i really need some help

[Sharon2714]

okies so i had the surgery etc and got staged 1 C serous borderline tumor .. i tried to research it on my own and really cant find too terribly much on it .... the gyn onc that i see is fairly confident all ca cells are gone (it was 1C because it involved both ovaries and had some sloughed off cells in the wawshings) ... he is famous for not aking any final judgements without all the report and i respect that ... i brought him all my radiology that i had yesterday .. i called the VA gyn today and she thinks i wont need any chemo ... the feeling i get from the onc is i dont need chemo (just a feeling mind u .. i wont know for sure til 9/08 post op exam)

i am concerned ... a good friend of mine gave me great advice to try to insist he looks into the chemo aspect of treatment ... i am interested in my long term survival and quality of life (wife and mother of three 19g, 15 b 10 g) ...

basically i need ammunition to talk with the doc ... can anyone point me to a good website that might address this issue so i can bring it with me to my appointment ? One with any point of view will help me tremendously ...

i thank god for this website and the people who i have met through this and all the people who have pioneered OVCA treatment before me so that i may live ... may god richly bless u indeed ... i thank god for the encouraging words of good friends that brought me back to this point and i thank god for every day of my recovery and for yours ... to Him be the glory
amen
love
sharon

[Sharon2714]

ty debbie i will thats another thing i have on my list to talk to him about at post op .. i really appreciate it

[chelan3]

Oops meant to say it's also called Low Malignant Potential or LMP.

[chelan3]

Hi Sharon,
I was diag. with 1a serous borderline ovca (it's also called Low Potential Malignant or LMP) in 2002.  I also wondered about chemo, but in all my research it was not recommended as borderline ovca is slow growing.  Chemo works only on fast dividing cells and would be of no benefit for a borderline ovca.  The main thing to do with a borderline ovca is to confirm the pathology.  Apparently borderline ovca can be difficult to diagnosis.  I had a frozen section done during surgery - it diag borderline ovca as did the final pathology.  My surgeon also sent it out to a gynocologist pathologist for confirmation.  They did confirm borderline ovca.  Although chemo is not recommended follow-ups should be maintained.  Some women with LMP go every 3 mos for a few yrs while others go every 6 mos.  I had follow-ups with my gyn every 6 mos and a yearly CT scan for 5 years.   Now I just go yearly and no CT scan.  
I also had a total hysterectomy a year and a half after diag.  Now they don't necessarily recommend a hysterectomy for stage 1 borderline ovca (not sure if this is just 1a or all stage 1).  Definitely make sure you get a second opinion on your borderline diagnosis though.

Take care,
Debbie

[Sharon2714]

donna ty for thinking of me on ur day
from now on ur birthday will always be special to me :)
i copied the link before they (MH) nerfed it and i printed the info ... it was exactly what i needed
love
sharon

[msjazz]

Cam ****.***  Came across this from a guy at MD Anderson.  

[Sharon2714]

w0w that was awesome thank god for the UK
now i have a jumping off point for the conversation with my doc
ty so very much
love
sharon

[yrrek]

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Specific cancers : Ovarian cancer : Treating ovarian cancer
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Which treatment for ovarian cancer
This page gives an overview of treatments for ovarian cancer.  There is information on

The treatments used    
Planning treatment    
Stage 1 ovarian cancer    
Stage 2 and 3 ovarian cancer    
Stage 4 ovarian cancer    
Getting a second opinion
The treatments used
Almost all women with ovarian cancer will need surgery.  The amount and type of surgery you have will depend on your stage and type of cancer.  Women with borderline tumours or low grade stage 1 tumours may need no further treatment, although some may have radiotherapy to the pelvic area.

Most other women have chemotherapy after their surgery.  

You may find that other women you meet with ovarian cancer are having different treatment from you. This may be because they have a different type of ovarian cancer. Or it may be that their cancer is a different stage. Don't be afraid to ask your doctor or nurse any questions you may have about your treatment.

Suggestion
It often helps to write down a list of questions you want to ask. You could also take a close friend or relative with you when you go to see the doctor - they can help you remember what was said.



Planning treatment
You are most likely to be treated by a team of specialist doctors working together, known as a gynaecology oncology team.  This will include a surgeon (gynaecologist) and a cancer specialist (oncologist).  It should also include a gynaecological oncology specialist nurse, who can give you information about treatment and any support you may need.  These gynaecology oncology teams are usually based in specialist cancer hospitals and so you may need to travel some distance to hospital for your treatment.

