Recurrence? or Not.

Hi Dr. Goodman, I have a question to you regarding my Mom.  She finished her chemo treatment of just taxotere Aug 31 for her recurrence of ovca 3c.  Exactly one month ago she under went surgery for umbilical hernia repairment.  It was a pretty difficult surgery where she stayed in hospital for 3 days and 2 weeks rested at home.  With that said her ca-125 began to slowly rise since then, which we were warned that may happen.  Little history.  She is currently under a bio drug MORAB clinical trial since 03-2007 so they test her ca-125 every 3 weeks for that.  Her ca-125 before surgery was 13 now 1 month later is at 22 and is being tested again next week because the trial people have certain criterias that must be followed.  When she did recurre last year it was in 2 retro peritraneal (sp?) lymph nodes.  After treatment they shrunk about 90% and ca-125 norm.  Doctors have been watching them since august as her trial requires CT Scans every 9 weeks.  She just had a CT scan last week and one of the two lymph nodes doubled in size but still in normal range I think its 1.2 x1.5 cm and another one popped up now on the scan, a new one, which measures the same.  So a total of 3.  Two previous ones which only one increased and the other is still the same size and a new one which measures about the same 1.2 x 1.5.  So everyone is giving her a benifit of the doubt and saying this is probobly in result to the surgery as lymph nodes can sometimes act wacky after surgeries.  Then the other side of us is asking is this an early sign of recurrence.  When she first recurred she was symptomatic with aches in the belly.  Right now she feels fine.  they are testing her ca-125 next week again and we are banking it all on that test becaue it was always very reliable for her.  

What is your opinion on this based on your knowledge and most of all expirience.

Thank You SO much
Worried Doughter
Fiana

[Annekathryn Goodman, M.D.]

Dear Fiana,
it is nice to hear from you again. I understand your concern. it is very possible that you are picking up signs of an early recurrence. As a general ballpark estimate, I assume that a woman who has a recurrence of ovarian cancer will develop recurrence again.  If it took a year for the first recurrence to happen, I assume I will see another recurrence in a shorter interval, so in less than a year.  This is not always the case. I take care of women who had  recurrences 5 years after first diagnosis and 5 years later, they are still fine. But having said that most women who experience recurrences will recurr within a shorter interval the next time.

However, your mother is feeling well. She is not sick. All that is seen are some tiny lymph nodes. It is reasonable to wait and see what happens to the CA 125 and her scans.

I know it is stressful waiting for a recurrence. It is really hard to find a mental and spiritual space to cope and carry on with life, family, activities. One of the problems with having a cancer diagnosis is that it is hard to put the cancer issue on the back burner and Carry on.

Please keep in touch
best wishes