Jatoo & everyone RE: Mom chemo

[Hazel30]

My Mom just finished her 9 week clinical trial for antibodies with a follow up CT scan.  Doctors determined that she will be having a recurrence  in Feb due to  slight rise in ca-125 and iliac lymph  node slightly enlarged 1.4 cm.  Now 10 weeks later ca-125 is 72 and lymph node 2.0 cm.  Because there is a 20% progression they recommend back to chemo Taxotere/Carbo.  
She is a little upset because of the hair loss again and everything else that comes  with chemo.  

Im curious to know weather its best for her to go back to carbo/taxotere again or reserve it for later and try something else?  Another question does anyone know where that lymph node is located.  Her ct scan was clear beside that enlarged lymph node.

Thank so Much
-Fiana

[freshair]

Hi, I am sorry to hear as always of a recurrence. There was a study posted that there was a longer survival where surgically removing the lymph node was better. You have to search back. I think I posted it.

If it were me (hindsight and with this new research) --I would have it removed (depends on where it is--not sure but you can do a search on the internet).

This study was not on removing masses but on a single node involved.

Much luck to you and my best to your Mom.
Helen

[Hazel30]

Yes, my Mom also asked me if that was possible and Im not sure but I will research on line and speak with her doctor about this.  Thanks for the info.

[SimplyStar]

there are 8 to 13 iliac lymph nodes   all situated around the iliac vessels  they are usually grouped  in 2 and 3's  they are important to the immune system, they would be arranged following lines on both sides of the pelvic area   sometimes they retain fluid and grow larger

[rmarie]

Here is the news report on the lymph node removal.  I just had surgery for a non lymph node recurrence and start chemo on Monday.  Good luck to your mother.  



Surgery for Isolated Nodal Metastasis of Ovarian Cancer Provides Favorable Survival
Researchers from John Hopkins and the Cedar-Sinai Medical Center have reported that patients with ovarian cancer who have a recurrence in a lymph node have favorable survival when the involved lymph node is entirely or almost entirely removed. The details of this study appeared in the March 2007, issue of Gynecologic Oncology.

The role of secondary surgery in women with ovarian cancer is controversial. However, there may be selected patients who clearly benefit from this approach. Researchers involved in this study performed a retrospective review of the effects of secondary surgery for isolated nodal recurrence of ovarian cancer. This study included 25 patients, the majority of whom had initially been diagnosed with advanced, aggressive ovarian cancer. Participants had received prior surgery followed by chemotherapy with a platinum agent cisplatin or  carboplatin. Optimal cytoreduction (surgery to remove cancer with 1 centimeter or less of cancer remaining) was achieved in all patients.

The median length of hospitalization was four days.
There were no significant side effects associated with surgery.
At a median of 19 months, 40% of patients were alive with no evidence of cancer, 28% were alive with evidence of cancer, and 32% had died of the disease.
The median overall survival following surgery was 37 months.
These researchers concluded that optimal cytoreductive surgery for patients with ovarian cancer that has recurred in a single lymph node “is associated with a favorable long-term survival outcome.” Patients with recurrent ovarian cancer may wish to discuss with their physician their individual risks and benefits of surgery.

Comments: Surgery appears to be relative effective in this select group of women with residual or recurrent ovarian cancer limited to isolated node metastasis.

Reference: Santillan A, Karam A, Li A, et al. Secondary cytoreductive surgery for isolated nodal recurrence in patients with epithelial ovarian cancer. Gynecologic Oncology. 2007; 104: 686-6

[Hazel30]

Hi there, so I  guess from what this iliac lymph node is and its functions its impossible to remove it?  or another words not beneficial in my Moms case.
Also you said its in the pelvic area?  Because thats where  she's been having some discomfort.
Thanks for the info.
Fiana

[SimplyStar]

No they can remove lymph glands,  just can't remove them all,  they do a selection,  it cuts down on the lymph node system some but is not fatal.

