What chemo and other questions?

Dr. Goodman,
I first want to say that you are an TRULY an angel for answering questions.

Dx,  Jan 2003 at age 47, Carbo/Taxol in Spring/Summer
Nov 2004 2 brain tumors--brain/surgery, gamma knife on other brain tumor
Spring/Summer 2005 Carbo/Taxol, December brain surgery on tumor that had the gamma knifet; Summer 2006 Doxil (3-months didn't work-growth), but month off went down 50 points-was it a wrongful blood test or Doxil kicked in??? My oncologist doesn't know. I would love your opinion. Winter 2006/2007 4 months Taxol --   numbers kept stable then went up on fourth month (didn't work-growth).

The growth on these regimens could have happened before I started treatment, right? Because I am one that takes rest between treatments which may be wrong or right I don't know.
Now with my last cat scan I have paraaortic lymph node that doubled 1.5 cm and multiple ones below. Left common iliar artery enlarged anterior to this probably within sigmoid mesocolon largest 8 mm. Impression: progressive disease manifested by continuing increase in the size of retroperitoneal lymphadenopathy and the interval appearance of pelvic and abdominal peritoneal nodules.
My brain is stable with another MRI due in June.

I don't want to keep going down the list of chemos. What is the difference on doing that versus no chemo. With my situation will any other chemos really help but destroy my blood and QOL and hasten the cancer. Please let me know your opinion. And if you say chemo what one would you recommend? Topotecan or Gemzar?
Also--another important question. My brain pathology on the first surgery said progesterone positive. What information do you have on that. I have wondered about progesterone. My second brain surgery said no cancer so I am feeling the surgery was unnecessary but the scans showed it was growing. Surgery for brain was at NYU and hysterectomy at NSLIJ.

Thank you, Helen

[Annekathryn Goodman, M.D.]

Dear Helen,
wow! What a ride you have had!
It sounds like you have had wonderful and careful care.
As far as the Doxil goes - yes it could be that it was just starting to kick in therapeutically. i usually give doxil for 3 to 4 cycles before deciding if it worked or not. So you should ask your doctor about trying the doxil again.

yes there are many other chemotherapy drugs that you could consider: more carbo, taxotere, gemzar, topotecan, and so forth.
the other option is to take a break from chemo and try tamoxifen or arimidex, or a progesterone such as megace. usually we think that when a gyn tumor has progesterone receptors, giving a progesterone will shut down its growth.

you can also not do anything more right now. if you are not sick rifght now, that may be a good option as well.
best wishes to you