Clinical Trails

[plady]

Dear Doctor:

I just went to my Doctor and had a consultation with him about what my next step in my treatments will be.  I have had 5 treatments with Doxil and he has decided to stop them because of the severe foot, mouth and hand pain and inflammation.  My CA125 had gone up from 364 to 407, but the latest test, one week later has dropped to 307.  It looks like the Doxil still might be working, but the side effects are so bad that I have to quit for a while.  My Doctor says he wants to do another CT scan and then decide what will be next.  He mentioned that he would check into seeing what clinical trials I would be a candidate for at MD Anderson or UT Medical Center, San Antonio.  He told me that if I took approved chemo drugs at this time that lessens my chances for being accepted into clinical trials.  He said he would look at the ct scan and decide whether to do a clinical trial or approved drug.  He mentioned Etoposide and Topotecan.  I have alread had Gemzar/Carboplatin combination, Taxol and Doxil. I am very depressed now, probably because of the pain, but I am so scared that I running out of options.  He told me that my cancer would
not ever be cured because it has reoccured so many times.  My last ct scan was clear and the pet scan I had run in January showed only microscopic cells. That just didn't seem as bad as so many things as I read.  I really am trying to be optimistic, but I guess I just feel bad right now. Please let me know your opinion, as I could really use some advice as what to do.

[vfc]

plady,

How much time has past since your last treatment with the gemzar/carbo?

How much time do you need to go back on it?

Did you have the gemzar/carbo as first line treatment? How many treatments did you do before?

Sorry for so much questions but you are the only one I know who have undergone such treatment.

[plady]

Dear Doctor Goodman:

I looked up ascites, so I would know what I am dealing with.  
I do not have any ascites.  I actually have no symptoms other than chemo side effects.  My doctor did tell me that when he did the surgery that my tumor was small and some cells had spread to the outside lining of the stomach.  I guess I should be more technical, but that's what I know.

Thank you,

plady

[plady]

Dear Doctor:

My pain in only in my hands, feet and mouth.  My liver, kidney functions are good.  My last ct scan was clear.  My doctor has told me that my pet scan in January showed only microscopic cells.  I don't know what ascites is, so I can't answer that question.  Thank  you so much for your responses to me.  It really helps emotionally to talk to someone else that is knowledagle about this disease.  

Thanks again
plady

[plady]

I don't know the doses.  I am not the type to keep up with all the details.  I guess I should, but I don't.  I was part of a research group, trial sort of thing with the gemzar/carbo.  
This treatment worked better thank anything thing else that I have done.  I wish I could go back on it, but my doctor says it's too soon.

plady

[plady]

I looked my records for you.  My platelets did go down and so did my red blood cells.  Had to take a show for red blood cells.
My ca125 started going down after the second treatment.

[vfc]

Thank you once again, plady! You're being very helpful!

Can you tell me the doses of both Gemzar and Carbo Platinum that you were taking?

[vfc]

Thank you very much for your reply, plady!

You say that the only side effect you had was low WBC. What about your platelets?

I've been informed that low platelets is the most common and severe side effect with the Gemzar/Carbo Platinum treatment.

Can you tell me after how many treatments you've started to notice the CA125 lowering?

[plady]

I had Gemzar/Carbo Platinum every two weeks for six treatments.  It really knocked down my ca125.  Down to 5, but unfortunately the cancer cells microscopic after two months.  No bad side effects, other than low WBC.

[vfc]

Hi plady,

Since you already tried Gemzar/Carboplatin combination, I would like to know what regimen (or schedule) you went through with this combination.

I'm sorry to hear about Doxil's side effects you are experiencing.

[Annekathryn Goodman, M.D.]

Dear PLady,
I am sorry for your feeling bad right now. What alot you have been through!
So, if i am adding this up correctly, you have had 3 different lines of chemotherapy?
When you say you have pain, where is it?

OK, first of all, it sounds like your oncologist is being very careful. I agree with getting another CT scan and looking into clinical trials.

I always want as much information as possible: so I would want to know:-where is the cancer recurrence?
do you have ascites?
how is your kidney function? The liver? and so on

If your last CT scan does not show any tumor, then you have time to thoughtfully see what options are available.
We have alot of debate in the gyn-oncology world about whether or not chemotherapy should be given when all you have is an elevated CA 125 but we do not see "measurable disease".

Some oncologists would offer a hormonal therapy such as tamoxifen or arimidex in that situation.

Another option if your CT scan is stable is to change the doxil to every 5 weeks or to drop the does.

You have many, many other options. Let's see what the scan shows.
best wishes