ovarian cancer recurrence treatment

[sheba602]

Hi Just wanted to ask if the CA 125 goes up before it comes down in doxil. My mums CA went from 1200 to 1800 after first dose of doxil. I would also like to ask why recurrence has a lower response to chemo. If they are the same type of cells why is the chemo response negligible or minor. Why is it such poor prognosis on recurrence. Does this occur with all types of cancer and does it tend to be more with advanced cancers. Is chemo useful in relapse and progression compared to stable disease. Can there be remission after recurrence treatment or not. All this is confusing so if you could maybe make it a bit easier to understand. Many thanks

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Occasional "flares" are seen, when tumor markers transiently rise when a new therapy is begun.
Recurrence is known to be less responsive than the primary tumor in most human malignancies. The reason is that the initial chemo kills the sensitive cells, and the remaining ones are more hardy and resistant. These tough cells then begin proliferating and cause recurrance. When this second tumor is detected, it is already populated by resistant cells which respond less well to chemotherapy.
All the best, and God Bless!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Could you let me know the chemo regimen your mother had the first time around, the number of cycles, and the dates when it was given?
This would give me a clearer idea of her clinical history.
Good Luck!

[sheba602]

Many thanks for yr answer. Very clear and now my way of thinking has changed regarding my mums cancer. With the rise of CA being dramatic does that signify the cancer recurring aggressively. Also does second surgery not help in removing the chemo resistant cells. Her response now has been her CA dropped from 1800 approx. to 1650. I know its not a big rate of drop but surely some response is better than none. Would there come a point when the marker rises. Is it from this that a prognosis is made. With yr experience what would you give approx as a prognosis on my mums cancer knowing she had response to chemo for 4 mths before recurrence but also had 4 mth chemo holiday. In those 4 mths her CA went from 112 to 1200.Any indication or knowledge you impart would be so appreciated. With every info we gain more insight into what we are dealing with. Many thanks again.