Reaction to Carboplatin, return of ascites

I was diagnosed 111c OVCA in June'06.  I had no symptoms at all except ascites which turned out to be malignant and in copious amounts. I had 8.5 ltrs, 11.5ltrs, 7.5ltrs & 4.5ltrs drained within 4 months.
I had chemotherapy starting with Taxol/Carboplatin for the first treatment - the second treatment was abandoned due to a severe re-action to Taxol. Then I had a further five 3 weekly treatments of Carboplatin alone followed by radical surgery on Jan 29th. About 90% of diseased tissue was removed.
I have been very fortunate in feeling very well all the way through - no pain - just a little discomfort and much more active than I expected.
I am now scheduled to have two more treatments of Carboplatin, then a CT scan followed by two more Carboplatin and am a little worried as I have read that there could be a sudden re-action to the Carbo after more than the six treatments.  Has anyone followed a similar course? Also did the ascites return?(I am nearly 69 yrs old)

[freshair]

Sorry you are so worried about a reaction since you had one with Taxol. Someone should be able to answer your question in awhile. I haven't had more that 6 treatments of Carboplatin.

You may ask for it weekly instead of once every 3 weeks. See what your doctor says.

All my best.

[catmungo]

Hello - I am from the UK as well (live in Norfolk) also my symptoms have been exactly the same as yours even down to the date but I have been treated completely differently.  With the fluid I had to be drained once and was due another one just before the operation but the consultant vetoed the decision.  As I got so ill I had to go in as an emergency and the fluid was drained - fluid was also found in my right lung which also had to be drained.  Due to the tumour I had a bowel blockage so the operation was cancelled.  I then had 3 cycles of Taxol & Carboplatin with no problems except numbness in fingers (Vitamin B is good for this).  I then went back into hospital again as an emergency after three sessions as the other lung was full of fluid and blood clots (this was missed during the first drain. So the op was cancelled again and I had the full course of 6 chemo.  Had the operation in December (major debulk for Stage 3) and have had a further 2 treatments of chemo since. I can honestly say other than feeling more tired I have had no other symptoms after the last two and no adverse reaction.  In fact all the nurses were amazed and commented on how well I looked.  I put that down to really healthy eating and walking a minimum of a mile a day - I dont eat red meat and have upped the fruit and veggies.  Have got the final oncol meeting this morning and I am back swimming next week.  Dont worry about the last chemos - you will get to the end - in fact the worst is hopefully now over.

[Helmar]

Hello... and I'm on my second cycle of Taxotere/Carbo... the first being in '04. This combination is working really well for me, and I've not had any problem with the carboplatin. I've heard from others, that one can build up an allergy to it, but it hasn't happened with me. Just one question... why is your Oncol. just giving you Carbo alone? It seems to work better in combo with something else, and even though you have had a bad reaction to Taxol, there must be other chemos that your Oncol. could be using. I'm sorry I can't offer any ideas re the ascites, as I've never had retention of fluid at all. Just my thoughts, but Carbo with another chemo could be more lethal to the cancer.
I hope you will do well. Best wishes...Helmar...

[EchoUK]

Thankyou all for your replies -

FRESHAIR - don't quite understand the purpose of having weekly treatment rather than the usual three weekly?

HELMAR - The consultant feels that as I have done so well on Carboplatin alone until now that we should continue as, since the operation, there is much less diseased tissue to be dealt with.  If after two more treatments there is not the required progress he will try another drug.

CATMUNGO - Nice to 'talk' to someone else from the UK as we seem do things differently here.
I had no other problems except the ascites which was confined to the abdomen.  I felt well once the chemo started - even though I had to go back for several drains -so my surgeon and the chemo specialist decided to do six chemo treatments first to shrink the tumours to make it easier to remove them. There is a trial going on at present testing chemo before surgery but I wasn't on it. I was so well prior to the surgery that I felt like calling it off! Thankfully I have recovered very fast. So far I have had no pain at any time and no problems with any other organs although the surgeon said there is about an inch of disease on the edge of my stomach plus about eight visible spots 'dotted around'. I am hoping to continue with the Carbo if it is successful as it presumably leaves me with more unused choices of treatment.

Best wishes to all fighting this rotten disease - like most people I had no real knowledge of it before it found me!

