Follow up

[silver&gold]

Hi Dr Goodman,

I was dx with stage 1A Clear cell carcinoma in April 05, after surgery my ca125 was 10 and has been between 7 and 10 since my 6 cycles of chemo. My cancer was from Endometriosis that had turned malignant , I also had several very large Fibroids and Ovarian cysts.
I have now been discharged from my Oncologist who has written to my GP so that I can carry on having a ca125 blood test every 6 months (I had to insist on that). My question is, do you think that this is enough ? what are the chances of reccurance after 5 1/2 years  ?  and although my ca125 was 500 at diagnosis could that have just been from the Endo,Fibroids and Cysts?  .D o you think the ca125 would pick up a reccurance in my case?.
Thankyou so much in advance.

Best wishes

Regards
Angie

[Annekathryn Goodman, M.D.]

Dear Angie
thank you for your excellent question. Medical folks have been debating the role and frequency of follow up after a cancer diagnosis for a long time.
The standard answer is that
75% of recurrences happen in the first 2 years; 90% occurr by 5 years
so follow up is fashioned as follows:

exams and CA 125 tests every 3-4 months for the first three years
exama and CA125 every 6 months for the next 2 years

at 5 years exams and testing could be yearly
however for women with ovarian cancer, I usually recommend continued every six month surveillance

there is not alot of data one way or the other to support this recommendation

CA 125 is thought to be a good test for evaluation of recurrence.  I think it is also important to be sure you are getting screening for other cancers such as breast and colon

best wishes and please stay in touch

[Jane39]

No apologizes necessary, Angie automatically knew what you were talking about, I was being thickheaded or mis-interrupting what I was reading.  Well I am 4 1/2 years out, keeping my fingers crossed and slowing sneaking up on that 5 year magic marker.  Hope and pray it stays behind me forever.  Thank you so much for responding.

[Annekathryn Goodman, M.D.]

Hi Jane
thank youso much  for your question. You are right to ask for a clarification

statistics can be very confusing and misleading.

actually: for the people with cancer who EXPERIENCE a recurrence,
75% will have their recurrence by two years and 90 % will have a recurrences by 5 years.

that is different than saying: of everyone who has a cancer, 75% will  recur in 2 years etc
clearly, that is not the case.

I do not think wrote this very clearly in my last post and I apologize for the confusion!!  Thank you for speaking up!
take care

[Jane39]

Hello there.  I too was diagnosed in 2006, Stage 1A Clear Cell, had excellent surgery (complete TAH/BSO) only positive cancer was found on inside of one cyst on right ovary, six cycles of chemo, CA 125 has always hovered between 3 and 7.  Have PET/CT scans routinely, routine physician visits, CA125, etc, but I was a bit disturbed to see that you say that there is a 90% chance of re-occurence at 5 years? 75% before that?  I know there isn't a crystal ball, but I've never seen those type of stats before and it was a bit unnerving.  I know to keep monitoring on breast (get routine mammos) and I know I should be getting a colonoscopy sooner (I am 44), but should I be doing something else? Thanks for any additional information you can provide.  Jane

[silver&gold]

Dear Dr Goodman,

Thankyou so much for answering my question, you are very generous with your time and it is very much appreciated.

Thanks again
Best wishes
Angie