If you have only seen a surgeon, you should ask to be seen by an oncologist before your treatment plan is finalised.  The team will plan your treatment according to

The type of ovarian cancer you have    
Whether the cancer has spread (the stage)    
What the cells look like under the microscope (the grade)    
Your general health
Your doctor may not be able to tell you exactly what stage your cancer is until after your surgery. During the operation, your surgeon will examine the inside of your abdomen. And they will take biopsies to check whether the cancer has spread.

Stage 1 ovarian cancer
If you are young and have a very early cancer that is borderline or low grade, you may only need to have the affected ovary and its fallopian tube removed.  Borderline ovarian cancers are unlikely to come back and so your unaffected ovary can be left behind.  You will still be able to have children in the future.  If you have had your menopause, or do not want to have any more children, your surgeon may advise that you have both ovaries and your womb removed.  Women with bordeline or low grade tumours may need no further treatment as the cancer is unlikely to come back.

If you have a medium or high grade cancer or stage 1b or c, you are most likely to have surgery to remove both ovaries and your womb.  This is because there is a risk of cancer cells being left behind if the other ovary and womb are not removed.

Your surgeon will also put fluid into your abdomen and send some of it to the laboratory to see if it contains cancer cells.  They will take samples of tissue (biopsies) from areas where the cancer could have spread.  You may have biopsies of the

Lymph nodes in your pelvis and abdomen    
Diaphragm (sheet of muscle under the lungs)    
Tissue lining your abdomen and pelvis
You may have the omentum removed. This is called omentectomy. The omentum is a sheet of fatty tissue inside the abdomen.  It is usually removed along with the womb because ovarian cancer can sometimes spread into the omentum.

After surgery, women with borderline or low grade cancer usually need no further treatment.  But if you have a medium or high grade tumour or stage 1b or c, you are likely to be offered chemotherapy to help stop the cancer coming back.  This is known as adjuvant chemotherapy.

Stage 2 and Stage 3 ovarian cancer
If you have a stage 2 or 3 ovarian cancer, you will have surgery followed by chemotherapy.  During the surgery, your surgeon removes your

Ovaries    
Womb    
Omentum - a sheet of fatty tissue in the abdomen    
As much of the tumour elsewhere as it is possible to remove
As much of the tumour as possible is removed, because if tumours are very small chemotherapy works better. Your surgeon will try to take out all the tumours and leave no area of cancer cells bigger than 0.5 cm.

Your surgeon will also put fluid into your abdomen and send some of it to the laboratory to see if it contains cancer cells.  They may also take biopsies of all the places where the cancer is most likely to have spread. This could include biopsies of

Your diaphragm (the sheet of muscle under the lungs)    
The lining of your pelvic and abdominal cavities    
The lymph nodes in your pelvis and abdomen
After you have recovered from your surgery, you will be given chemotherapy to reduce the chance of the cancer coming back.

Stage 4 ovarian cancer
The treatment you have for stage 4 ovarian cancer will depend on

How far your cancer has spread    
Your general health    
How quickly the cancer is growing
You may be offered surgery to remove as much of the cancer as possible. This is sometimes called 'debulking'.  You may have chemotherapy to try to shrink the tumours before the operation and make the surgery easier. After the surgery you may have chemotherapy to try to shrink any remaining tumours.

If you have a very advanced cancer, it may not be possible for a surgeon to remove it.  You may also not be well enough for a big operation.  You can have chemotherapy to shrink the cancer as much as possible and to slow it down.  Radiotherapy is sometimes used to relieve symptoms, depending on where in the body the cancer has spread.

You will need time to think about your options for treatment. And you will need support from your family as well as your doctor in making your decision. There is more about your treatment options on the treating advanced ovarian cancer page.

Getting a second opinion
Some people feel they would like to get an opinion from a second doctor before they decide about their treatment. If a surgeon (gynaecologist) is treating you, you should get an opinion from a cancer specialist (oncologist) about whether you need chemotherapy or radiotherapy. Most doctors are happy to refer you to another NHS specialist for a second opinion if you would find this helpful.

Note: A second opinion means just that. It does not mean that the second doctor will take over your care. Your treatment will usually still be managed by your original specialist.








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Last updated 19 March 2008

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