[Kimchi]

I, too, had fluid in my abdomen area(lots of gas and constant diarhea (diarrhea)) and diaphram (breathing diff).  Fluid on right side of diaphram was drained before my hystooperation and abdomen flushed and debulked during operation.  But since I've been on Taxol/carbo for stage 4 OC,  5 cycles and one to go,  no one has checked my lung for fluid.  Like you, I have been getting comments on how well I look and I feel 100% better than before operation but also more tired.  Maybe those of us stage 3 and 4 with fluid in those areas heal & deal differently.  I also walk alot, eat very little meats and take loads of vitamins, especially C. But I am wondering if the chemo takes care of residual fluids, when do dr test for fluid (x-ray,us,mri)during or after completion of cycles? Have been trying to post a question to Dr.Goodman about this but alotment is full!!

[EchoUK]

KIMCHI - I have been checked for ascites by the doctors at my hospital checkups. They listen to my lungs and 'tap' my abdomen which I also do myself. (It makes a certain noise if there is fluid there)  I also keep a check on my weight. I didn't suffer from gas or diarrhea but I was short of breath when the fluid built up. I had to be taken to hospital by ambulance on the two worst occasions as I couldn't bend enough to go by car!

FRESHAIR - No-one has mentioned smaller doses yet but when I had the Taxol/Carboplatin combi it took about three hours or more - the carboplatin only takes about one hour.
I think Taxol has to be given slowly - sometimes over as long as 24 hours.

[freshair]

I thought that if you were worried about a reaction you could get the chemo in smaller doses. Once a week hardly gives me any side effects. I am on low dose taxol with no side effects-only being tired one day (not every week) and a quessy stomach the day after but no need for anti-naseau pills. We'll see how my count went down in a week and a half. If they didn't go down enough my oncologist may add carboplatin again.  

[Barney22]

Hello there - I'm in the UK too - treated in London.  I've had 2 x 6 lots of carboplatin (plus taxol for the first 6) with no problems and it's much easier to tolerate than taxol.  Hair grows back and you don't get the peripheral neuropathy as you do with taxol.  A big trial has been done here looking at outcomes from taxol/carbo versus carbo alone and they have found little difference, so I wouldn't feel too worried about not having taxol.  If carboplatin works for you and your CA125 comes down that's all that matters really.  I had bad ascites at the outset but it hasn't returned during 2 recurrences really and what little there was was dealt with by the chemo.  I know this is no fun at all but you sound to have a good start - keep strong and determined to beat this disease!  I've had really excellent treatment once I was diagnosed - the NHS has been great - have faith in it.  If you want a second opinion it's much easier to get it than people think and you can transfer if necessary.  Find out all you can and ask lots of questions - consultants respect that.  Good luck - Jenny

[EchoUK]

Hello Jenny,

Thanks for answering.  Did you have chemo prior to surgery as I did? There seem to be very few posters on the forum who did.  Also when were you first diagnosed and what symptoms did you have which alerted you to a recurrence?

I felt really fit and had absolutely no symptoms before the quite sudden onset of the ascites?
I was working full time and looking after house and large garden until two weeks before I was diagnosed :(

The surgeon I had is one of the most down to earth people you could wish to meet and very popular with the hospital nurses who call her by her first name. She certainly 'calls a spade a spade'. The chemo consultant seems to be on the right track (so far!) I don't think I could gain from a second opinion at this stage.

Good luck with your treatments too!

[Barney22]

Hello again - it seems a long time ago now but isn't really.  I was diagnosed in Oct 04 but had been feeling very unwell for about 4-5 months - misdiagnosed as IBS - very common story I'm afraid - my GP was mortified but as I had a very early ultrasound scan which showed nothing on the ovaries back in February 04 that was the end of that possibility at that stage.  It was only the ascites which led to an MRI and CA125 etc.  I have known each time when the cancer returned - feeling tired, hot flushes, bit breathless, backache.  No, I didn't have chemo before initial surgery as the MRI showed that it probably wasn't needed, but I did have a split course of chemo with a second lot of surgery half way through to remove the omentum - hadn't been possible the first time.  That worked well for me, and it's not so different really.  I know of a number of women who have had a dose of chemo first - it's quite common I think, especially if they think the tumour is attached somewhere eg to the bowel - the chemo can help by shrinking the tumour and make the surgery simpler - that's my understanding.  Found out today that my blood results have improved so it's back to the chemo course on Monday - not looking forward to it although it does appear to be working thank goodness.  Look after yourself, love Jenny

[EchoUK]

Hello Jenny,

Thanks for responding - I also start chemo again on Tuesday. It is a strange thing with this cancer  - I only feel poorly after treatment - go in feeling fine!
Amazing what you don't know aabout it until you have it!
Best of luck with your next course - be thinking of you Monday,  Love Ruth