PtCt scan versus markers

[ehr]

I have written intermittently over the years. In late 2002 I was diagnosed with stage 4 unknown primary (fluid in the lung, collapsed lung –decortication) which was later determined to be Ovarian Cancer. I went through taxol & carbo, then taxol maintanence. After a  two year+  remission was treated with doxli for a year+ then  carbo again (now allergic) Gemzar (didn’t work) back to Taxol (worked like a charm) a year later had to move on and Avastin was the ticket, stabilized for a year and then added nexavar.  6 months later rising markers dictate a change again. Please keep in mind that my CA 125 is well  over  2000 and my 27-29 over 120. They have been pretty high for years now (over 1,000). The confusing part is that my PtCts have been clean.  With my markers rising to 2600 and 130 respectively we just did another PetCt this month  and the results were the same – clear as ever.  My doctor feels that the Avastin is still effective and wants to replace the nexavar  (which I have had some toxicity problems with) with low dose 25mg oral citoxin. I was asking about etopiside or even taxotere  since I had such good reactions to taxanes in the past. He feels we can save those options. I ddnt qualify for the vaccine study at Roswell. Treating a number is tough but at least on Avastin I feel great am very active and work full time – realy no side effects.  Do you have any thoughts on my situation. I think my cancer is an anomaly we might have to think outside the box a little. Thanks so much for your help over the years.

[Annekathryn Goodman, M.D.]

Hi There
thank you for your updates.
I think your oncologist is taking great care of you.
The way I think about it : you are asymptomatic and your Pet does not show significant disease.
So I think you can take your time making a decision about switching. give it 3 months before deciding. if your tumor markers are up in 3 months then follow up with a scan.

please keep us posted
best wishes

[ehr]

I am now completing my first three week cycle of oral cytoxin and I feel great compared to when I was taking the nexavar. But my last blood test just after the PtCt saw my CA125 rise to 3500 but my 27-29 drop to 90 (it was up to over 130  prior to that  (for those two weeks I was not talking anything orally). So there are many mixed signals. I am really afraid of ditching the Avastin based on markers alone as I have read on these forums that the disease can spread faster when you stop taking Avastin. Right now I would just settle for how I am doing and feeling right now, excellent - freeze frame!