I could hardly wait to get back and post the fascinating appointment I just had with my chemo oncologist. My talk with my chemo-onc was as exciting and confusing as the surprise clear CT/PET scan results I got last week. But I left my appointment with new hope and am anxious to share that hope with the rest of you.
(Just a quick history for anyone new here: I started carbo/taxol for UPSC Stage 3-C in November 2008 after uptimal debulking surgery in October, 2008; and finished 6 rounds of carbo/taxol and 28 rounds of external IMRT pelvic radiation and 3 brachys on July 1, 2009, finishing with a NED CT-scan and a CA-125 of 11. I enjoyed 5 blissful months of remission, but in November 2009,on a routine monitoring appointment, my CA-125 jumped to 155. That triggered a CT-scan and a PET scan that lit up 3 lymph nodes. I started weekly taxol at 1/3 strength December 10, 2009. The weekly taxol was slowly bringing my CA-125 down again, but two weeks ago my CA-125 climbed from 45 to 47. So after 10 rounds of taxol I had a 'mid-point' CT/PET scan last week. We were all SHOCKED when NOTHING lit up on the PET, and 2 of the enlarged lymoh nodes were invisible, and the other had shrunk to 11mm and showed no 'uptake' on the PET.)
Soooo, my chemo-onc discussed my options now.
1.) I could take a break from chemo and just be closely monitored. I had a CA-125 drawn today that we don't yet have the results of, but if it goes up again, my chemo-onc felt we would all be uncomfortable with just monitoring. Of course, if the CA-125 taken today drops me under 35, then a break may make the most sense.
2.) I asked if I could just do ONE round of full-strength carbo/taxol, because I think that would drop my CA-125 under 35. The chemo-onc said he wouldn't do that, because even if it dropped after 1 infusion, it would go back up again. Instead he said, "if our goal is to still go for a CURE, let's consider going 'balls-to-the-wall' again and do 4 to 6 rounds of full strength carbo/taxol and try and knock this beast completely out of you." (!!!! He used the word 'CURE'!!! even after a recurrence from UPSC!! I was flabergasted!!) I was so shocked, as it contradicts what he said when I started chemo the first time right after my surgery. At that time he said "If you cancer comes back, we will stop talking 'CURE' and talk instaed about 'managing your condition'." So I asked him outright if he really thought I still had a shot at a cure or even a prolonged multi-year remission. And he said, I wouldn't suggest putting you through this again if I didn't. WOW. Take that in, ladies. Even after a recurrence, my oncologist thinks he might still cure me. HOPE springs anew. Of course, I am getting a 2nd opinion on Monday on all this, and both oncologists will have to agree that this hope is valid before I go into this aggressive chemo again.
3.) We talked about 'maintenance' chemo. My chemo-onc has said this before and repeated it again, maintenance chemo has been proven to not extend life. He doesn't ever continue chemo in even weak doses for people in remission. So my idea of getting a weak dose of taxol once a month was nixed.
4.) I brought up tissue assays. The chemo-onc said that the science just isn't advanced enough yet for uterine or ovarian cancers that would make a tissue assay worthwhile. Unlike cancers of the breast and colon, the assys for us won't show what chemo drugs will work, although they sometimes show what will NOT work. (STILL valuable knowledge, I think!)
I think that was most of the new information I have to share. If I think of something more I'll post it later. I have no idea what my treatment wwill be like until I get my new CA-125 and until I see my gyn-onc on Monday for his input. But I am curious to hear what the rest of you with recurrence think about taking a second aggressive run in the hopes of still achieving a cure. HECK! If it even has the chance to shoot me into a 2 or 3 year remission, it would be worth the gamble to me. But I want to hear what you all think. Thanks!