled a meeting with the medical Onco to see what needs to be done next?
4> Are there any sites in the US where we can send her tumor for culture to see how her cancer will respond to different chemo agents to plan her further treatment?
Thanks
1. Since she has already had 3 cycles of Taxol/Carbo. Will the next 3 cycles via IP be of any help. What ever research i do on the net they give stats for 6 cycles via IP?
I did not have IP chemo, but the women in my oncs office who have had it say they are pleased. Others on here have had it and could tell you more about the specifics of it. I will try and find someone to respond to you.
2. The surgeons were concerned that the cancer spread to the ascites drain site during chemo which is not a very good sign. However the PET did not show any activity.
When I had my recurrence my PET & my CT were clear. My CA 125 was rising rapidly and my onc said it was microscopic cells and he wanted to get rid of them before they had a chance to buddy up and attach to something. Although it isn't a good sign that there was spread while on chemo, it did move to a weakened more susceptible spot and the onc might be doing IP to blast the chemo directly at that site, which should give it a better chance of working.
3. Is her Cancer Chemo resistant, since it did not clear up the peritoneum after 3 cycles. The surgeon has scheduled a meeting with the medical Onco to see what needs to be done next?
She did phenomenal with the 1st 3 IV chemos. Her CA125 came down 4000 points and that has to be called a success in anybody's book!!! Has she had another CA125 test since her surgery? I am sure it came down even more after that. It is fairly common to do 3 chemos prior to debulking to make it easier to get out larger tumors and it is becoming more common to do 3 IV an 3 IP chemos. There must be some study on it somewhere because my onc is doing it more. There isn't any reason to think that the IP chemo won't work as well if not better than the 1st 3 IV chemos. Also, chemos are cumulative and that stuff stays in your body & keeps working long after your last chemo.
4. Are there any sites in the US where we can send her tumor for culture to see how her cancer will respond to different chemo agents to plan her further treatment?
I know absolutely nothing about this subject, but I am going to look into it. I have had one recurrence and the drug they gave me worked, but it made me really sick. If they only had a test that showed you the most effective drug that wouldn't make you sick!!!!
It is really good news that the bowels & rectum were not involved as that could be serious, complicated, and altogether uncomfortable as one of our friends here knows all to well. I ope this has made sense. I slept all day & it is 1 am and I am getting sleepy now. Good luck to your family and I will be praying that your mother has some peace of mind and that her numbers continue to go down.
Kindest Regards,
Jan
I did not have IP chemo, but the women in my oncs office who have had it say they are pleased. Others on here have had it and could tell you more about the specifics of it. I will try and find someone to respond to you.
2. The surgeons were concerned that the cancer spread to the ascites drain site during chemo which is not a very good sign. However the PET did not show any activity.
When I had my recurrence my PET & my CT were clear. My CA 125 was rising rapidly and my onc said it was microscopic cells and he wanted to get rid of them before they had a chance to buddy up and attach to something. Although it isn't a good sign that there was spread while on chemo, it did move to a weakened more susceptible spot and the onc might be doing IP to blast the chemo directly at that site, which should give it a better chance of working.
3. Is her Cancer Chemo resistant, since it did not clear up the peritoneum after 3 cycles. The surgeon has scheduled a meeting with the medical Onco to see what needs to be done next?
She did phenomenal with the 1st 3 IV chemos. Her CA125 came down 4000 points and that has to be called a success in anybody's book!!! Has she had another CA125 test since her surgery? I am sure it came down even more after that. It is fairly common to do 3 chemos prior to debulking to make it easier to get out larger tumors and it is becoming more common to do 3 IV an 3 IP chemos. There must be some study on it somewhere because my onc is doing it more. There isn't any reason to think that the IP chemo won't work as well if not better than the 1st 3 IV chemos. Also, chemos are cumulative and that stuff stays in your body & keeps working long after your last chemo.
4. Are there any sites in the US where we can send her tumor for culture to see how her cancer will respond to different chemo agents to plan her further treatment?
