para-aortic lymph nodes

Hi again Dr A. Appreciation again for your time and kindness. Update on my mum. Her CA went up again and this is only after 2 mths treatment free holiday. The onco mentioned due to rising CA and scan it shows cancer in the above mentioned nodes. When she had surgery 4 of those nodes were removed. How rapidly and what does it mean when CA rises from 112 to 153 to 248. Would you class that as astable rise. She has started having mild symptoms of nausea and belching. How does one recognise bowel obstruction or start of so as th take action. Her bowels are ok. Is there a progression from the paraaortic region and if so to where ? Also her cancer seems to be in the particular lymph nodes and also stomach lining. Are these controlled ? Also please one a cancer is in lymph nodes does it metastasise quicker than the original. Having 4 lymph nodes removed does that also mean it is extensive considering I believe there are 20 paraaortic nodes on each side. Pl enlighten the lymph node issue. She should be on Doxil next week. How does end of life occur. Do they run out of chemo options. Many thanks

[Annekathryn Goodman, M.D.]

Hi There,

I think you are asking me about prognosis. It is hard to predict what a particular person's experience will be.  Your mother is experiencing some growth of her cancer. It is not necessarily mean that her cancer will be growing more quickly now.

As far as lymph node involvement by cancer, this a common but usually, lymph node involvement does not make a person sick. For women with ovarian cancer, the toughest part is when the cancer in the lining of the abdomen grows. That does cause bowel obstruction. It does not sound like your mother has symptoms of a bowel obstruction right now.

How does the end of life occur?  For many women who experience ovarian cancer, there comes a time when it is not possible to eat anymore because of the cancer in the abdomen. this leads to malnutrition, lowering of the immune symptom, swelling and fluid in the legs that makes it hard to get out of bed.

When a person's performance status drops to a 3 or 4 (not getting out of bed), chemotherapy is no longer helpful.
I am sorry.This is rough stuff. It sure does not sound like your mother is at that point.
take care