[rmarie]

there were some cancer centers that removed most of the abdominal lymph nodes to stop the spread of OVCA, this, I believe has not been supported by the research.  However, when they do our initial surgery, they do remove lymph nodes for biopsy.  Because they are in pairs, the other picks up and does the work.  the fluid that moves in the lymph system also moves in the blood vessels. The removal of one lymph node is very possible, unless it is an area that they cannot reach, or if removing it can cause severe damage, ie problems with a blood vessel.  I would ask your mother's physician about the study I posted and see what he/she says.  It is worth a shot.  They remove lymph nodes all the time when they operate on women with breast cancer.  

[Ang80]

Hi
I always look out for your posts.
Sorry to hear that the trial didn't go as hoped. I know how worried you are and I am the same with my mum. How much has your mums CA125 risen she the start of the trial?
With regards to the operation, I am not a Dr but am a daughter of a OVCA sufferer like yourself and my opinion is to remove everything possible that is infected with horrible disease. I know they can't take everything away but if they can remove it then get rid of it and the disease!
When mum was having her debulking they said they might remove her spleen but it would be a lifetime on drugs. I told mum to have it removed as its better to take drugs then have an organ with cancer inside it, it turned out they didn't need to remove it.

What happens now in terms of treatment? Are you going back to 6 cycles of taxol and carboplatin?

Take Care and thinking of you and your family.

[Hazel30]

Thanks to everyone for your support.  My Parents and I discussed the option of surgery and we are all for it.  Now the next step is to discuss this with my Moms gyn/onco.  At this point I cannot see why we cannot remove this lymph node along with chemo but I have to see what his thoughts are on this.  Thanks again and I will post once we meet with him in a week.

To Ang80:  My Moms ca-125 was I believe 47 when she started her chemo.  Four weeks later was 51 and another 4 weeks later was 76.  

-Fiana

[Helmar]

Hello... I also had a cancerous lymph node in the left groin area. I've since had 7 rounds of Carbo/Taxotere and this has reduced the node considerably. I spoke with my Surgeon about the possibility of more surgery to remove this lymph node, but the answer was an empthatic no. He explained that it laid very close to the main artery, and one tiny slip into that artery and it would be 'goodnight' for me. I'm not ready to go just yet.. so I'll hang in and go with the chemo. Losing my hair is the last thing that worries me... I would rather be bald and be here, than have the best head of hair in the cemtery. :-)
I wish you Mum all the best, and hope she will get good results...Helmar...

[freshair]

Hi Helen,

I just love your sense of humor! Head of hair in the cemetery--I just got a good belly laugh and you know how good those laughs are for us all.

Stay well,
Helen

Yes, it depends on where the node is.

[Jatoo]

Dear Fiana:

Sorry for your mom. My computer was down yesterday.

Surgery is a very good idea if possible. Please keep us posted if this is going to happen. Going back to Carboplatin Taxotere would be interesting particularly if she recurred less than a year or six months. I pray that she can go back to remission.

Jatoo

[Hazel30]

She recurred about 10-11 months after her last treatment of carbo/taxotere.  I believe that still makes her platinum sensitive.  She will also continue her antibody trial along with the chemo and hopefully that will give her a longer remission again.

[Jatoo]

Dear Fiana:

That's a good sign. It's almost a year and that makes her sensitive to the chemo. My wife was only like four(4) months. That's why I was that desperate to look for alternatives.

All the best,
Jatoo

[Helmar]

Hi Helen... Glad you had a laugh :-)... we can all do with one. I think that's probably one of the reasons that I manage... I try not to take things too seriously. The cancer is here... I'm doing what I can, along with my Docs. to keep it in check, so what's the point in being 'doomy and gloomy' about some hair. If I can keep off this poison long enough, I guess my hair will eventually grow back, but if not.... well, I don't really care. My wig is good. :-)
How are you doing now? Hope you're feeling well, and enjoying your days.
Best wishes and warm hugs from 'Down Here'....Helen...