Topotecan

[Hazel30]

Hello Dr.  My Mom is doing topotecan for her 2nd recurrence (first time other drug beside taxotere/carbo).  This week will complete her 3rd treatment (3 weeks on 1 off) is each treatment.  Her ca-125 has never been brought down by this drug/. Before treatment 140s and now 224.  Her ct scan as of friday showed very very small increase in the lymph node and the new spots that were seen on the capsul of the liver in May has shruck a tiny bit.  She will complete this treatment this week and meet with her main oncologist next week to see what he wants to do.  So my question is, what would you recommend at this point?  Do you think that topotecan is not working for her or is it too early to tell?
Overall she is feeling better right now since May before she began this treatment but we also dont want to waist time on a drug that is not doing anything and may allow the cancer to progress.

Thank You so much
Fiana

[Hazel30]

Thanks for the reply.  Its strange to hear different opinions from different doctors.  We have not yet spoke to my Moms main oncologist who would make the decision, but we did have brief discussions with several other doctors.  Everyone opinions are different.  Its so hard to analize this because this is my Mothers life we're talking about.  
I also wanted to see if maybe 1 or 2 more treatments would make a difference in the ca-125.  I guess we will decide once the doctor weighs everything out.
Thank you very much for your reply.
Fiana

[Annekathryn Goodman, M.D.]

Hi Fiana
thank you so much for the update on your mother. I am glad she is feeling better. it may be too early to really say if topotecan is working or not. I am interested in what her oncologist thinks.
I base decisions about changing therapy on several factors:
-how someone feels
-side effects
-evaluation of response (by xray and /or CA 125)

so if she is not having side effects and feels well, pushing on for another 2 months would be my choice.
please keep us posted
best wishes