IP Consolidation Therapy Risks

Hi, Stage 3B diagnosis. I have completed 8 treatments of carbo/taxol.  CA-125 before surgery over 1500, before start of chemo 50, and now 5.  Clear CAT.  Now my oncologist would like me to have 2nd look surgery followed by maintenance chemo via IP through a port in the abdomen, possibly cisplatin. I have read of this type of chemo being used with good success as first line treatment, but have not been able to find anything in regards to it being used as consolidation chemo.

Correct me if I am wrong, but I am concerned that since I have already
had surgery, wouldn't an abdominal port would require an extra invasive procedure in the area of the cancer cells which increases the chance of scattering the cancer cells into surrounding tissue?  

How do I weigh the risks vs. the benefits?  Would would you recommend to a patient of yours?

[Annekathryn Goodman, M.D.]

Hi Lisa,
Sorry about my delay in replying. I was hoping that the current annual meeting of the International Gynecologic Cancer Society Meeting would shed some light on the controversial issue of consolidation chemotherapy in ovarian cancer. Unfortunately not so.

I would say that the standard of care at the present time is to give 6 to 8 cycles of platinum (carbo or cisplatinum) and taxol after surgery for ovarian cancer.

Over the past 30 years many "consolidation" regimens have been tried and studied. None of them have really shown to reduce the recurrence rate for ovarian cancer. They just increase toxicity and reduce quality of life.

The most recent study  looked at one year of taxol given every three weeks (after the 6 cycles of carbo/taxol). The results suggested that there was an increase of "disease free survival" but that increase included the year of chemo. Not clear if this is really true or just playing with statistics. There has been quite a storm of controversy over this study.

If you were my patient, I would probably at this particular time, stop and just do check ups. Perhaps if more compelling data comes out, I will  change my mind but I have not seen it yet.
best wishes to you

[LisaLisa1]

Thank you, doctor, for your advice.