Is chemo necessary for stage1c

[biochem]

I had a cyst of 10cm, later in frozen section it was found as low malignant tumor.
later undergone staging procedure by laprascopy .The biopsy indicates negative malignancy,found no evidence of spread of cancer.
I need to know for Stage I c type of ovarian cancer is chemo therapy needed.
I wish to have a baby soon.Please give me your valuable suggestions.

[alanpvegas]

prob not, but the oncologist is the one to make that decision based on your entire medical workup.  It is not uncommon for Stage 1 ovca patients to receive chemo, maybe a few cycles to be sure.  Even if so, isn't being sure you are are around for your child more important than having the child right away?  Take care of yourself first before starting a family...it's the most responsible thing to do.

[nyc lady]

"Normal" protocol for chemo is stage 1C and above....the "C" indicating spread outside of the tumor.  It is also more common for a full hysterectomy at at stage 1C.  I am confused about your diagnosis....there was no spread of cancer outside of the frozen section of the mass?  

I was diagnosised at Stage 1A, they had removed my right ovary/tube due to a very large mass, the final  biopsy came back with malignancy.  I did not have chemo.  My OB/GYN did the surgery, I was immediately refered to a GYN/ONC.  I will never forget the night that my OB/GYN called...it was exactly 2 weeks to the date of my surgery (which will be 7 years on the 13th of this month). He said to me within 5 years I would lose my other ovary....well it was 3.5 years later and I developed a mass and they removed the right ovary/tube and uterus.  This time it was benign.  After the first surgery, I had a CT Scan every 3 months for 2 years, then every 6 months and still every 6 months - I now get transvaginals and not CT Scans.

I know of another women, stage 1A that had chemo and a total hysterectomy at the time of diagnosis. Not all GYN/ONCs follow the same protocol.  

Is your GYN/ONC suggesting chemo?  How many treatments?  As Alan said, you need to be healthy before having a family....the wait until chemo is done may be worth it in the long run.

Please, let us know what your GYN/ONC suggests and let us know how you are doing.

[coogeegirl]

I was diagnosed with Stage 1C Ovarian Cancer in November last year, I had six rounds of Carbo/Plat chemotherapy plus six weeks radiation therapy. I now am having checkups every six months.

I had already had a total hysterectomy bar one ovary due to the fact that I have already had endometrial cancer which was found in the course of infertility checkups. The pathology was great from my intial operation everyone was happy leaving the one ovary in (I was thinking about surogacy and I was not keen if I could help it going into menopause) as I had fabulous pathology and the likelihood of me getting cancer again was less than 5 per cent.

Well unfortunately that less than 5 per cent happened to me and the remaining ovary became cancerous and from where it was sewen into my pelvis managed to adhere itself to the bowel and well I have already told you the rest.

I really understand your need to have a baby but don't let it cloud your judgement in looking after yourself first.

[coogeegirl]

Sorry meant to say that I am having checkups every three months

[Casey06]

What did the final pathology report say? Was it a Borderline Or Low Malignanacy Tumor that did not spread? I would think that was 1A (contained to one ovary)?

I am curious to know what folllow-up they are suggesting for you, because that is exactly what I was diagnosed with on Aug. 13, and my doctor says no chemo or follow-up is required (which is starting to make me nervous, based on what I am reading). My doctor is a very good GYN/ONC, but he doesn't want to see me for another year and isn't suggesting any follow-up CA-125 or ultrasound either?

I am waiting to get the final pathology report from the hospital. maybe I will understand better after reading it.

Thnaks and good luck to you. I will keep an eye on your posts.

[dian07]

I had surgery, a total hysterectomy, in April of '05.....staged at IC....my gyn/oncologist insisted I have 6 rounds of carbo/taxol and I did as he suggested......he told me that I had a slight chance for the "c" word......"cure"......don't you dare take a chance with your life.....you are not IA....you are IC....that means your cancer was "not" confined to your ovary.....you need the chemo....buck up girl and get it!
Peace.
dian

[nyc lady]

I was diagnosised with stage 1A in September of 2000....They removed just my right ovary/tube at the time (diagnosis was from final pathology report not suspected prior to surgery)....my follow up was every 3 months where I had a CT Scan....then after 2 years it was every 6 months until they found a mass on the left ovary...then I went in for surgery (3.5 years after the first surgery)....I was still on a 6 month check up after the 2nd surgery (2004)...in 2006 I developed what they believe is an ovarian remnant cyst and went to appointments every 6 weeks, then back to 3 months and this is the first time that I am going at the 6 month point....I have transvaginals every 3 to 6 months.

PLEASE get a 2nd opinion....I have never heard of anyone - even Borderline - being given a "yearly" appointment so early in the diagnosis.  If you are questioning what your doctor is suggesting, then I would see if another doctor suggests the same follow up.

I have recently heard that they are now looking at the lower staged cancers being slower growing and thus the possibility of recurrence at later times then later staged cancers.  Remember all stats that exist are based on 5 year data....the rate of recurrence of lower grades could be past that 5 year mark.

