I was diagnosed IIIC Jan'05, had optimal debulking and 8 rounds of carbo/taxol. My CA125 crept up slowly from 10 in Aug.05 after chemo was done to 29 in June'07. Last week at my regular 3 month check-up, my CA125 spiked to 109. I had a CT scan the next day and my gyn.onc. found I had several enlarged mesenteric lymph nodes all clustered in a small area on the scan, said it was a recurrence and should be treated with 6 rounds of carbo/taxol (lower dose than the first time) every 3 weeks. I would be grateful to hear your opinion. Thank you.
Your doctor knows you the best. If your doctor feels that the lymph nodes represent a recurrence, that may be so. A rising Ca 125 and a change on the Ct scan in the setting of a history of treated ovarian cancer is most likely a recurrence.
I would suggest that you ask your doctor the following questions:
-Could the Ca 125 and the lymph nodes represent anything else?
-Do you have any history of or development of inflammatory bowel disease?
-Does the CT scan show any other abnormalities?
-is there any role in adding a PET CT scan or doing a biopsy of these lymph nodes?
Mesenteric lymph nodes are lymph nodes that run along the web of blood vessels that supply the intestine. Usually "mesenteric" lymph nodes refer to the small intestine. It is possible to develop a recurrence here but if there is no other sign of cancer, I would want to be sure I was not missing another problem.
Ovarian cancer can recur (come back) in many ways. The behavior of a particular cancer depends on many factors that we do not understand. However, in general there appear to be 2 major types of behavior :
1- cancers that spread along the surface of the lining of the abdomen (peritoneum). These cancers are usually associated with fluid in the abdomen (ascites) and tumor growth in the fatty tissue that is attached to the stomach (omentum). There is usually also a coating of cancer along the surface of the other abdominal organs such as the intestine, spleen, liver, and stomach.
2. Cancers that spread through the lymph node system. Commonly, women who experience ovarian cancer with this behavior type will not have alot of tumor within the abdominal cavity. Most of the tumor will be in lymph nodes.
There are definitely some cancers that will exhibit both type one and type two behaviors.
For women who experience type one ovarian cancer, when this cancer recurs, there is ascites or fluid in the lung or a coating along the surface of the intestine, stomach, omentum
For women who experience type two behavior for their cancer, a common recurrence will be only in lymph nodes but not within the lining of the abdomen per se.
You should ask your doctor what type of cancer behavior was seen at your surgery in 2005.
If the cancer had type one behavior, then it would be unusual (although not impossible) to just see a recurrence in mesenteric lymph nodes.
I agree with Hazel - when the mesentery of the bowel is involved, removing the cancer involves removing the associated intestine. Sometimes that can lead to very little remaining intestine. If a person does not have a certain length of small intestine, they are unable to digest their food. When that is the possibility, chemo is a much safer option than surgery.
Hi there I just wanted to comment that my Mom also had the same situation as you and just finished 6 rounds for her recurrence which also was in the lymph nodes but in aortic lymph nodes. Ask your doctor if they can be removed, my Moms were not. There was more risk involved in removing them then just by treating them with chemo.
My wife has enlarged lymph nodes in her chest. She is 5 years out from her origianl diagnosis. Her CA125 has spiked to 70+. How is your mom doing and what are they doing for her? They tried to biopsy my wife but the nodes were too tough to get to. Actually, they tried once but the specimen came back as muscle tissue, not lymph node. She's had an MRI recently to see about breast cancer (negative) and is slated for her second PET scan this week. The first was in January 07.
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