Treatment?

What does your mom's Oncologist recommend? Is there a treatment plan. My CA 125 was in the 200's and it was not operable, so a year I had no treatment, but was monitered every 3 months.

Then in Dec 2016 my CA 125 was 435 and my Oncologist immediately ordered another CT Scan and I started chemo treatments every other Fridays for 6 cycles.

I hope her Oncologist explains to you what the next step or a treatment plan will be. If they cannot do anything at this point, maybe they will tell her to come in for a check up every 3 months or so like they did for me.

I hope you will find the solution you are seeking. God Bless you and your mom with guidance and peace. May her Angels minister healing.

Suspicious

Varun,

I hope your mom's other tests show that this is something less serious than ovarian cancer.  It could be many things.  I know it is hard not knowing what is going on.  At least her doctor is being proactive and it sounds like he will find out what this is.  CA-125 is not an accurate test, but it's all there is right now for ovarian cancer.  It can be elevated from just about any inflammation in the pelvis.  I hope you get some answers soon.

Take care

bettyboop3917 said:

Varun

I am happy that the doctor is running more test for it sounds like they are needed. It seems like with the test being ran it takes forever for you to have any real answers. I know it was that way for me at lest. However all the test does tell them something before they deside what is the best way to handle it. With doing an ultrasound I would think that will help them know much more of what is going on.

I will be praying for you and your mom. 

Varun~Links N my ltr will help U 2 check N2 & behind the docs!

Dear Varun:

Now Ovarian is something that I can comment on with confidence.  If you read my “about me” page by clicking on the picture of me and my husband of “55 years”, you will know a bit more about both of us.  We just celebrated my husband’s start of his 15^th year of survival from Esophageal Cancer, Stage III.   Most EC patients die the first year, and few ever survive for 5 years.  It has far worse survival stats than Breast Cancer for instance.  So, I’ve been living and researching cancer for many years now.  It’s unusual for a husband and wife to both have cancer.  So that puts both of us in the position of understanding a cancer diagnosis in the family both from the standpoint of being a “caregiver” as well as a “cancer patient.”  So that gives me a perspective that many do not have and that they never really want to have by the way!  I always said, “When my husband has cancer, I have cancer.”  Little did I know that I would be diagnosed myself with Peritoneal Carcinomatosis and Ovarian Cancer Stage IV in November of 2012.  So I can truly say, “I know how you feel!”

So now that I have more of a clue as to what your mom’s doctors are looking for, I can give you some excellent sources of information.  I do hope you have access to a reputable “gynecologic oncologist” who can treat your mother.  They have greater training and insight into how God made us women!  That said, please use the information below to “check behind” your doctors and request that the tests noted below are part of their plan to accurately diagnose your mom.  If Ovarian cancer is the final diagnosis, hopefully it will not be in the advanced stages. 

Wishing your mom every success, and physical and spiritual strength for the both of you.  If anything falls in the category of “longsuffering” and “character building”, an Ovarian cancer diagnosis will.  For me it requires trusting in the Lord to lead me to the right doctors, and then for physical, as well as spiritual strength, to “endure and persevere!”  It’s a long and difficult journey.  So be certain that your mom is receiving the best of care.  She is worth it!

Most sincerely,

Loretta

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P.S.  There are multiple medical conditions that can cause “Ascites”.  It is not linked to Ovarian Cancer alone, so I thought I would put this link re “Ascites” as well.  So a finding of “ascites” is only one symptom of Ovarian cancer.  Other cancers can also carry with it a symptom of “ascites”.  I surely hope your mom’s doctors can “walk and chew gum at the same time.”  That’s an American expression meaning capable of accomplishing more than one task at a time.  I would hope she is being tested “aggressively!”  Never entertain the possibility of “hurting your doctor’s feelings” by seeking a second opinion.  It’s your mother’s feelings that take priority!

1.  http://www.emedicinehealth.com/ascites/article_em.htm

2.  http://www.emedicinehealth.com/ascites/page2_em.htm#causes_of_ascites

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3.  http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer

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4.  http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/questions-ask-doctor

A long list of questions to ask the doctor.

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5.  http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/medical-illustrations

These are drawings of the areas involved.  Use the menu on the other side to read about how a diagnosis is reached, treatments, long-term survival, etc.

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6.  http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/introduction

Ovarian, Fallopian Tube, and Peritoneal Cancer: Introduction

Approved by the Cancer.Net Editorial Board, 08/2016

ON THIS PAGE: You will find basic information about this group of diseases and the parts of the body they may affect. This is the first page of Cancer.Net’s Guide to Ovarian, Fallopian Tube, and Peritoneal Cancer. Use the menu to see other pages. Think of that menu as a roadmap for the complete guide.

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7.  http://www.cancer.net/sites/cancer.net/files/asco_answers_ovarian.pdf

 “ASCO ANSWERS is a collection of oncologist-approved patient education materials developed by the American Society of Clinical Oncology (ASCO) for people with cancer and their caregivers.”

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8.  http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/diagnosis

If your primary care doctor is suspicious that you might have ovarian, fallopian tube, or peritoneal cancer, you should see a gynecologic oncologist. A gynecologic oncologist is a doctor who specializes in treating cancers of the female reproductive system.

This section describes options for diagnosing ovarian, fallopian tube, and peritoneal cancer. Not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

The type of cancer suspected…..Your signs and symptoms…..Your age and medical condition…..The results of earlier medical tests

Early detection and treatment is important. This is often not possible for ovarian, fallopian tube, or peritoneal cancer. There are no effective screening methods until cancer is suspected. Often, women don’t have any symptoms until the tumor is large or in later stages of the disease. About 70% of epithelial ovarian cancers are not found until the disease is in an advanced stage and has spread to other parts of the body, most commonly the abdomen.

