elevation of ca125 during chemo

[plady]

I was diagnosed with ovarian cancer state III 6-21-05.I had a complete hysterectomy. I was treated with combination of gemzar/carboplatin.  My ca125 came down very quickly, but became elevated again in January 06.
I had a cat scan done which was clear. I then had a pet scan done and my doctor said I had a few mocroscopic cancer cells.
I started Taxol.  About halfway through my Taxol treatments I had a port installed in the adominal (abdominal) area.  I had one treatment with Cisplatin into this port.  My CA125 went from 60 to 400, after one treatment.  My doctor said he thought I had a distribution problem.  We went back to Taxol treatments.  My ca125 went down to 150.  After the next Taxol treatment it only went down to 125.  After my last treatment my ca125 went back up to 190.  I am very confused as to what might be happening.
Are the tumors growing?  Very worried.  I have a doctor's appointment today at 1:00 PM.  PLease give me some insight so I
can ask the right questions.  YOur help would be greatly appreciated.

[Annekathryn Goodman, M.D.]

Hello,
Your Ca125 became elevated within 7 months of your hysterectomy. I am guessing that you finished your first line chemotherapy around November. If the CA 125 elevation is from cancer recurrence, your cancer would be classified as "platinum resistant" If it is not clear whether your cancer has grown back, the best thing to do is look in the abdomen by laparoscopy. There are a few conditions that can cause an elevation of the CA 125 including inflammation of the gallbladder, diverticulitis, and certain herbal medicines that can irritate the liver.

If it is clear that your cancer has grown back, your doctor should talk with you about non-platinum based therapy or about clinical trials. I agree with the choice of taxol. other drugs include doxil and topotecan. there are many more drugs that are available on a clinical trial study protocl.

As far as your CA 125 going up after intraperitoneal (IP)chemotherapy, any irritation of the peritoneal lining can cause an elevation for the CA 125. One should be cautious as to how to interpret an elevation after IP chemo.

best wishes to you

[plady]

Thank you for your comments.  I went to my doctor yesterday and he did an examination and said he couldn't feel anything.  He had me take another ca125 and I am going to have a ct scan done Thursday.  I don't know what a laparoscopy is.  He thinks that I may have become resistant to Taxol, and says after the results of the ct scan he will talk to me about another plan and he also said that I may be a candidate for an investigational drug.  I was very curious about what you said about herbal medications.  What are herbal medications?  The following is what I am taking now.  I have considered not taking anything during chemo, but I have felt so good except for a few days after chemo.  I do have neuropathy but it has been manageable. I have also had hair loss, which I am sure is normal.  I don't know if what I have been taking is goodd for me to take or not. This is what I am taking:  10mg Crestor,
Premarin Cream, Multi Vitamin, 400 IU VitaminE, 50mg CoEnzyme
Q10 with 250mg LCarntine, 300mg B-6, 1000mg B-12,500mg Conjugated Linoleic Acid, 1000mg Cranberry Capsules, 600mg Alpha Lipoic Acid, 500mg Ester C, 1900mg Calcium as calcium citrate, 1200IU Vitamin D, 600mg green tea capsules.  I have also been taking EVISTA, but I read where it can cause ovairan cancer so I have discontinued this drug at this time.  I know I this is a long post to you, but I would really appreciate your comments.  I am really worried at this time and I am trying to decide what to do about my treatment and I need to gather all the information that I can.  Thank you so much.

[akg]

Hi There,

Laparoscopy is a surgical approach where a small incision is made in the abdomen (usually in the belly button), and a small camera is inserted into the abdomen to look around. You might be familiar with laparoscopy to tie a person's fallopian tubes.

Your medication list looks OK to me. Herbal medicines include packages of mixtures of herbs. Sometimes it is hard to get all the ingredients. Crestor, a cholesterol lowering drug, can sometimes elevate the liver function blood tests. Your doctor has probably checked you for this.
It really sounds like you are in good hands. Your doctor is careful and thorough. I agree with what he is doing.
best wishes to you.

[plady]

Thank you for your help.  I never expected to even hear from you the first time, much less, the second time.  I really appreciate your response.