CA 125 rising

[sheba602]

Many thanks for yr response. Just replying to yr qustion on follow up appt my mum had. Her CA ha gone up from 358 to 500 and scans show cells in lymph . According to her onco he wants to give my mum another 4 weeks before another scan and blood test and not wanting to start her chemo till then. Basically giving her more time off chemo as he feels her performance status is still good. Is it dangerous not starting chemo if CA continues rising or is it best to let the patient carry on if symptom free and enjoy QOL.  My mum is a bit confused even though relieved she has another month off. This will be about 3 mths since first line chemo. Or could be he wants to keep her off chemo long enough for the cancer to start showing response and a definite one to the chemo. Would it be fair to say that the plan re chemo is to hope the response one gets is great enough to warrant the side effects. Would there be any other reason to delay chemo. Esp as he can see cancer in lymp nodes. You say lymph nodes with cancer in them does not cause pain. What does it do then and whats the worry with it apart from the circulation. Is the chemo then to get rid of micro bits in the lymp and the general circulation. Many thanks

[Annekathryn Goodman, M.D.]

Hi There
basically progression, relapse, recurrence mean similar things. The cancer has grown back.

the wikipedia explanation of how we measure tumors and response to therapy is excellent . I have pasted part of it below.
best wishes

http://en.wikipedia.org/wiki/RECIST

Response Criteria
Evaluation of target lesions

Complete Response (CR): Disappearance of all target lesions
Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD
Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started
Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions

[Annekathryn Goodman, M.D.]

Hi There,
ok, let's focus on 2  of your important questions:

-It is not dangerous to wait a month to start chemo. This will give your mum more time to get strong, have good nutrition, and to charge her bone marrow. Chemo can cause anemia and low white blood cell counts so it is good to go into chemo with a strong blood count.

-lymph nodes
ok here is a wonderful site that defines the function of the lymphatic system:
http://www.cayuga-cc.edu/people/web_pages/greer/biol204/lymphatic1/lymphatic1.html

Cancer in lymph nodes means that cancer cells have traveled from the original site of cancer (such as the ovaries) to a highway (freeway) in the body that leads to distant sites.
So for your mother, the significance of having cancer cells in her lymph nodes means that we may see the cancer show up  far away from the ovarian site such as the upper abdomen, the liver, the lungs. In and of itself, a particular lymph ndoe with cancer in it may not hurt and cause illness.

please keep in touch
best wishes

[sheba602]

Thank you for yr reply DR A. My mums CA went up to 800 which is to be expected considering no chemo for 3 mths. Her report says disease progression and another report says disease relapse. I do understand the terms but in the case of cancer whats the criteria for describing or differentiating recurrence, relapse and progression. Apart from the CA values I assume the 3 terms must be somehow related? Is progression when CA value never goes to normal and without chemo it rises and recurrence occurs after remission? Does prognosis get based on the recurrence or progression and is the stage indicative of whether the cancer will progress or recur. Many questions and appreciate yr time.