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Ovarian Cancer, Constipation, Pleio-morphic Adeno Carcinoma Cells. Treatment ?
Question: Hi, A friend has been diagnosed with ovarian cancer. Age 70 years, bore two children, widow for 16 years. Presenting symptoms constipation and obstipation. CT scan done, reveal ascites, omental thickening, bowel loops entangled around sigma of colon. CA125 - 769.1 CE A and CA - 19.9 are in normal range. No clear ovarian masses see on CT or USG. Asitic fluid examination showed pleio-morphic adeno carcinoma cells. Patient has been given two doses of chemo Carboplatin plus Paclitexal. Third chemo due on 16 XXXXXXX Surgical intervention under consideration. Request opinions please. Thanks
Hello and thank you for your query.
Let me provide you with some information regarding your friend. When we talk about ovarian cancer in the case of your friend, it appears to be of a relatively advanced stage. With that being said, we still have some good treatments and in many cases we can lead to good outcomes and improvements in survival with chemotherapy.
Your friend is 70 which we consider elderly but if she is otherwise healthy and active she can likely endure the chemotherapy. Chemo will have some side effects which I am sure she has been told about - includes hair loss, fatigue, some nausea and sometimes a change in her blood counts. Her oncologist will monitor her blood counts regularly and she may need some medication to help keep her white blood cell count in a good range. This will take some time to determine. Typically the first few infusions of the chemo are very well tolerated. She will likely have a plan of 6 treatments given every 3 to 4 weeks before a reassessment is done. Some oncologists prefer to check for a response sooner such as after the third treatment.
Now, as far as surgery - this has to be considered carefully. she should be evaluated by a gynecological oncologist - a surgeon with highly specific training in the management of ovarian, uterine and cervical cancers.
The CA125 is a great blood test that helps us monitor response to therapy. Very likley her CA125 will trend down - sometimes to below 25. Her oncologist will use that as a marker for both response and possibly for recurrence. If surgery is not an option, she may be considered to start on what is called "maintenance chemotherapy" where she would receive a weekly infusion of medication to prevent significant recurrence of her malignancy.
A question frequently comes up regarding prognosis. "How long can I expect to live?" This question I rarely answer because it is impossible to predict. Rest assured your friend is in the hands of an oncologist who has selected an appropriate regimen of chemotherapy. Positive thinking, good friends and even prayer are as important as any medication and I encourage you to continue to be supportive to her.
Thank you again for your query. If you have any additional questions regarding this, I am available to address them.
Sincerely,
Dr. Galamaga
Let me provide you with some information regarding your friend. When we talk about ovarian cancer in the case of your friend, it appears to be of a relatively advanced stage. With that being said, we still have some good treatments and in many cases we can lead to good outcomes and improvements in survival with chemotherapy.
Your friend is 70 which we consider elderly but if she is otherwise healthy and active she can likely endure the chemotherapy. Chemo will have some side effects which I am sure she has been told about - includes hair loss, fatigue, some nausea and sometimes a change in her blood counts. Her oncologist will monitor her blood counts regularly and she may need some medication to help keep her white blood cell count in a good range. This will take some time to determine. Typically the first few infusions of the chemo are very well tolerated. She will likely have a plan of 6 treatments given every 3 to 4 weeks before a reassessment is done. Some oncologists prefer to check for a response sooner such as after the third treatment.
Now, as far as surgery - this has to be considered carefully. she should be evaluated by a gynecological oncologist - a surgeon with highly specific training in the management of ovarian, uterine and cervical cancers.
The CA125 is a great blood test that helps us monitor response to therapy. Very likley her CA125 will trend down - sometimes to below 25. Her oncologist will use that as a marker for both response and possibly for recurrence. If surgery is not an option, she may be considered to start on what is called "maintenance chemotherapy" where she would receive a weekly infusion of medication to prevent significant recurrence of her malignancy.
A question frequently comes up regarding prognosis. "How long can I expect to live?" This question I rarely answer because it is impossible to predict. Rest assured your friend is in the hands of an oncologist who has selected an appropriate regimen of chemotherapy. Positive thinking, good friends and even prayer are as important as any medication and I encourage you to continue to be supportive to her.
Thank you again for your query. If you have any additional questions regarding this, I am available to address them.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for the answer. I would like to know if you would recommend any other combination for the chemo instead of Carboplatin plus Paclitexal. Also if there is a specific dietary recommendation like avoidance of dairy products. I am trying to get the CT scan scanned and if possible will send it across in a day or so. Thanks again. Your advice and answer is very useful. XXXXXXX
Hello XXXXXXX
Good to hear from you again.
I'd be happy to take a look at the scans. You can send them to my attention at YYYY@YYYY .
Honestly I would not recommend anything other than carboplatin and paclitaxel (taxol) at this time. This doublet of medications has been time tested and well proven to be quite effective at shrinking ovarian tumors. I am quite optimistic that your friend will have a good therapeutic response to this regimen.
As far as diet is concerned, it is important that she maintain a healthy diet with good balanced caloric intake of proteins carbs and small amount of fats as well. she can have dairy and such with no issues. Healthy vegetables are always good to eat as well. I do not generally recommend herbal preparations while patients are on chemo as we do not know how these products affect the chemo medications and how they are absorbed and how well they act against the cancer cells.
I advise that your friend maintain good physical activity as well through the course of her chemo. It will help her endure some of the side effects as well.
Again, I thank you for the query and await the email of the scans when you are able to send them along.
Sincerely,
Dr. Galamaga
Good to hear from you again.
I'd be happy to take a look at the scans. You can send them to my attention at YYYY@YYYY .
Honestly I would not recommend anything other than carboplatin and paclitaxel (taxol) at this time. This doublet of medications has been time tested and well proven to be quite effective at shrinking ovarian tumors. I am quite optimistic that your friend will have a good therapeutic response to this regimen.
As far as diet is concerned, it is important that she maintain a healthy diet with good balanced caloric intake of proteins carbs and small amount of fats as well. she can have dairy and such with no issues. Healthy vegetables are always good to eat as well. I do not generally recommend herbal preparations while patients are on chemo as we do not know how these products affect the chemo medications and how they are absorbed and how well they act against the cancer cells.
I advise that your friend maintain good physical activity as well through the course of her chemo. It will help her endure some of the side effects as well.
Again, I thank you for the query and await the email of the scans when you are able to send them along.
Sincerely,
Dr. Galamaga
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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