I know absolutely nothing about this subject, but I am going to look into it. I have had one recurrence and the drug they gave me worked, but it made me really sick. If they only had a test that showed you the most effective drug that wouldn't make you sick!!!!
It is really good news that the bowels & rectum were not involved as that could be serious, complicated, and altogether uncomfortable as one of our friends here knows all to well. I ope this has made sense. I slept all day & it is 1 am and I am getting sleepy now. Good luck to your family and I will be praying that your mother has some peace of mind and that her numbers continue to go down.
Kindest Regards,
Jan
COMMUNITY LEADER
1> Since she has already had 3 cycles of Taxol/Carbo. Will the next 3 cycles via IP be of any help. What ever research i do on the net they give stats for 6 cycles via IP?
IP chemo is a relatively new treatment, so there probably has not been time to release any studies that deviate from the normal protocol of 6 treatments. I would imagine your mother's doctors feel it would be beneficial to her, however. It tends to be much stronger than normal IV chemo because it is administered directly into the abdomen onto the cancer cells.
2> The surgeons were concerned that the cancer spread to the ascites drain site during chemo which is not a very good sign. However the PET did not show any activity.
PET Scans can be limited in what they can detect. Cancer cells smaller than an inch may not always be picked up in a scan. It is possible the cells may have been there and shrunk as the other sites in the peritoneum did. This is just a guess, however.
3> Is her Cancer Chemo resistant, since it did not clear up the peritoneum after 3 cycles. The surgeon has scheduled a meeting with the medical Onco to see what needs to be done next?
It is probably too early to say she is chemo or platinum chemo resistant. The normal protocol for IV or IP chemo is 6 cycles. Since she has not reached that yet, it would be presumptious to say she is resistant to chemo. Usually, a patient is not considered platinum chemo resistant unless remission is achieved after the initial 6 cycles of chemo, but has a recurrence within 6 months.
4> Are there any sites in the US where we can send her tumor for culture to see how her cancer will respond to different chemo agents to plan her further treatment?
The test you are asking about is called a chemosensitivity assay. There are several laboratories in the US that provide this service, but I am not qualified to recommend one over another. You can look it up and do some research and decide which one you think is best. Perhaps someone else who has used this service will come along and make some recommendations to you.
I hope this helps. Best wishes to you and your mother as she fights this. Please come back and let us know how the IP chemo works out for her.
Gail
IP chemo is a relatively new treatment, so there probably has not been time to release any studies that deviate from the normal protocol of 6 treatments. I would imagine your mother's doctors feel it would be beneficial to her, however. It tends to be much stronger than normal IV chemo because it is administered directly into the abdomen onto the cancer cells.
2> The surgeons were concerned that the cancer spread to the ascites drain site during chemo which is not a very good sign. However the PET did not show any activity.
PET Scans can be limited in what they can detect. Cancer cells smaller than an inch may not always be picked up in a scan. It is possible the cells may have been there and shrunk as the other sites in the peritoneum did. This is just a guess, however.
3> Is her Cancer Chemo resistant, since it did not clear up the peritoneum after 3 cycles. The surgeon has scheduled a meeting with the medical Onco to see what needs to be done next?
It is probably too early to say she is chemo or platinum chemo resistant. The normal protocol for IV or IP chemo is 6 cycles. Since she has not reached that yet, it would be presumptious to say she is resistant to chemo. Usually, a patient is not considered platinum chemo resistant unless remission is achieved after the initial 6 cycles of chemo, but has a recurrence within 6 months.
4> Are there any sites in the US where we can send her tumor for culture to see how her cancer will respond to different chemo agents to plan her further treatment?
The test you are asking about is called a chemosensitivity assay. There are several laboratories in the US that provide this service, but I am not qualified to recommend one over another. You can look it up and do some research and decide which one you think is best. Perhaps someone else who has used this service will come along and make some recommendations to you.
I hope this helps. Best wishes to you and your mother as she fights this. Please come back and let us know how the IP chemo works out for her.
Gail
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