doxil and CA

Hi Dr A. Been trying to keep you informed but not been able to get through. Thats just an indication of how busy you are and also how we all appreciate greatly your helpful info. My mums CA rose to 880 after being off first line chemo of carbo/taxol 6 cycles and 2 single agent chemo of carbo. It went fro 98 to 880 in 4 mths. Her symptoms are burping at the moment and slight pain in lower left quadrant where she initially had pain before diagnosis. Would that be the area of sigmoid colon where the scan shows slight serosal thickening. Her performance status is 0. Scans have shown there to be progression as the periaortic,  retroperitoneal and iliac channel left side only,  lymph nodes have metastasis. size 1.5cm. No organs involved and no ascites. No pleural effusion and still classed as stage 3c. No bowel obstruction. She has lower left leg swelling which was there before diagnosis. Her onco is going to try 3 cycles liposomal doxirubicin and then decide whether to have second line surgery. She is very fatigued after first cycle of this chemo. Her body weight is great ans she carries on her daily life. Her letter said progressive and also recurrent ovca. Is there a difference in both words as progressive in my mind is a worse description than recurrent. Or relapse. Also whats yr reading on the lymph node setting. As it seems to be concentrated in the lypmh nodes is it easier to control or is it going to progress to a major organ. How does a cancer go from lymph to organs esp ovarian which is a surface cancer. She recurred only after 3 mths and is that a measure for prognosis. The CA is a guideline and surely at least because one can see an increase that indicates it is active and second surgery may not be needed. I do believe some people show normal CA but the cancer is active. What do you think is happening in my mums case now considering her performance status is good . Is it also normal that after only one cycle of caelyx she would show fatigue so fast.

[Annekathryn Goodman, M.D.]

Dear Sheba
thank you for the update.

from a prognostic standpoint, the good things are:
-good performance status
-nodal involvement and not intraperitoneal involvement

the worrisome part is that your mother' s  cancer recurred within 6 months which sugests that it is resistant to platinum.

I agree with your mother's doctor. Doxil is a good choice. It does take 3 to 4 treatments with doxil to see response. It is unusual to be so fatigued from it. Ask her doctor if your mother is anemic. Also how is her nutritional status.
please keep us posted
take care