Recurrence mucinous cystadenocarcinoma

[marie3B]

Dr. Goodman, I have contacted you before.  I was dx 6/2007 stage 3b ovca mucinous cystadenovarcinoma.  Had Cisplatin/Taxol, I/V & I/P.  Recurrence is showing that tumors are coming through the colon wall near the rectum and there is a 3cm tumor behind the liver from diaphragm.  I will be starting the folfox chemo since the mucinous tumors to the ovaries are acting like colon cancer and may be of GI origin.  If surgery is done to remove the area of the colon and giving me an ostomy opening I may be given Avastin.  Does this sound like the way to go?  My own onc wanted to try carbo & taxotere, but the 2nd opinion was the folfox.  I appreciate your advice.  Thank you, Marie

[Annekathryn Goodman, M.D.]

Dear Marie
thank you for your update. I apologize about my delay.
It sounds like you are getting excellent therapy and are in good hands with your thoughtful doctor.  The plan sounds very good.  As you say, one of the struggles with treating a cancer that is grade one is that chemo is not as sensitive.

There definitely can be a role for surgery in slowly growing , low grade tumors. If there is not alot of other tumors, surgical removal of the colon makes sense. However, if there are many other areas of involvement, the surgery can be much more complicated. For instance, sometimes it is not possible to just remove that one spot in the colon and it is necessary to remove the whole colon and have a pemanent ileostomy.

please keep us posted on how you are doing
best wishes

[marie3B]

Up-date.  I am on the folfox / Avastin combo.  From my pathology the tumor board at  U of Chicago leans toward a GI origin for my ovarian tumors.  I have had 3 cycles.  They did not make me have the colon surgery to receive the Avastin. Only bad effect was severe stomach pain in the night of my second cycle.  Same pain early this morning after the 3rd treatment , but was less intense and only lasted a few minutes.  After 6 cycles we check for respone.  If this is not working would I return to the chemo options for ovca or would we just try to manage what is there surgically?  My onc has high hopes for the chemo I am on and is working so hard to help me.  I thank you and all you great doctors that give your time to help us live.  Marie

[marie3B]

This is a grade 1 cancer.  Did not get a full response from first line treatment.  The small spots in the left diaphragm area did not go away.  Onc considered me stable.  I had some rectal bleeding and anemia.  CT scans and PET are not showing the colon lesion.  That were found through colonoscopy.  CA125 is low, 1.7.  Never a good indicator for me.  Both new colon lesion and tumor near liver are same cell type as the original cancer.  Onc plans on doing some of the chemo, checking for response, then surgery to remove what remains, then complete chemo. Sound good? Thanks again, Marie