Aa
OC: stage 1b
Dear Dr Goodman,
I was just dx with stage 1b oc grade 3 poorly differentiated epithelial tumour ? serous carcinoma.. My ca125 was 200 in Mar 2007 and steadily went up to 520 by end of Aug. A series TV ultrasounds , MRI and exam by GO did no pick up the 4.5 cm tumour in the LO and left F. tube. By the time I had the "precaution" TAHOP done in Dec. the agressive, grade 3 cancer had already spread in the RO. At the time, I was a healthy 45 yr old subject with no other health problems, this was just a routine physical to which I added a ca125 test.
Question: I would like to know why the tumour was not picked up in any of my tests. The GO looked me in the eye and said that he was 99% sure that this was not cancer, but to have surgery to remove my LO as a precaution. He referred me back to my reg GYN to perform the surgery. The cancer was contained in the two ovaries and one Ftube and did not spread anywhere else in the peritoneal area or in the wash or ascites.
Question: The lymph nodes were not tested as my Gyn is not an onc. How will this affect my prognosis? Would you advise to still have them tested? Is it for staging only that lymph nodes are tested or does removal increase survival? My GYN said it does not matter now as I will have to have chemo and radiation due to the grade. ALso, in my case , how would I have benefitted if I had a GYN ONC perform the surgery?
Also, does the grade of the cancer change over time or does is start out as grade 3 ? There was a nine month gap from the time I realized that something was amiss. What is survival of grade 3 found in the first stage?
As well, could a laporoscopy have picked this up earlier? Is there a colour change or visible signs?My ovaries were not swollen 4.5 cm. The cancer cells had replaced my left ovary, the capsule still intact and had started to invade the RO.
Thank you.
I was just dx with stage 1b oc grade 3 poorly differentiated epithelial tumour ? serous carcinoma.. My ca125 was 200 in Mar 2007 and steadily went up to 520 by end of Aug. A series TV ultrasounds , MRI and exam by GO did no pick up the 4.5 cm tumour in the LO and left F. tube. By the time I had the "precaution" TAHOP done in Dec. the agressive, grade 3 cancer had already spread in the RO. At the time, I was a healthy 45 yr old subject with no other health problems, this was just a routine physical to which I added a ca125 test.
Question: I would like to know why the tumour was not picked up in any of my tests. The GO looked me in the eye and said that he was 99% sure that this was not cancer, but to have surgery to remove my LO as a precaution. He referred me back to my reg GYN to perform the surgery. The cancer was contained in the two ovaries and one Ftube and did not spread anywhere else in the peritoneal area or in the wash or ascites.
Question: The lymph nodes were not tested as my Gyn is not an onc. How will this affect my prognosis? Would you advise to still have them tested? Is it for staging only that lymph nodes are tested or does removal increase survival? My GYN said it does not matter now as I will have to have chemo and radiation due to the grade. ALso, in my case , how would I have benefitted if I had a GYN ONC perform the surgery?
Also, does the grade of the cancer change over time or does is start out as grade 3 ? There was a nine month gap from the time I realized that something was amiss. What is survival of grade 3 found in the first stage?
As well, could a laporoscopy have picked this up earlier? Is there a colour change or visible signs?My ovaries were not swollen 4.5 cm. The cancer cells had replaced my left ovary, the capsule still intact and had started to invade the RO.
Thank you.
MEDICAL PROFESSIONAL
Dear Zeda,
Unfortunately, there is no screening test or even good diagnostic test for ovarian cancer. A screening test means that in the general population, a test can pick up a cancer or precancer before it has spread.
A diagnostic test means the cancer is present and the test shows that the mass or cyst is definately malignant.
It is very common to have ovarian cysts. Most of them are benign. It is a tough decision to take a person to surgery to possibly remove a normal organ.
Now having said that, once the diagnosis for cancer is established, the next question is what to do now?
You had a surgery that showed cancer on both your ovaries. You do not know if there is any spread.
The standard of care is to offer you a second surgery to remove lymph nodes and perform biopsies around the abdomen to look for spread . The standard biopsies include biopsies of the diaphragm, the omentum, the lining of the sides of the abdomen, the appendix.
