Ovarian cancer is back after surgery and chemo

[Brother Dave]

My mother-in-law, whom I love dearly, was diagnosed last year with Stage 3c Ovarian Cancer.  She had a complete historectomy, and the doc said he got 95% of the cancer.  Then she underwent the usual 6 months of Taxol chemo treatment.  She never regained her strength even after the chemo stopped.  Now, we are told the cancer has come back.  The doc started her on chemo again, and it totally wiped her hour.  I mean she has been in bed for the past 3 weeks.  Last Tuesday they removed 8.3 liters of fluid from her abdomn.  Today we took her back to the doctor and he put her in the hospital for dehydration and a blood clot in her leg.  She still has no energy and gets winded just walking to the bathroom.  I have no idea where this would fall in the scale of prognosis and the doctor won't commit.  Any help here would be appreciated.  We want to do what is best for Ma, but other than love and kindness we don't know what to do.  

[joey417]

my mom has had 4 occurances and now has terrible distention of the abdomen and left sided pain that is debilitating and almost nothing has kept her down for 7 years with this cancer. she is 73. they only grained barely a liter out of her abdomen how can that be. she lookes 10 monthes pregnant and now can barely eat. they have recommended avastin because the topotecin did not work after 2 rounds. where is this disteded abdomen coming from if not ascites.

[crecco]

I'm sorry but I have to disagree with you. I am 46 years old and was dx stage IV metastatic ovarian cancer in Nov. 2005. Due to my health at the time and the aggressiveness of my cancer I was started on the norm taxol/carbo 1 week later for the reccommended 6 rounds plus 2 more. My Dr. wanted to shrink my tumors as much as possible BEFORE I had surgery, which I finally had in June of 2006. At which time after removing the tumor on my ovary, only one other small tumor was found and removed(which was on my diaphram). After recuperation from the hysterectomy, I had a radiofrequncy ablation to my liver to remove 3 small tumors that were IN my liver and therefore couldn't be removed during surgery. The RFA was done in July 2006 and preventive chemo was resumed at the end of the same month. My initial dx was made after a needle biopsy to a lump on my upper torso (of which by that time I had found something like 13, of various sizes), a pelvic exam, a mammogram, and a CT scan. The biopsy tissue was sent off to determine the exact kind of cancer I had(which took about 1 week) but by then the Dr.s had already decided the cancer was very aggressive and therefore aggressive treatment was needed, but surgery at that time was out of the question as I wouldn't have lived through it. So July 2006 I had no visible disease, unfortunately that only lasted until Nov. 2006 when 2 more spots were found in my liver. I had been on preventive chemo (taxotere) until then but since that was no longer working I was put on Doxil in Jan. 2007, which didn't end up doing much for me except making me feel horrid for about 3 months. Since my CA-125 had pretty much leveled off another RFA was done in May 2007. My CA-125 was still going up after wards so Aug. 2007 my chemo was once again switched, this time to Gemzar, and I'm very happy to say my CA-125 is getting very close to normal, the lowest it's been in almost a year. The down side is having to adjust to another chemo med. But since I have been told I will probably be on chemo for the rest of my life, Iv'e accepted the fact that chemo is going to be part of my life now. Once I decided that I wasn't ready to go yet, chemo wasn't near as hard to accept. If thats what it takes to keep me around awhile longer, then thats what it takes. Sorry, I didn't mean to ramble on, I just wanted to explain that there are exceptions to the standard treatment with good results.( 3 DR.s later told me that at initial dx, I wasn't expected to last a year). After the initial shock wore off I realized I was going to have to put up the fight of my life, and I was NOT going to lose. My prayers and the best of luck to anyone else out there fighting this same fight.

[SimplyStar]

You say she was dx with stage 3 in May 2006, how was this done with the surgery being 11 months later?  What surgery was done in April 2007,  the cyst is where?   This seems to be completely out of the norm.  Usually  it is staged during the initial sugery, then chemo, then follow ups.  My daughter never had the ascities, but she is the same age as your daughter and was dx with stage 3 immediatly during her surgery in July 2006, followed by first line chemo,  recurred in Feb 2007,  now on chemo again.  What alternative methods did she try prior to her surgery.  Your explanation of this might help others  understand some of the methods that have been used.  

[ladyjemmay]

Question - my daughter (age 50) had stage 3 ovarian cancer, diagnosed in May 2006, tried alternative methods and had surgery in April 2007, was on chemo both pre and post surgery.  Has been off chemo for about 2 months, but has problem with ascitis.  Seems to need to be drained every 2 weeks.  Her oncologist says the fluid is cancer-free.  But she now has a cyst that may need to be removed.  She is very depressed.  From my reading, if she has the fluid build up (ascitis) doesn't that mean that the cancer is back?  How can I help.  We don't live in the same city, and I am still working, but I plan on going down on weekends.

[SimplyStar]

Your posts have touched my heart, I can tell you loved your MIL deeply and have felt the pain along with her. When it comes time for God to take us home, it is sad for the family, but a release from our worldy pain and suffering to go to Him.  Thanks for the time you had to share with her and know she is free now.  Take care now and remember her in your hearts as the woman she was before this burden was thrust on her.

