Second Look Surgery / Consolidation Chemotherapy

Background:  37 years old, Stage 3B, ca-125 before surgery over 1500, currently at 6.  Six cycles of Carbo/Taxol completed.  Doctor is mentioning second look surgery and suggesting consolidation chemotherapy by IP directly into the abdomen.  Would like to know your thoughts on this.  Thanks!

[Annekathryn Goodman, M.D.]

Hi Lisa,

It sounds like you are in a good place. It is great that your CA 125 is 6. The standard of care is to just do check ups after 6 to 8 cycles of carbo and taxol.

However, there is definitely a risk that your cancer can come back. We have been struggling with this issue for decades and still have not come up with good solutions for consolidation chemotherapy. All sorts of things have been tried. IP chemo, IP interferon, radiation, targeted monclonal antibodies and so forth. In carefully done clinical trials, none of these therapies has been shown to reduce the risk of recurrence or dying from the cancer.

The most recent clincial trial was published last year by Dr Maurie Markman. His group gave women another year of monthly taxol chemotherapy. He reported that this reduced the risk of recurrence significantly. It has been argued that women just were on chemotherapy a year longer with lots more toxicity without truly improving survival. There has been alot of debate about his study in the oncology community. Some oncologists do recommend his protocol and others feel it is better to wait and give chemotherpay only for those who develop a recurrence. You should talk to your oncologist about this and see where he stands.
best wishes.