This information will give you a stage for this cancer.
Right now you have "unstaged cancer" There is a 20 percent risk that with further biopsies, more cancer will be found. But there is an 80% chance that you are experiencing a stage Ib cancer.
Grade is a description of how organized and how rapidly growing the tumor is. A grade 3 is also called poorly differentiated ( or organized). Grade 3 is the most common type of situation for ovarian cancers. It does mean that is is quickly groing.
a laparoscopy may have picked this up but truly the only way to know is the complete removal of the whole ovary with microscopic analysis.
Somtimes, advanced disease can be picked up on a CT scan or a PET CT scan in which case a surgery may not be necessary. However, the surgical removal of malignant tissue is thought to be therapeutic.
It is also standard to recommend taxol and carboplatin chemotherapy- 6 to 8 cycles - for all stages of ovarian cancer. For certain women with stage 3 ovarian cancer , giving chemotherapy directly into the abdomen (IP or intraperitoneal chemotherapy) is thought to imporve survival.
Please let us know what you decide to do.
best wishes
Unfortunately, there is no screening test or even good diagnostic test for ovarian cancer. A screening test means that in the general population, a test can pick up a cancer or precancer before it has spread.
A diagnostic test means the cancer is present and the test shows that the mass or cyst is definately malignant.
It is very common to have ovarian cysts. Most of them are benign. It is a tough decision to take a person to surgery to possibly remove a normal organ.
Now having said that, once the diagnosis for cancer is established, the next question is what to do now?
You had a surgery that showed cancer on both your ovaries. You do not know if there is any spread.
The standard of care is to offer you a second surgery to remove lymph nodes and perform biopsies around the abdomen to look for spread . The standard biopsies include biopsies of the diaphragm, the omentum, the lining of the sides of the abdomen, the appendix.
This information will give you a stage for this cancer.
Right now you have "unstaged cancer" There is a 20 percent risk that with further biopsies, more cancer will be found. But there is an 80% chance that you are experiencing a stage Ib cancer.
Grade is a description of how organized and how rapidly growing the tumor is. A grade 3 is also called poorly differentiated ( or organized). Grade 3 is the most common type of situation for ovarian cancers. It does mean that is is quickly groing.
a laparoscopy may have picked this up but truly the only way to know is the complete removal of the whole ovary with microscopic analysis.
Somtimes, advanced disease can be picked up on a CT scan or a PET CT scan in which case a surgery may not be necessary. However, the surgical removal of malignant tissue is thought to be therapeutic.
It is also standard to recommend taxol and carboplatin chemotherapy- 6 to 8 cycles - for all stages of ovarian cancer. For certain women with stage 3 ovarian cancer , giving chemotherapy directly into the abdomen (IP or intraperitoneal chemotherapy) is thought to imporve survival.
Please let us know what you decide to do.
best wishes
Thanks.
If the fluid was negative after the surgery, I would think that there is a good chance of it still being negative.
Good luck to you and your mom.
If the fluid was negative after the surgery, I would think that there is a good chance of it still being negative.
Good luck to you and your mom.
Best wishes. My mom received her CT results. The lymph nodes looked good however there was fluid around her lungs and in the abdomen. All these areas seemed to be clean from PATH reports though. Is there a chance the fluid could now have cancer?
It is scary to think that I could go from a stage 1 to stage 3. I have an app. with the GynOnc on 1-23 to discuss the next steps, I will insist to have the lymph tested. I really do not know what to think, I have not found any information on the chances of it spreading to the lymph with no other spread.
Your story sounds similar to my mother's. She is 56. Her Gyn 3 weeks ago removed a large complex cyst and it turned out to be cancer, very aggressive. PATH reports showed no cancer in ascites (over 4 liters) or surrounding abdominal organs, but he forgot to take out and test the lymph nodes. She now has wisely let a GynONC take over but he told her she can't be staged until they test the lymph nodes, so as we sit now, she could either be a stage 1, or stage 3. She had a CT yesterday and I am assuming that will show something regarding the chances the cancer spread to the lymph nodes. My question has been, if the cancer didn't spread to the other close organs, what are the chances it spread to the lymph nodes?
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