ovaian brain tumors

[Jo A]

Dec. 7, 2005 I had surgery for stage 3 ovarian, followed by chemo. All went well, CA125 dropped from 803.9 to 5. Two weeks ago I had a followup, CT showed slightly enlarged lymph nodes but other wise "perfect".

Last week I went to the hospital basically incoherent. Preliminary CT of my head showed one large tumor on my left temporal lobe but an MRI then showed 3 more all on pathways that relate to comunicating & understanding languge.

Tues. I began whole brain radiation. The plan is there will be another MRI & then more chem.

I'm being very realistic about all this but at the same time I really don't know what to expect. I can't find any literature that deals with ovarian brain tumors.

Could you provide me with any & all info you have. Not knowing is so much worse than having the facts. Thanks.

[cyberfreeze]

A related discussion, Genetic disposition was started.

[Jo A]

The radiologist ordered another MRI last Thurs. because he has no idea why I'm experiencing the troubles I have. Result was no thing new & different, actually no change at all from the MRI done when I went to ER on Feb. 15. So it would seem that since all three MRI's are the same the radiation hasn't done anything??
At this point, isn't treatment just for quality of life & not to buy more time? What would you guestimatethe time frame till death is?

[Annekathryn Goodman, M.D.]

Hi There, I agree - not knowing is much worse!
I have pasted some abstracts on brain metastases from ovarian cancer. It is rare. When the tumor in the brain is solitary, that is a better situation and women can experience a remission. Even with a few tumor, therapy can eradicate the tumor. Usually surgery is an important part of treatment. Because of the location of your tumors, surgery is not very safe. However, it is possible that with shrinkage from chemo and radiation that surgery might be reconsidered. It is also possible that therapy will not make these tumors go away. that is a scary thought. If that happens, you could get sick from this cancer this year. It is very important that you have a health care proxy in place and that you are very clear of what your wishes are. Sometimes with brain involvement, you could have episodes of disorientation. It is also important to have a medical alert bracelet and have clear information with you about who to call if you have an episode of confusion.
best wishes to you

There is a nice website oncolink that has good information. i have pasted a link below
http://www.oncolink.com/types/article.cfm?c=2&s=4&ss=818&id=9536


Cohen ZR, Suki D, Weinberg JS, Marmor E, Lang FF, Gershenson DM, Sawaya R.
Department of Neurosurgery, Chaim Sheba Medical Center, Tel Ashomer and Sackler School of Medicine, Tel Aviv, Israel.J Neurooncol. 2004 Feb;66(3):313-25

Between January 1975 and April 2001, 8,225 patients with ovarian cancer were seen at The University of Texas M.D. Anderson Cancer Center. Brain metastases developed in 72 of these patients (0.9%). The medical records of these patients were reviewed to assess the incidence of these metastases and their correlates of survival, as well as to describe the various treatment modalities used against them and their respective outcomes. The mean age of patients at the time of brain metastasis diagnosis was 53.7 years. The median interval between the diagnosis of the primary cancer and brain metastasis was 1.84 years. Neurological deficit, headache, and seizure were the most common symptoms. The brain was the only site of metastasis in 43% of patients. Multiple metastases were seen in 65% of them, although this may be a slight underestimate, as brain metastases in 17% of patients were evaluated prior to the magnetic resonance imaging era. The median survival time after the diagnosis of brain metastases was 6.27 months (95% CI, 4.48-8.06 months). The combination of surgical resection and whole-brain radiation therapy (WBRT) resulted in a longer survival time (median, 23.07 months) than did WBRT alone (median, 5.33 months) or surgery alone (median, 6.90 months) (p < 0.01 in both instances, multivariate Cox proportional hazards model analysis). The prognosis for patients with brain metastases from ovarian cancer appears to be poor. The existence of systemic dissemination at the time of brain metastasis was associated with a worse survival trend. The only significant predictor of survival in our series was the treatment modality. In particular, the resection of brain metastasis from ovarian cancer followed by WBRT appeared to be superior to resection alone or WBRT alone.



Tay SK, Rajesh H.
Gynaecologic Oncology Services, Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore, Singapore. ***@****
Int J Gynecol Cancer. 2005 Sep-Oct;15(5):824-9

Brain metastasis from epithelial ovarian cancer is uncommon. We studied the presentation, treatment, and prognosis of brain metastasis in a single institution. A retrospective review of clinical details kept in the computer database of gynecologic oncology services in a tertiary institution between 1993 and 2003 was done. A Medline search for English publications on brain metastasis from epithelial ovarian cancer was performed from 1966 to 2003. The study period included 605 patients, and 4 (0.66%) patients developed brain metastases. The patients were usually well, until they presented with hemiparesis. The median primary treatment to brain metastasis interval was 16.5 months. Three out of four cases had multiple brain metastases, and all had small-volume extracranial tumor relapses. Serum CA125 measurement was not reliable in the screening for brain metastasis. The median survival after brain metastasis was 19.5 months. Single brain metastasis can be treated with surgery. Our experience supports the prevalent published opinion that all other cases should be considered for combined radiotherapy and surgery or radiotherapy and chemotherapy. Surveillance of tumor recurrence with serum CA125 monitoring does not predict brain metastasis, which carries a poor prognosis. The best mode of management of these patients is yet to be determined. Large study with multicenter participation to establish the standard treatment is urgently needed.