[Helmar]

It's very sad to hear that you've lost your dear Mother in law, but as she was experiencing a difficult time, from what you described earlier, it must be of some relief to both you and your wife, to know that she is finally at peace, and no longer has to go through this trauma.
Wishing you all the best....hugs...Helen...

[Brother Dave]

Saddly, Ma passed away at 0015 on 9/1/2007 at Hospice of the Ozarks, in Mtn. Home Arkansas.  She was surrounded by her family and went peacefully.  I hope I never have to witness this dreadful curse of ovarian cancer again.  God bless you all and thanks for all your help and advice.

[Susie9Bee]

My sister and  I both have ovarian cancer (BRCA1 gene) and she had the same side effects after her first 2 treatments of Taxol and Carboplatin. The Docor wanted her to try Emend, even though she wasn't nauseous, to see if it would help. Miraculously, it did the trick. She takes dexamethazone with it too for days 2, 3 and 4. Good luck!

[Iamblessed]

Has her physician prescribed the drug Emend? I took that throughout my entire chemotherapy and hardly had any problems with nausea or vomiting. And during my chemotherapy I was on 2 chemo meds and sometimes 4 different ones at the same time during chemo.....I would get a 2nd opinion. Hope that helps.

[lactac1224]

If you want a second opinion you should get a second opinion.  Don't do anything that you will question later like "I wonder if we did everything we could".  There is a time to let go, but make sure you are all at that place.  If there is another hospital in the area call them up, make an appointment and have them request your MIL's records.  Then let her doctor know that you are getting a second opinion.  That is what I would do.  When my Aunt was diagnosed the original response was- sage 4- resistant to treatment -we wouldn't do anything.  We wanted a second opinion and were getting nowhere.  I went to the best cancer center in our area and waited at the desk until they arranged an appointment for her that day.  Sometimes with onc. they do not realize that time is of the essence.  The second opinion was the same as the first and then it was easier to make the decision for her to let go.  It got easier if that is possible.

If you are still trying to figure out how to get her nurishment,  go to a good health food store - not a chain, but somewhere where the people really know what they are doing.  They cangive you advice.  It seems to me there is a powder that can be put into a shake that will boost the protein in the shake if you are only able to get a little down.  Also, there are protein shakes that have more of a boost than ensure.  One final thing.  We were told to stay away from sugar when possible.
I am wishing the best for you!
Laura :)

[Brother Dave]

After Doctor visit yesterday, we were told that ma's cancer was not responding to the chemo.  We asked about a different drug, and the doc said that when this cancer comes back it is sometimes very resistant to any drug.  He wants ma to decide wheather or not to discontinue treatment.  I have been in contact with Cancer Treatment Centers of America and they said that medicare and medicaid will not allow her to go out of state for treatment.  What kind of deal is that?  The other treatment facility is in Little Rock at UMAS.  I would like to get a second opinion but all the doc wants to talk about is discontinueing the treatment and discussing hospice.

[Brother Dave]

We are calling the doctor again today, because I think she is dehydrated again.  She is passing fluids at about a 2/1 ratio and still not eating.  We have given her Ensure when she can keep it down.  But, this is all very wearing on my wife who gets almost no help from her siblings (a brother and a sister).  Granny is staying with us as she did while she was treated last time, we have a baby monitor in her room so we can hear her call out at night.  I'm pretty sure the doctor said the chemo was Taxil, or Toxal or something like that.  Its the same stuff she had last time.  Thanks again everyone.

[SimplyStar]

Ginger tea helps with nausea.  It is safe and does a good job.

[Helmar]

Hello... I presume you mean Doxil... and that's a slow starter. It will probably take at least 3 treatments of this one, before it shows some response, so if your M.I.L. can tolerate it a little longer, it may have a good affect on her cancer. I had 4 shots of this, and the only side affect  I had was mouth ulcers, but it did work really well. Unfortunately for your M.I.L. she seems to have other health issues to cope with, and that's makes the situation more worrying of course. I wouldn't venture to predict, or suggest what course this could take for your M.I.L.... and no-one can really, as we are all individuals when it comes to this disease, but I just hope that the chemo will respond soon, and she will get some relief from all of this. Perhaps she could try some of those health drinks instead of the more solid food, in the hope that she can at least keep something down to allow her some nourishment. I hope you will keep in touch, and let us know how your M.I.L. is doing. Thinking of you, your wife and your M.I.L... and wishing the best for you all....hugs....Helen...

[Brother Dave]

The chemo is Toxil.  Will COQ10 help with the nausia?  Her living will prevents the use of a feeding tube.

[SimplyStar]

Read up on COQ10   it strengthens the heart.  You didn't say , or I missed it, what chemo is she on now?  If Doxil, definitly the COQ10.  It is very hard to be a care provider, you can feel so useless at times. All I can say is keep trying and stay strong.  Would she tolerate a feeding tube?

