Estrogen driven / receptive

I asked my oncologist if my ovca is estrogen driven or receptive.  I asked because others on the forum have access to different treatments if the cancer is estrogen driven. My onc told me that that does not apply at all to ovca, only breast. From what I read she is wrong.  I also told her that my path report makes me wonder if my cancer began in the appendix and was just diagnosed ovca.  She also said that that does not matter.  I wondered because mine was mucinous adenocarcinoma, site of origin not determined.  Appendix was so involved it was just eaten away. She dismissed my concerns without even considering the possiblity.  Am I wrong, or should she be willing to look into these things for me?? Thank you for all you do. Marie

[Annekathryn Goodman, M.D.]

Dear Marie
these are good question and your oncologist is also not wrong in her answers.

There is a class of malignant intra- abdominal tumors that can come from either of ovaries or the intestine. You are right, these tumors are called mucinous tumors.
For women who experience an advanced malignancy that involves both the bowel (appendix) and the ovaries, the most important first step is surgical cytoreduction.

That is , it is extremely important to remove all visible disease. Women who have an optimal surgery (defined as removal of  disease to less than 1 cm residual0, they have a better response to chemotherapy. Also there is a longer duration of remission and increased survival.

As long as a good surgery has been performed, it becomes less important whether the cancer starts int eh appendix or in the ovary.

Some ovarian cancers do slow down with the use of anti estrogen therapies such as tamoxifen, arimidex and other SERMs (selective estrogen receptor modulators).
These are usually of the endometrioid or serous cell subtype. They are usually grade one or two. It is not clear whether testing fro estrogen receptors is helpful but we do do that as these therapies are considered .

best wishes

[marie3B]

Thank you.  I have read so much about estrogen receptors and ovarian cancer it surprised me when my oncologist said it had nothing to do with ovca, only with breast cancer. I appreciate all that you do for us. Marie