Maintenance Chemo

[Hazel30]

Today my Mom had her check up appt w her gyn/oncol.  Her 4th out of 6 treatments is tomorrow.  Her doc brought up a thought about Maintenance Chemo since we are soon approaching the end to her 6 cycles.  Said we'll discuss it later in 6 weeks when she comes back , I think then she will be all 6 treatments.  She is 46 and was dx stage 3c.  She's been doing well with chemo, today we saw her ca-125 diagram chart that shows the level it drops.  As of 3 weeks ago her ca-125 was 16.  Tomorrow shes doing her new blood work routine.  The doctor is very impressed with how she's been doing and her results.  

Im not too sure what Maintenance chemo is and how it works.  He said once every 4 weeks with taxotere for a year.  My QUESTION IS:  How does it help a women and what does it guarantee or the benefit it provides.  Chemo again and plus a whole year must do a lot on a persons body and immune.  I just want to be sure its the right choice to make.  I think he is also suggesting this because he sees how my Moms body is handling her current treatment.  She is doing very well with it and is able to control her blood levels on her own with no nuelesta.  Maybe this is why he thinks Maintenance chemo may be for her.

Any input on this would be great.
Thank You so Much
- Doughter Fiana

[kathy o]

I had Maintence Chemo for a year after 9 initial treatments. I had a reoccurence about 6 months after last maintence chemo. I was able to tolerate it ok, not as hard as with Carbo. I look at it like it gave me another year to live. I never had to have any blood cell boosters and my hair started to grow back. Isee that some women choose not to do this but we all have to make the decision that we think is right for us. I am the same age as your MOM. I am glad to hear that she is doing well and tolerating Chemo with out  blood boosters. My neighbors Mom  who has a different health insurance, also got Ovarian Cancer a few months after me had no maintence chemo and it was never mentioned to her is nine minths out now with a steady holding ca-125 of eight. She wanted to have bypass surgery but her Dr. said no way, he told them that her Cancer would come back, I could not belive that he told them that they were devastated.
I asked my Dr. if when I was done with these treatments if I would have Maintence again and he said no, so it must be a one time thing.  Good Luck

[milashka]

I have stage 3C and just finished my 6 initial treatmente; my oncologist gave me three choices: maintenance chemo with Taxol or with Doxil or no maintenance. I decided against maintenance and he is fine with it, and said ultimately maintenance does not prolong life. It's just extra insurance it won't come back so soon, but then again I sat in the chemosuite with women who had a recurrence while on maintenance. I think I posted this before but I'd rather get my body strong for the next big round of chemo then continuously poison it for another year. Just my personal choice.

Here is an interesting article I found online. It is from 2004 and I don't know if there are newer studies by now. My oncologist just returned from an international OvCA Conference in Miami and I am sure would have shared the latest views regarding maintenance with me:

SAN DIEGO -- The adoption of maintenance chemotherapy immediately after a patient demonstrates a complete clinical response following surgery and first-line chemotherapy may not always make the most sense for patients with advanced ovarian cancer, results of a retrospective study suggest.

"Because most women with advanced stage ovarian cancer respond well to the first chemotherapy, but ultimately recur, many have suggested that we should consolidate on the initial gains of treatment by adding second-line chemotherapy just as soon as the first-line therapy ends. But before we embark on giving patients additional therapy like this we should prove that it's worth it," study investigator Dr. Scott McMeekin said in an interview at the meeting.

The strategy behind maintenance chemotherapy--instituting second-line chemotherapy immediately following a clinical response but before evidence of recurrence--has gained popularity with many oncologists, after last year's release of results from GOG 178, a large study by the Southwest Oncology Group and the Gynecologic Oncology Group (J. Clin. Oncol. 21[13]:2460-65, 2003).

The objective of the GOG 178 study was to compare two different durations of consolidation treatment. The results suggested that a longer course (12 vs. 3 cycles of paclitaxel) gave patients a longer median progression-free survival (28 vs. 21 months).
Many oncologists have adopted this strategy without even questioning the best timing for initiating second-line therapy, Dr. McMeekin of the Oklahoma University Health Science Center, Oklahoma City, said during the annual meeting of the Society of Gynecologic Oncologists.

"Obviously, after a big surgery and 6 months of initial chemotherapy, giving another year of consolidation chemotherapy immediately can have a negative impact on a patient's quality of life," he commented.

Dr. McMeekin noted that GOG 178 did not examine quality of life issues. Indeed, 23% of patients on the long duration treatment had peripheral neuropathy in that trial.

He and his associates decided to evaluate outcomes when second-line chemotherapy was delayed until a patient experienced disease recurrence.

They retrospectively reviewed records for 59 patients with stage III and stage IV ovarian cancer who had achieved a remission following treatment at their institution with surgery and an initial 5-8 cycles of platinum-based chemotherapy.

Rather than beginning consolidation treatment immediately, the patients were given no further treatment unless they had a recurrence. Third-line therapy was started as soon as the disease recurred or progressed after the end of second-line therapy.

Median follow-up was 51 months. At 5 years, 36% of patients remained disease free and received no additional chemotherapy.

"This is important, because all of them would have received chemotherapy if they had been treated with a consolidation program," he explained.

Among patients who had recurrent disease, 87% of recurrences took place more than 6 months after the end of initial therapy, and 50% occurred at least 12 months after the end of initial therapy.

The median time from the end of initial therapy until the start of second-line chemotherapy was 21 months, and the median time until the start of third-line therapy was 43 months.

In comparison, for patients in GOG 178, the median time from complete response through consolidation therapy to recurrence was 28 months. (It was presumed that at this point patients would go on to receive third line agents.)

The difference between the two studies is that, overall, GOG 178 patients received much more chemotherapy. In addition, patients in the Oklahoma study were able to undergo individualized therapy.

"Our data suggest that in women with a complete clinical response, treating later with second-line agents may be okay, and perhaps even better. A randomized trial to evaluate when to start second-line agents should be performed," he concluded.

BY KATE JOHNSON

Contributing Writer

COPYRIGHT 2004 International Medical News Group
COPYRIGHT 2004 Gale Group

[jamie O'Hara]

my mom has 3c ovarian cancer and is 58 she is also schizophrenic. she will not do the chemo thing so i guess i was wondering how long do we have she had hystorectomy 3 months ago we only found out about this 4 months ago and they said its back i am so upset she is too young we helped raise eachother what do i do or what can i do ?

Jamie
***@****
novato ca

[jamie O'Hara]

leprechauns32yahoo.com