[Brother Dave]

MiL has had 2 chemo treatments since discovering the reoccurance.  After the first she was physically devistated.  She was in bed sick for 3 weeks.  Durring that time, she would not eat or drink much.  We took her to the hospital because we were fearful of her being dehydrated as happened with her former treatment.  The hospital kept her for 3 days,  rehydrated and kept up her other meds.  We took her home on Monday and the following day had to take her back to have the fluid drained from her belly because she could not breathe.  A week later we again took her to the hospital at the doctor's request.  She stayed 11 days and had her 2nd chemo treatment while in hospital.  Now she is back home, still weak, nausaited, and will hardly eat or dring anything.  Every time she eats she gets sick.  We have used 3 or 4 different nausa meds but none seem to work.  She sleeps a lot and in addittion to all this she has developed a blood clot from her right knee to her ankle, which is being treated with blood thinners.  She is 68 years old, diabetic (insulan dependant), and has a history of heart problems (she has a stint in her heart).  We are fearful that if she does not begin to eat very soon, the outcome will be grimm.  Can anyone help me and my wife with respects to what to do or what to expect in the near future?  Thank you so much for your past information.  God bless you all.

[Helmar]

Hello again... I just want to wish your M.i.l. well, and hope that the chemo will have the desired affect. Just wondering...do you have children? As there seems to be cancer in both your, and your wife's family, you may need to keep watch on any children in the future, Sometimes these things can pass down the family line. I have a daughter in her 20s, so I'm very concerned for her, now that I have Ovarian cancer, although there is no cancer in either side of our family... I am ' first cab off the rank'...but there is that possibility for her now. I guess it's a case of ' be alert not afraid'.
Wishing you all the best....Helen...

[Brother Dave]

Thank you both for your input.  Ma is 68 years old and has been in remission for only 6 months.  Her initial treatment ended in December of 2006.  But even after that she had very little energy.  I have had the honor of knowing and loving my Mother-in-Law for 26 years.  It is with great sadness that we now must face the possiblility of loosing her.  My wife also lost her dad to cancer several years ago, and my own mother is a Breast Cancer survivor of over 15 years.  I am hopeful that the course of treatment chosen by her doctor will give us more time with her.  Again, thank you for caring.

[Helmar]

Hello...As westgal said.. we are all different, but I think the one thing that we probably share in common, is to never give up. The fluid can be drained, and hopefully your M.i.l.'s Oncol. will have her on some chemo that should prevent that from returning.. or at least reduce it some. I've not had the fluid, but a close friend has, and apparently, it can be very debilitating. I was dx in Feb'04..Stage 4. Like your M.i.l. I didn't have a long break from when I finished the ititial 6 chemos, to recurrence... only about 9 months, and I've been on chemo 'off and on' since, but I don't even think about it, unless I am going to the Oncol. or for blood tests etc.. I think maybe you/your wife, needs to have a serious chat with your M.i.l.'s Oncol. and try and get some idea of what he thinks her future with this lousy disease is. Most of these treating Oncols. don't like to surmise anything, as with this disease, no-one really knows what turns it will take, but I do think that in a lot of cases, where the patient doesn't seem to be doing well, the Oncols. must have a slant on what the course will be....but they prefer not to be pessimistic. I hope you can get some answers, and I hope that you M.i.l. will rally, and do really well. It's commendable that you think so highly of your M.i.l... some S.i.ls. don't. *laugh*....
Wishing her well... and keep us posted as to how she is doing. Hugs..Helen...

[westgal]

I meant to say your mother-in-law, not your mom.

[westgal]

From the information you provided, it sounds like your mom is experiencing (unfortunately) some of the things that are associated with treatment along with the recurrence. You didn't mention your mom's age, however, to normalize some of this, I was 52 during my 6 months of first-line chemotherapy and was hospitalized four times for dehydration (after surgery). At home, there were times that I couldn't walk from the living room to the kitchen without sitting down. Even after chemotherapy was completed the fatigue continued for approx. four months despite a transfusion to raise my red cell counts. I could go on and on. I wonder if she had another chemo drug along with the taxol.

Sorry to hear she has had the recurrence. You didn't mentioned the length of time she was in remission, however, the longer, the better. Although I have not had a recurrence or ascites (fluid that they drained from your mom--which you can read about in other posts), it would be helpful to ask the extent to which the cancer has returned and the doctor's plan for treatment after her renal function is stablized (and the blood clot issue has been resolved).

As far as a prognosis goes, my doctors just say they are optimistic because the outcome differs from person to person. My ovca can return at any time. So hope and pray that she becomes well enough for additional treatment after which she goes into remission again.

It is great that you are looking for ideas on this forum. When I was in the hospital the most helpful thing for me was just having someone there (and someone to listen to my concerns as they arose---I was well enough to advocate for myself which helped). When I was at home the most helpful thing for me was having someone to take me grocery shopping and go with me on errands--again depending on her age if at all possible encourage her to do simple things outside of the house even though she feels tired (if she is really elderly of course that may not be possible). Sounds like your mom is getting good care and has a caring family.