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Urgency to do chemo for Ovarian Recurrence?
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Urgency to do chemo for Ovarian Recurrence?

Dear Doctor
My mother most recent CT scan report stated " There are multiple retrocaval and left para-aortic lymp nodes, largest in left para-aortic measuring 1.5cm in short axis" and her CA-125 readings increased from 7, 14, 27, 38, to 54 in the past 6 months. From the tests and scan, her oncology has confirmed she has recurrence. She had 6 cycles of chemo Paclitaxel and carboplatin about 18 months ago, and her doctor recommended her to do the same chemo as soon as possible.

Unfortunately, my mother is very hesitant to do chemo again. Her chemo side effect has just recently settled a bit. She is so scare to go back to it. Since her CA-125 is still relatively low (she used to have >200 before her first chemo treatment), does she need to do chemo immediately? Can she wait for 2 to 4 months? Is the risk to wait very high in her current stage? Is there any alternative in chemo type/drug for her?

Appreciate your input.

thanks,
Clara
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Dear Clara,
I would defer to your mother's doctor who knows her the best.
There is debate and little data about when to start chemotherapy after a recurrence is diagnosed.
There is no clear data on survival based on when chemo is started.

If your mother is feeling well and wants to wait, ultimately that is her decision. It might also be useful to talk to her doctor about other approaches to chemo. Sometimes just using one drug such as carboplatin or low dose weekly taxol  is fine and is much less toxic.

Finally there are other drugs with activity against ovarian cancer such as doxil which is much easier to take.
However the standard of care would be to give both carboplatin and taxol or carboplatin and gemzar for a recurrence that occurs 12 monhts after completing prior chemo
please let us know how your mother is doing
best wishes
ak
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I personally would  not wait. Cancer is very cunning and baffeling it tends to sneak up on and then can grow agressivly fast.The early treatment is the better chance to be disease free. I had a terrible time on chemo as well Just ask your doc for some pain meds to help your mom get through the day and nights Good luck DeDe
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