[baguba]

Just my input....I was dx Stage 1C, OVCA,  5 years ago this past June.  I recurred in May of last year.  When I was orig. dx my onc. did not give me an option; she said I WOULD have chemo.  In spite of that (and almost 5 years of excellent health) I did recur. I had surgery, more chemo - 6 rds. carbo/taxol; and am now getting ready to take my 12th maintenance chemo of Taxol only in Oct.  Hindsight is always 20/20 but I wonder if I was offered maint. the first time, if perhaps I would not have recurred.  Who knows?  What I do want to say to you, though, is this; Stage 1C - even after a recurrence, is manageable, and from what my doctors tell me, still beatable (I never give up hope). My onc. is treating a lady who has recurred twice, and is now 8 years out from her second recurrence and doing phenomenal! You owe yourself that chance! The last word you want to hear 3, 4 or 5 years down the road, (when, God willing, you are bouncing maybe 2 babies on your knees)  is "Oops"......take eveything they throw at you now; you won't regret it. If you're confused, seek another opinion. Do this for yourself, you won't be sorry. And, a tip of the hat to my fighting sisters and their families on National Ovarian Cancer Awareness Day!  God Bless us All!

[libbyisi]

I'm 25 and staged 1c in Feb.  Recently finished chemo (carbo/taxol) in June.  

Post-surgery, my onc said that chemo treatment was basically "non-optional" since having it greatly decreases the risk of it spreading (even though they removed my left ovary and all visible cancerous masses).  While the experience was unpleasant, I have absolutely no regrets about going through with it.

I hope to have babies in my future as well - the docs gave me Lupron, an injection birth control that (as I understand it in layman's terms) shut down my ovary so that there were no dividing cells, and therefore -hopefully- the chemo would bypass it.  While it is not a proven method of preservation, heck, I am willing to do anything in hope to save my fertility.  Maybe it's something for you to talk to your docs about.

Best, Libby

[chelan3]

Hi, I thought I had replied to you already, but I don't see my comments.  I'm confused about your diag.  where you diag with borderline or LMP or Stage 1c ovarian cancer.  
If you truly have LMP ovarian cancer at stage 1c (stage 1 indicates - confined to ovaries, stage 1a means confined to 1 ovary, stage 1c means cancer was found in both ovaries), then chemo is usually not used.  LMP ovarian cancer is slow growing and rarely recurs and if it does is usually treated with surgical removal only.  LMP can show up at any stage, I know another lady on another ovca forum who was diag with LMP stage 3c.  She only had surgery and it has not recurred.  You should see if you can get a copy of your pathology report so you can be sure what it is you were diag with.  If you're uncomfortable with the results, see about a second opinion of the pathology.  Borderline or LMP tumors can be a tricky pathology and with this you want to be sure.  
Now, for LMP ovarian cancer they take into consideration the age and fertility concerns of the women when recommending treatment and/or surgery(hysterectomy).  
I was diag with stage 1a LMP ovca 5 years ago at age 32, I haven't had a recurrence and did not have chemo, but did have a hysterectomy a year and a half after diag.  
Good Luck.

[chelan3]

I see on the dr forum you posted that your cyst ruptured.  That is another reason they would stage it in the 'c' category.  Hopefully dr goodman will answer you soon. But as I mentioned above usually LMP is not treated with chemo and they will likely allow you to have children before possibly recommending you have a hysterectomy.  They are reluctant to recommend hysterectomy in young women with LMP now a days, especially if you want children.  Again, as I mentioned above it would be a good idea to get a second opinion on the pathology to ensure it is LMP.

Let us know how you make out.

[Casey06]

Thanks, your comments were very helpful to me also.

What follow-up have your doctors done to monitor you? My gyn/onc doesn't plan any, just a yearly check-up. Dr. Goodman and another site recommend CA-125 and TVUS every 3 - 6 monthes.
(See my post to nyc lady for pathology report, if you need more info).

Thanks!

[Casey06]

Reference article:

http://www.emedicine.com/med/topic3233.htm

[Tybear]

I completley agree with Chelan3. If your tumor was a LMP (low malignant potential) then no, chemo would probably not be recommended. Low grade tumors do not respond to traditional chemotherapy, and at your stage, it would not be worth it to put you through the toxicity of chemo, knowing it would probably not work. I have kind of what you have, but mine is stage 3c, and even though it's still grade 1, it's aggressive. It's called Micro papillary serous carcinoma. I am doing a clinical trial, because I've already been advised that chemo won't work. I did taxol/carbo, with no results. A yearly check up is not enough...you should be at least every 3-6 months, but that is just my opinion.
Good luck...
Becky

[chelan3]

I had follow-ups every 6mos for 5 years including a yearly CT scan.  Now, I just have regular 1 year check-ups with gyn (no CT scans) the CA125 was never a marker for me, before my first surgery it was 65 and after my family dr checked it every 3-4mos for a while but it just bounced up and down between 35-50.  I had endometriosis and wild heavy periods which both affect the CA125 values.  After my hysterectomy 1-1/2 years after orginal surgery it dropped down below 10 and it hasn't been checked in the last few years.  

Casey, Just read your prior post, I'm not a dr, but it looks like you had seromucinous borderline tumor Stage 1a. - sounds like it was confined to the left ovary.  Seromucinous when I googled it means its a combo of serous and mucinous type of tumor.  Mine was serous but I know the gyn pathologist specialist mentioned my tumor did have some mucinous properties but not enough to call it a serous/mucinous tumor.

[biochem]

Thanks guys for your valuable suggestions.yes,as the reports says  negative malignancy,so no cancer cells  inside  my body system, is it advisable to go for an chemo therapy.I understand recurrence will be there after a while.My CA125 is 21 now.
sure i will go for an second opinion.