advanced stage 3c and recurrence

Hi DrA. Just an update. My mum has now has 2 cycles of Doxil . Her fatigue has been worse than usual. Her CA went up from 1200 to approx 1800 but gne down now to 1650. I did read with Doxil The CA goes down after 3 cycles or so. What is the difference in cancer cells in recurring cancer and why does it present a bleak pic considering its the same cells as when initially dx. Is recurring cancer different and if so is it thru this the prognosis is made. Does ovarian ca have a poor chemo response when its in the lymph and if its recuuring. PLs shed some light and clarity on why chemo response is less in recurring cancer and whats the end of life pattern. She is having a scan after the 3rd cycle to determine. Her perf. status is still 0 and her worst symptoms are fatigue and numbness and also swelling in one leg. All her symptoms are on her left side which is her original side of pain b4 diagnosis. Also I read doxil side effects incl.  back pain. Could her back pain be from the disease or the chemo. Any advise or answer would be so appreciated. Whats prognosis do you think esp as lymph nodes involved.

[Annekathryn Goodman, M.D.]

Hi There,

Thank you for the update. That is great that her CA 125 is coming down. It does take longer to see a response with Doxil - usually 3 to 4 cycles.

is recurrent cancer different than primary cancer? Yes it is . If you think about it - the surgery removed cancer and then primary chemotherapy killed a percentage of the cancer. The cancer that is growing back is the portion that was not killed by the primary chemo. Therefore these cells are resistant to the original chemo. Cancer cells are mutating all the time because they have unstable DNA. So the cells change and have different behaviors.

Having ovarian cancer in the lymph nodes versus other areas does not worsen  the prognosis. The most important thing for prognosis is where the cancer cells are killed  by chemo.
best wishes