Ovarian Cancer Recurrence

[Chuck10010]

My wife was first diagnosed with Ovarian Cancer in December 1999.  She's had two surgeries and she is now having her third recurrence.  She has been on platinum based drugs as a first line therapy, taxol alone the second time, Doxil the third time and now Topetecan.  She's now had 4 treatments with Topetecan and she's beginning to feel the fatigue.  The oncologist says that the fatigue will continue to get worse.  The doctor plans to continue with the Topetecan for approximately 6 months (1 treatment per week}.  After all this time and the number of recurrences, we just don't know what to expect.  Are we reaching the end of the line with the cancer?  She has a tumor now that is about the size of a golf ball in the right pelvic region right near the colon.  With all the chemo she's had already, I don't know how much more her body can take.  Can anyone provide any insight?

[Chuck10010]

Thanks again for the information.  I'm new to this site so I'm still figuring out how it works.  The doctor has not done another CA125 and will wait until the 8th treatment to do this.  Right now they are just monitoring the blood counts.  The fatigue is getting worse although she still tries to go out for dinner, family events, etc.  She's been through alot and is getting tired.  She has also had anxiety issues from the start and is on numerous anxiety drugs.  The doctor has mentioned the Gemzar but I've not heard of the Avastin.  So far my insurance company has been great (Blue Cross/Blue Shield PPO) but you can never tell how they may react to a new drug.  From what I've read, it would be difficult for her to get into a trial with 3 recurrences and what seems to be a platinum resistant cancer.  Although, the onocolgist says that there are the platinum based drugs that we can try again.  Sometimes I think that the uncertainty is the worse part of the cancer.  

[Helmar]

Hi Chuck... If I could just 'butt in' here and tell you of my experience with Topotecan, it maybe of some help... I hope. I had 10 treatments of Topotecan, given over 2 weeks...5 days consecutively each week for the two weeks. My CA.125 rose and it didn't really work, but the theory my Oncol. had was that this splits the cells, thus raising the numbers, and he then prescribed Taxotere/Carboplatin, which I am currently on now. I've had great success with this combo, as my CA.125 which was originally 7500 has now reduced to 580 in just 5 treatments. I've just had the 6th.treatment last Wednesday. According to my Oncol. this latest chemo 'mops up' the split cells which the Topotecan has made, and thus kills off the cancer. It seems to be working, as I'm feeling really well... no pain or discomfort, and a great appetite.
Like all of these drugs, what works for some, may not work for others, so it's a matter of trial and error. If' it's not working, it's best for your wife to try another. No point in going through the side affects for nothing.
Wishing you and your wife all the best, and I hope she is feeling much better soon. Best wishes...Helmar...

[Chuck10010]

Jatoo and pjet, thanks for your comments.  I wanted to mention that my wife was originally diagnosed with Stage III ovarian.  Since she has been on Topetecan, she is getting more and more tired.  Does anyone have any experience with this?  It's just been 4 treatments now (one treatment per week) and the doctor wants this to continue for 6 months.  The nurse in the office, who is very knowledgeable says that the fatigue will continue to get worse.  Probably to the point where she'll want to do nothing but sleep.  She's already had a blood transfusion due to very poor counts after the first Topetecan treatment and she's also on Neupogen and Procrit to improve the counts.  Any experience with Topetecan would be appreciated.  The doctor tells us that it only has a 30 - 40% success rate and we may have to use another drug but we won't know that for about 2 months.  It's also my understanding that the side effects of the drugs worsen from here on.  Is this also true.  

Alot of questions but would appreciate your answers.

[Jatoo]

Dear Chuck:

Has the CA 125 gone down after four(4) treatments? Meaning is the drug working? We had daily treatment of Topotecan for a week and it did not work. The Onc had to stop. She had all transfusions/treatments: platelets, Neupogen, Procrit. Topotecan was very harsh on her blood counts. If it is working, ask the Onc if they can reduce the dosage.

We are now on Avastin plus Gemzar and reduced CA 125 from ~500 to 71. Actually one can just go on Avastin alone and it is easy on the bloods. The dosage of Gemzar which is also harsh on the blood was reduced or you can postpone treatment.

You can start to post again since you are already on the next page of the forum.

I hope this helps.

Jatoo

[Chuck10010]

Jatoo and pjet, thanks for your comments. I wanted to mention that my wife was originally diagnosed with Stage III ovarian. Since she has been on Topetecan, she is getting more and more tired. Does anyone have any experience with this? It's just been 4 treatments now (one treatment per week) and the doctor wants this to continue for 6 months. The nurse in the office, who is very knowledgeable says that the fatigue will continue to get worse. Probably to the point where she'll want to do nothing but sleep. She's already had a blood transfusion due to very poor counts after the first Topetecan treatment and she's also on Neupogen and Procrit to improve the counts. Any experience with Topetecan would be appreciated. The doctor tells us that it only has a 30 - 40% success rate and we may have to use another drug but we won't know that for about 2 months. It's also my understanding that the side effects of the drugs worsen from here on. Is this also true.

Alot of questions but would appreciate your answers

[pjet]

I want to congratulate your wives on their survival.  I am almost two years out, platinum resistant and on doxil for almost a year now and wondering what is next.  Your posts give me hope and lots of information to work with.  Thank you so much.  Wish all of you a good day.

[Jatoo]

Dear Chuck:

1. It's great to know that your wife has surpassed the five(5) year anniversary which is normally the basis for the statistic of the probability of outgrowing the disease. This can happen when your wife responds well to platinum and taxanes chemo drugs. But then it happens that the cancer becomes resistant to these drugs. Now the good news is that your wife is not in the end of the line
of having finished all the drugs. For one thing, these days the biologic or monoclonal drugs are doing fairly well and there is also an option of hormonal drugs.

2. Try researching Avastin and Sorafenib. On the phase 1 or preliminary study, these combination shrunk tumors on 6 out of 14 patients. Avastin alone on a clinical trial produced complete remissions.

3. My wife is presently using Avastin and Gemzar since January of these year and reduced her CA 125 from `500 to as low as 87. It stabilized her. She is platinum resistant so she can't just use Taxol and Carbo just like your wife. She responded partially with Doxil, then no response with Topotecan. So we also thought we were at the end of our line until these biologic drugs appeared. NIH or the the National Cancer Institute has a phase II study for the Avastin with Sorafenib just in case you can't get these drugs covered by insurance. We are not on a clinical trial since it is covered by our insurance.

So Chuck there is a lot of hope. I have posted many times other combinations which you can find in the Archives. You can also see treatment options in the medical side of this forum also in their Archives. But right now biologic drugs are doing wonders to a lot of patients that post in another site where I go to.
I will include your wife in my prayers and please pray for my wife too.


All the best,
Jatoo