Recurrent Ovarian Cancer 31 years later?

[chriscc]

Where can I find any ongoing medical research group or forum examining recurrent ovarian cancer after extremely long periods of time (31 years)?
If it's true that "90% of women with advanced forms of ovarian cancer will experience a recurrence of the disease after initial treatment" why is there no followup treatment prescibed even if initial surgery/radiation/chemo treatment program is successful?

[akg]

Hi Chris,
No, It is probably not important since it has been so long. In general one tries to remove as much or all of the tumor as possible first and then follow that with chemotherapy. That would be true for a new primary or a recurrence that has occurred after a long interval.

I hope all goes well
akg

[chriscc]

Thank you for the quick reply.
One quick followup - Is it important that my mother's oncologists know whether it's a recurrence of the original ovarian cancer (a remnant) or a second primary cancer (ie peritoneal) in terms of preparing & executing a treatment plan?

[Annekathryn Goodman, M.D.]

Dear Chris,
There have been several reviews of late recurrences (greater than five years) of ovarian cancer. For example, one study reported on 6 women out of a registry of 203 women with ovarian cancer who were treated in the years 1994 through 1998 who developed a recurence five years after primary diagnosis. (European Journal Gyn Onol volume 26, pages 439-442; 2005). Another report described three women who developed a recurrence after 20 years of follow up.

At some point one has to wonder if we are facing a recurrence or a second primary cancer. Second cancers can arise from the lining of the abdomen (Peritoneal cancer) which can look just like ovarian cancer.

I do not know of any ongoing research on this as yet. There is some very interesting basic science research going on that is looking at particular genes that are important for the development of metastasis. I suspect that the difference for women who experience a recurrence within five years and those who develop it after 5 years has to do with differences in the genetics of these cancers.  

As far as follow up treatments- Many different regimens have been studied over the past 20 years including - vaccines, interferon, intraperitoneal chemotherapy, intraperitoneal monoclonal antibodies, radiation. Unfortaunately none of these have demonstrated an improvement in survival or time to recurrence compared to close follow up without additional therapy. Recently a study has been reported looking at maintenance monthly paclitaxel for an extra year. The study reports a reduction in recurrence rates but there has been alot of skepticism by the oncology community because the chemo has been toxic and if you add up the time a woman if off chemotherapy it is not much different.  There is a review on this topic in Seminars in Oncology volume 33 supplement6 pages 3-11; 2006.