The following tests may be used to diagnose ovarian, fallopian tube, and peritoneal cancer: 

•  Abdominal-pelvic examination. Usually, the first exam is the abdominal-pelvic examination. The doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to check for any unusual changes. Some early cancers are very small before they spread and cannot be reliably felt and detected by pelvic examination. 
•       A Pap test, usually done with a pelvic examination, is not likely to find or diagnose ovarian, fallopian tube, or peritoneal cancer. However, research advances in DNA testing may help find cells trapped in the cervix that could be studied for changes that indicate cancer elsewhere in a woman’s reproductive system. These findings are considered experimental but are a promising new method for earlier detection of these types of cancers.
•  Transvaginal ultrasound. An ultrasound wand is inserted in the vagina and aimed at the ovaries and uterus. An ultrasound uses sound waves to create a picture of the ovaries, including healthy tissues, cysts, and tumors. Researchers are studying whether this test can help with early detection of ovarian cancer.
• Blood tests/CA-125 assay. There is a blood test that measures a substance called CA-125, a tumor marker. This marker is found in higher levels in women with ovarian cancer, fallopian tube cancer, or peritoneal cancer. Woman younger than 50 with conditions such as endometriosis, pelvic inflammatory disease, and uterine fibroids may also have an increased CA-125 level. This test is more accurate in women who have had menopause. Other tumor marker tests, such as HE4, are available, but neither of these markers have been shown to be effective for the early detection of these cancers.
• Computed tomography (CT) scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. An x-ray is a way to create a picture of the structures inside the body using a small amount of radiation. A computer combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow. A CT scan can be used to measure the tumor’s size. While the technology of CT scanning has continued to evolve, tumors or abnormalities less than about 5 millimeters (1/5th of an inch) are difficult to see.
• Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan.
• However, you may hear your doctor refer to this procedure as just a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to actively use energy, it absorbs more of the radioactive substance. A scanner detects this substance to produce images of the inside of the body.
• Lower gastrointestinal (GI) series. This is a series of x-rays of the colon and rectum taken after the patient has a barium enema. This procedure delivers a special dye into the rectum and colon through the anus. The barium highlights the colon and rectum on the x-ray, making it easier to identify a tumor or abnormal area in those organs. This test may be used if the doctor is concerned that the cancer is blocking the large intestine, although a CT scan with contrast (see above) is more commonly used in these circumstances.

• Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

•  Paracentesis. This is a medical procedure that removes peritoneal fluid that has built up in a person’s abdomen. This fluid build-up may be called ascites. A sample of the fluid is examined under a microscope for signs of cancer (see below, under Biopsy).

• Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definitive diagnosis. A pathologist analyzes the samples(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

  Biopsies for ovarian, fallopian tube, and peritoneal cancer are often done during a first surgery. During the surgery, doctors may remove as much of the tumor as possible (see Treatment Options).

 A tumor sample will be analyzed by a pathologist after the surgery is over. A biopsy alone is sometimes used if the diagnosis is uncertain or if there is too much tumor to remove initially with surgery. This is usually done when chemotherapy is planned as the first treatment, with possible surgery afterward. (See Treatment Options.)

 After diagnostic tests are done, your doctor will review all of the results with you. As noted above, surgery and an examination of the lymph nodes may be needed before results are complete. If the diagnosis is cancer, these test results help the doctor describe the cancer. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. You may use the menu to choose a different section to continue reading in this guide.”  

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9.  http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/additional-resources

10.  https://www.youtube.com/watch?v=n0pBz8BegPU

(Varun- This is a 4:40 min. video that should be helpful.  Click on the “more” after the short description, and more info will appear.)  Ovarian Cancer: Progression and Treatment Options

 Best Doctors - Published on Nov 7, 2012 - Dr. Matt McDonald discusses the progression of ovarian cancer and how it is treated.

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11.  http://www.cancercenter.com/video/cancer-types/medanim/ovarian-cancer/

A woman's reproductive system contains two ovaries, which are vital in the role of reproduction. The ovaries are attached to either side of the uterus and are responsible for producing sex hormones, including estrogen and progesterone, as well as releasing eggs.

Sometimes, the orderly process of cell growth, death, and replacement becomes compromised. Cells begin to grow out of control and without order. When this happens, a tumor can develop on or inside the ovaries. The tumor can be benign or malignant. Malignant tumors are cancer. The two most common types of ovarian cancer are germ cell carcinoma and epithelial carcinoma. Germ cell cancer begins in the egg cells located within the ovaries. Ovarian epithelial cancer develops from cells that make up the surface of the ovary.

Symptoms of ovarian cancer include: • Fatigue • Pressure or pain in the abdomen, pelvis, back, or legs • A bloated or full feeling in the abdomen or pelvis • Nausea, indigestion, gas, constipation, or diarrhea.

Ovarian tumors are at risk for spreading to other organs, a process called metastasis. Ovarian cancer can metastasize in three ways:

• Invasion: the tumor grows large enough to invade nearby organs

• Shedding: Individual cancer cells break off from the main ovarian tumor and transplant to nearby organs

 This medical animation explains how ovarian cancer develops in the body. Learn about the ovaries and how a tumor develops, as well as symptoms, diagnosis and treatment.

• Spread: Cancer cells travel through the lymphatic system to lymph nodes and other organs in the pelvis, abdomen, and chest.

The diagnosis of ovarian cancer is made by physical and pelvic exams, transvaginal ultrasound, CA-125 blood test, and biopsy. Cancer of the ovaries is the leading cause of reproductive cancer death in women, as it is often diagnosed at an advanced stage.