Fistula surgery during chemotherapy

CA125 was 296 pre surgery 195 pre chemo and dropped to 95 two weeks after 1st chemo then 2 weeks after 2nd round dropped to 18.9 My sister needs a temporary colostomy for recto-vaginal fistula. She is stage 2C, Endometrioid, grade 3 with a pelvic mass before chemo that seems to have responded very well. I believe the surgery would extend chemo interval to 5 weeks, laproscopic. She would also benefit from 2nd look.  Her Dr. says it is up to her when to have surgery so I am asking is it safe after say 3 or 4 chemos or better to wait after 6. She can't sit and pain are reasons for early surgery. Possibility for pelvic radiation after surgery to cul-de-sac if disease still present? Also will CA125 change much from say 2 weeks after chemo to day of chemo? Thanks.

[Annekathryn Goodman, M.D.]

Hi There,
It makes sense to remove as much of the cancer as possible as soon as possible. usually we consider an interval surgery after 2 to 3 cycles of chemotherapy unless a person is not medically stable for surgery
best wishes

[kmoe]

Although I appreciate the comment it did not address any of my questions. I was asking about a laproscopic surgery to repair a fistula to relieve pain and suffering as soon as possible. Not an interval de-bulking. She had debulking surgery with "bulk of disease has been removed". She also had a CT scan show some kind of mass before starting chemo and her CA125 was 195. It dropped to 19 after two rounds of chemo. I would think that her cancer is almost gone.

[akg]

Hi there, I would think if she needs a surgical repair of her fistula, she will need a laparotomy
best wishes