do you think she will need chemo

[Nan3002]

My mom had her operation they took out both ovaries uterus appendix(they said this type of cancer was linked to the appendix, anyone here familliar with that?) and some layer of fat, they said they had only found PRE cancerous cells on the cyst, now that they further tested it the found 4 spots that have cancerous cells that have just started which they call borderline (More cancerous that pre but less that full cancer, can anyone explain this ?), what i want to know is what does 4mm mean? she said after 5 they worry more but not for as much for a 4 which means its only a beginning. Now she has to go see the cancer specialist and there is talk about it maybe going to the lymph nodes, what do you think the chances of that are? and if there was cancer there how do they treat it in the lymph nodes?, do they have to remove them? what are the odds of beating cancer that has reached the lymph nodes? what is the survival rate? I know the doctor told her that the chances are very low that it would have spread there since it hadnt spread anywhere else yet and that they prbably removed it all when they removed the ovaries and it was only a 4mm whatever that is? She also said its a slow growing type of cancer i forget what she called it but slow sounds better than fast, she also had a ca 125 that was good but i do know they are not all that reliable.Please help me out here if you are familliar with any of this, i want to say that i appreciate all what you do here, its a great help to have someone to come to when you have nowhere else to turn and im very happy i can come hereTHANK

[xrayu2]

I do not have self experience, but I have seen where they do not do any chemo if the cancer stays in the ovary.   If it is in the lymph nodes, it will require chemo-there is no other way to get rid of it in the lymph nodes.  They will remove some lymph nodes to biopsy them , but cannot remove the nodes to get rid of the cancer.  I hope I have helped you some.  Most patients that I see with ovarian cancer are Stage III and higher.  The lower staged ovcas, where they do not require chemo rarely ever pass my way.

[ConcernedInNY]

Hi Xray...you say most cases you see are Stage III and higher - which I guess makes sense since most cases are found in Stage III.

Please tell me - I know everyone is different, but how do people in Stage III fare?  Are treatments these days better than they were 10 years or even 5 years ago?  How effective is chemp at getting rid of the cancer or at least keeping it under control?

[Nan3002]

If the cancer is only on that ovary is that considered stage one?
How likely is that to be removed that that her ovaries are gone?
How likely is it to come back and how likely is it to have pread to the lymphnodes if it hadnt spread anywhere else so far?

[Nan3002]

If the doctor told her it was a slow growing cancer which one of these do you think it would be?
Germ cell
Epithelial
Stromal (granulosa-thecatum)(sertoli-leydigcell)
Im so scared right now today is not a good dayfor me, im really sick to my stomach and it sems like its starting to sink in.
One of the things that worry me the most is how likely it is to have spread to the lymphnodes if it hadnt spread anywhere else including other ovary tubes uterus appendix and omantum?
The way the doctor explained it she said the lymphnodes are in a totally diferent direction so it could have went that way just as much as the other way(ovary, uterus and so on)

xrayu2 you mentioned that they cant remove the lymphnodes but she told my mom that they can be removed so im not sure if they can or cant.
Alos my mom is diabetic does that decrease her chances of fighting it?

[xrayu2]

About the lymph nodes, they can remove lymph nodes to find if the cancer has spread there and they may take several to see how many may have cancer in them.  I tried  to say the only way to get rid of the cancer in the lymphnodes is to have chemo-because you really don't know which lymphnodes are cancerous and which are not.  Does that make more sense?  

As far as type, there are several types(more than you listed).  If I am not mistaken, epithelial is the most common. Only pathology can tell you what the type is.

If the cancer is confined to the ovary-no spread anywhere else, then it can be removed by surgery only.  She will not need chemo for Stage I disease.  If it is in just the ovary I would say chances are good that that is the only place and I am sure they will watch her for a year under close observation.  People with Stage I have a very good outcome with surgery only and no recurrence.  I am wanting say the statistic is 97%, Stage II 86%, then it drops t9 64%.  Don't quote me on the numbers, but I will look when I go back to work next week at the numbers for you.  I hope I have clarified myself better and I hope it is a little clearer than mud.  I will try to answer you the best I can.

[Nan3002]

Thank you so much, yes you have cleared it up for me but it is all complicated, what type is usually the slow growing one?

I am pretty sure this is what she said she had...low malignant potential.....is that one of the better ones?
What about the diabetes question oes anynoe have an answer to that one?

Thank you so much for taking the time to reply it is so nice of you!

[xrayu2]

As you said all patients are different.  We have patients over their five years cancer free and living life fully coming in only for labs and annual scans.  At the same time, we have women that never get the tumor under control.  WE have one lady that has been having recurrence after recurrence, she is 79, takes care of her 97 year old mother, and this has gone on for years(7?) she is not sickly appearing adn comes every three mnonths for her scans to see if the current therapy is helping anything.  The last visit showed her tumor decreased by half.  I think alot of that has to do with who did their surgery to begin with.  Most gyns do not have enough ?experience? to remove every bit of the cancer.  If a cell is left then it plays havoc because it can continue to grow. Patients that had their debulking/surgery by a gyn/onc are much better off.  They know thru experience exactly what should or should not be in the abdominal cavity. They do pelvic washings to try to rid the body of all the microscopic cells.  And attitude, as with any staged cancer, is a key factor.  Whether it is lung, ovca, colon,etc., a patients atitude and family support helps.  Almost like a mind over matter situation.  Some cancers simply do not respond to conventional chemo.  That is where Estrogen blockers, like Tamoxifen(originally used for breast ca) is helping fight or put at bay ovca that is hormone dependent. I hope I have helped to anser some of your questions.  The doctors know fairly quick if a the chemo regimine being used is going to help.  Most will quickly stop it and try something different if it is not being successful.