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Thread: CONFUSED about ovarian cancer

  1. #1
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    Feb 2014

    CONFUSED about ovarian cancer

    my mother has been recently diagnosed with stage4 ovarian cancer. Since she had cancer cells in the fluid in her lungs she is a stage 4a as i understand it.

    In contrast to what I have read, her doctor (Which is an oncologist, not gynecologic oncologist, since the initial suspicion was breast cancer) claims that no surgery is required and it is driving me mad since I read everywhere that having lung fluid is not a contra-indication for surgery.

    She's supposed to recieve the first chemotherapy course (carbo+taxol) tomorrow and I am worried that she should get surgery instead.

    Any ideas? Am I missing something here or am I correct?


  2. #2
    It's pretty common to do some chemo first and surgery later. The chemo can do a lot to shrink the tumors so surgery can be more complete and easier on the patient. The chemo should also dry up that effusion, and you might find that she'll start feeling better quickly if the chemo helps get rid of that and eases other symptoms. Sometimes they do chemo first so the patient can get stronger in preparation for the surgery. That may sound odd, but it's not unusual for patients to gain weight, become more active, and feel a lot better during chemo.

    I don't think the fluid around the lung contra-indicates surgery, but surgery for the tumors in the abdomen might not stop the fluid around the lung -- chemo is the thing that is most likely to stop the fluid. So if she had surgery now she might have to wait four to six weeks to start chemo and get relief from the effusion. I don't know if that's what the doctor is thinking, but it might be.

    It also depends on her general health. If she has other medical conditions, that could make surgery more difficult.

    But I think it is unusual to think surgery is "not necessary." With some types of cancer if it reaches stage 4 surgery will not help, but with ovarian cancer they find surgery usually does help, even at stage 4. If you can see a gynecological oncologist for a second opinion, it seems to me that's a good idea, but I wouldn't interrupt the chemo treatments to do that -- many gyn/oncs will do some chemo first, so you have some time to seek advice on what the next step should be. The carbo/taxol combination is the standard frontline chemo treatment for ovarian cancer, so that is no different than what a gyn/onc would use.

    I think it would also be good to ask the current doctor to explain more details about his decision and what all the options are.

    Please let us know how it goes. I hope she has a good experience at chemo tomorrow. I was terrified, but I had no problems at all. The chemo nurses are wonderful. They're great about giving tips on how to avoid trouble and they welcome questions.

    They'll tell her to drink lots and lots of liquids, every day. 2 quarts a day minimum. They mean it! If you don't drink a whole bunch you really do feel lousy. And take the anti-nausea meds, even if you think you're tough! The meds really work, but they have to be taken before the nausea starts, not after.

    I'll be thinking of her and hope she has a really good day.
    Diagnosed with stage 2c papillary serous cystadenoma borderline malignancy of the ovary in 2009. Hysterectomy, omenectomy, appendectomy, debulking.
    - 2010 - laparoscopy showed inoperable recurrence, so started chemo.
    - Frontline chemo - carboplatin and cyclophosphamide, six cycles
    - Additional chemo regimens: Avastin - ten cycles; Weekly Topotecan - 4 cycles.
    - Spring 2012 developed pleural nodules. Topotecan plus Avastin - 1year.
    - April, 2014, had surgery to remove Aspergillus infection from right lung.
    - September, 2015, started on Megace because my tumors are PR positive. Stopped Megace after three months.
    - September, 2016, hospitalized for shortness of breath and back pain.
    - September, 2016, respiratory failure reversed with prednisone. Maintaining on 50 mg Prednisone per day and supplemental O2.
    - October, 2016 left hospital with no supplemental oxygen. Feeling great! Will start tapering off the prednisone Oct. 10.


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