chemo treatment for recurrence

[pennyj]

Thank you for taking my questions which concern chemotherapy options for a 2nd recurrence of epithelial ovarian cancer.  Original diagnosis was for stage 3 ovarian cancer in January 2005: cancer had spread from ovaries to bowels and diaphragm; hysterectomy & debulking March 2005; standard chemo treatment 6 sessions carboplatin & taxol - good results.  1st recurrence January 2007: various spots in abdominal cavity and on liver; surgery for tissue assay only; chemo was cisplatin, taxol & gemzar - good results.  2nd recurrence January 2009.  PET scan shows growths on bowels and lymph nodes.  Liver is clean.

My oncologist told me that usually at this stage of the disease standard treatment consists of single-drug therapy.   To me that sounds like the beginning of the end and it doesn’t feel like it’s appropriate yet.  I felt better at the time of my 2nd recurrence than I did when first diagnosed and I feel far better and stronger now than I have in the last 4 years.  My CA-125 is not nearly as high as the first two times.  Last test was 20 as opposed to 1937 & 76.  I have no interest in spending the rest of my life in chemo…. I’d prefer aggressive chemo now so that I can at least have a last hurrah and do a 6 – 8 month “trip around the world” in 2010.  I figure I can always consider the single-drug option after that.  My oncologist is willing to treat me aggressively with doxil, topotekan, and avastin.

My questions are (1) is this a reasonable course of action (2) what are the pros and cons of choosing this course (3) is the suggested cocktail the best choice for me, and (4) are there any trial studies that might benefit me.

[Teresa222]

I may be wrong about this, but I feel the only reason you had anything other than a single drug therapy when you first relapsed is the fact that your remission lasted SO LONG.  You had the same good fortune on your second remission.  Obviously, platinum based drugs have been very successful on you thus far. Now, they will probably use a singleton dose as not to use up your options so quickly.Perhaps they will recommend Doxil.  You have been VERY FORTUNATE.  I believe I would listen to that ONC who has provided the decisions that have afforded you two long remissions.

[marie3B]

I agree with Teresa222 100%.  I hope you get another long remission.  Your chances are much better than most women with recurrent ovca. Marie

[lucymullis]

If I were in your "shoes", I'd get a second opinion.  Sounds like you have a good doc, but another viewpoint might be very helpful for you at this point.  

[pennyj]

Thank you for your comments.  I appreciate your honesty and perspectives.  Last week my boyfriend and I traveled to MD Anderson for a 2nd opinion.  I was tested for the BRCA1/2 gene mutation and am waiting for the results before deciding which treatment option to pursue.

[JC145]

Please keep us posted.  I am being treated for my first recurrence with taxotere and carbo and am hoping for another break.  (First tx finished 11/06. Took tamoxifen for a year.  2nd tx started 1/09).  I am curious to see what you find out with the test from MD Anderson.  Thanks for sharing and good luck.  Judy

[cd628]

I also had a second reoccurance and have been on Doxil for over 3 years, with minimal side effects.  I can't speak for others, but it has been great for me.  It sounds like your doctor is giving you a good choice.