chemo or no

[colleen42]

To: dr goodman
My daughter 18 yr old recently had surgery to remove 28 cm ovarian tumor.  all symtoms and blown off by two drs but then found great dr .  did the surgery and great staging surgery.  came back stage 1a grade 2 less than a centimeter of invasive adenocarcinoma.  not in the margins.. all other biopsies neg.  After tumor board met they say no  chemo.  I have read and it says all grade 2 chemo .  what are your feelings and what data would change a grade 2 to no chmeo.  ?  I am worried and afraid.  Love her Drs they are great gyn onc.  In New york.  Please your opinion would mean alot.  thanks colleen

[KareninVA]

I was diagnosed with Stage 1a Grade 2 ovarian cancer in June 2008.  I opted to have 4 rounds of chemotherapy after considerable discussion with my gyn-oncologist and research.  The appropriate treatment protocol for patients with Stage 1a Grade 2 ovarian cancer is subject to much debate.  In some countries, the postoperative protocol is observation, not chemo; in other areas, 4-6 rounds of chemo (carboplatin/taxol) are recommended.  Unfortunately, few patients are lucky enough to be diagnosed in Stage 1a Grade 2, so there has not been adequate research to conclusively determine whether chemo lowers the risk of recurrence.  Given the split in medical community, it might be worth seeking a second opinion from another gyn-oncologist.

[shewrites]

I was diagnosed 1A in March, 2002 -- yes, that's seven years ago.  My doctor is considered aggressive, and I had six rounds of chemo.  I'm followed regularly, and there have been no problems since.  I was post-menopausal, so I had a complete hysterectomy and removal of omentum, appendix, etc.  

Did the doctors work to preserve your daughter's ability to have children?  If so, they may want to avoid chemo as part of that process.  Northwestern University is studying fertility issues, and I posted something about that awhile back.  

I didn't start chemo for two months post-surgery due to a travel commitment that I had.  I believe the doctor okayed that because I was a 1A.  You're always entitled to get a second opinion, and I believe you have time, so don't panic over making this decision.  

Sorry you're having to deal with this.  Best of luck, and keep in touch.  

[mariebean]

You posted on the ovca forum instead of the ovca expert forum.  Might want to repost there to get an expert opinion from Dr. Goodman.  I am stage 1 grade 2 (and also had fertility sparing surgery) and my doctor gave me the option of chemo or no chemo.  I chose chemo for piece of mind, but everyone has different levels of comfort.  Good luck and take care.  

Marie