Tamoxifen treatment

[CFK]

i was diagnosed stage 3c Sept 2005 and had successful surgery followed by 6 x Carbo/Taxol. My CA125 was 212 at diagnosis and after treatment went down to 19. Unfortunately, after 5 months CA125 started to rise until Feb this year when it rose to 100. I had CT scan which showed lymph nodes nad increased to over 3cm. I started on Caelyx in April 07 and had 6 treatments Half way through treatments the lymph nodes had reduced to just over 1cm. I finished treatments in Sept and CA125 was 122 (this was after 5 treatments as CA125 sample is taken before each treatment starts). I had further scan and it showed lymph nodes were  over 2cm. Tests showed that I am oestrogen positive and I am now on Tamoxifen as I have no symptoms and no other sign of disease on scans. My understanding is this: 1) if only sign of recurrence is enlarged lymph nodes this is not as serious as organ involvement. 2). Although the Caelyx did not put me into remission it must have had some success as lymph nodes came down to a certain extent. My oncologist does not want me to restart chemo unless it is really necessary and will monitor CA125 to see if Tamoxifen is working. Do you agree with this and also my understanding of my condition? I hope I haven't rambled on too much and thanks for your time.

[Annekathryn Goodman, M.D.]

Dear CFK,
thank you for your question - yes i agree with your oncologist. you have had a good treatment. Tamoxifen is very sensible.

Women who experience nodal disease and don't have large disease in the lining of the abdomen do have a better course. this is at least partly because you do not have the same risk of bowel obstruction which happens from cancer involving the bowel. You Fahd a response to Caelyx (Doxil). this is a drug that can work for you in the future.

As Ajay says, there are situations where it is worth considering the surgical removal of isolated nodal disease. You should ask your oncologist about that.
take care

[ajay777]

hi CFK,

1) if only sign of recurrence is enlarged lymph nodes this is not as serious as organ involvement

This is the same question that i was also thinking to ask.

Does lymph nodes metastasis or organ metastasis and lymph nodes recurrence or organ recurrence carry more importance? My mother also had 3c OVAC with one lymph node metastasis that came in the pathological report, i also wanted to know if lymph node metastasis and lymph node recurrence pose a great threat and in what way is it to be considered a danger?

[ajay777]

hi CFK,

i also request if u can also ask these questions?
what should be considered as a optimal medical procedure for lymph node recurrence.

1-if lymph node recurrence is there, should it be surgically removed and given 1-2 dose of chemotherapy or giving only chemotherapy (6 doses ) for only small lymph node recurrence is optimal?

2-As lymph nodes usally become chemosensitive, giving more chemo doses rather than removing them surgically is justified?

3-what is the standard procedure followed if lymph nodes are the only site of recurrence? does the deciscion depends upon the treating oncologist or is there any standard procedure followed worldwide?

if u get any revert from the doctor please do send it to me.

HOPE YOU GET CURED? KEEP UP THE SPIRITS ?

[CFK]

I think my question has been missed as it was pushed onto page 2. Please note that 'ajay777' has posted a question below mine which has nothing to do with me. Would you be able to answer my original question  from 11/20/07? Thanks for your time.

[ajay777]

hi CFK,

very very sorry for that , i really apologize for posting my question here.