Stage 1 Ovarian Cancer Clear Cell

Shadow58
Shadow58 Member Posts: 4
edited March 2014 in Ovarian Cancer #1
I am trying to research ... In November 09 I had surgery and they removed both ovaries ..the left ovary had Stage 1 Cancer ..clear cell. Nothing in the right ovary or pelvic wash.
they recommended I stage the cancer. So in Dec 09 complete hysterectomy...no cancer was found
anywhere....lymph nodes clean. Said they cancer was removed in the first surgery and
they removed the ovary unbroken...today met with the oncologist and he recommends chemo???
they same chemo that I would be given if I had Stage 3 or 4 cancer. why?? because it
was a clear cell cancer. Said if 100 women had ovarian cancer only 5 would have clear cell.
I don't understand the treatment....if the cancer is gone why chemo?

Comments

  • groundeffect
    groundeffect Member Posts: 639 Member
    Chemo
    From my understanding of clear cell cancer, it is rare and hard to treat.

    I was originally diagnosed with stage 1c ovarian cancer, which meant an ovary had burst. I had chemo following my hysterectomy, and have just finished my 5th round of chemo (out of 6) after having a small OVCA tumor removed from my abdomen in September. It was well defined, and no other cells were found in the samples they took, but the choice for chemo was made by me, my husband, and my oncologist to give me the best hope of getting any other cells that may be floating around.

    Your doctor really wants to see you have the best outcome. I fretted about having chemo the first time, but my gyn told me in one of my visits that doctors really want to "win" and beat cancer at the first opportunity. That woke me up-it isn't because they want to see you have chemo, it's the best option to get that win! My chemos have actually been done in a local facility, not at the hosptials where my oncologists have been, so I have no reason to suspect ulterior motives such as profit-making. The chemo protocol is the same, and it's saved me a two-hour trip for each treatment.

    I suggest you do some reading about clear cell OVCA and then seriously consider the chemo. I do believe your oncologist would like to win this time!
  • Clear Cell
    Good Morning,
    I was staged a 2B in June of 2009. I had cancer tumors on each ovary. Ascites(fluid) was clean, washing was clean, and lymph nodes were clean. I also had a clear cell. If my research is correct, clear cell is the most aggresive. Here is the problem with Stage I and Stage II. There are micro mini cells that can be left behind. The surgeon can not see them and the scans do not pick them up, because they are to small. The CA-125 blood test does not pick them up. The first line chemo Carbo/Taxol, should kill them off. It is a safety net. I took 6 rounds of chemo. I did not want to do it. My CA-125 when I walked out of the hospital was a 10. That is a good number. After 6 chemo treatments it dropped to 5. I suspected that my debulking surgery was a success, but I am not that naive to believe that this cancer was not going to come back. It killed my mother at 53, but she was a later stage and refused to have surgery. If they are recommending the chemo, take it. It will interrupt your life for 4 monthes, but it might also save your life. This kind of cancer is way to dangerous to fool around with. It is better to do everything you can now, then later. I am not trying to scare you, but this is serious business. Thank-You, Paula
  • LMT
    LMT Member Posts: 8
    Chem - clear cell
    Thank you for sharing your story. I was diagnosed with stage 1A and my doctor also wanted me to have the chemo. I had a total hysterectomy. I have already had one treatment and have another tomorrow. Because it is such an aggressive type of cancer I am not taking any chances that one cell was left. I figure it took one to get it started. It is a personal decision for each person but I am at peace with my decision.

    I will keep you in my prayers.
  • lindaprocopio
    lindaprocopio Member Posts: 1,980
    LMT said:

    Chem - clear cell
    Thank you for sharing your story. I was diagnosed with stage 1A and my doctor also wanted me to have the chemo. I had a total hysterectomy. I have already had one treatment and have another tomorrow. Because it is such an aggressive type of cancer I am not taking any chances that one cell was left. I figure it took one to get it started. It is a personal decision for each person but I am at peace with my decision.

    I will keep you in my prayers.

    It's the GRADE of your cancer, not the STAGE....
    My cancer cells were/are Papillary Serous, a rare Grade 3 cancer, just like Clear Cell, and Grade 3 cancers are aggressive and recurrent. Most women I know with papillary serous cancer cells in their pathology, even at Stage 1, take chemo as adjuvant therapy. You are so very blessed to have caught your cancer early, and have the opportunity to almost guarantee it will never come back. But if you wait, it can secretly make inroads and that chance for a cure can be lost. It is a very personal decision, but I know I'd do the chemo if I were in your position. I was Stage III-c at diagnosis and even with 6 rounds of chemo, my cancer returned. But I sure wanted to give myself my only (very slim at Stage 3) chance for a cure, and I don't regret taking the chemo, even in hindsight.
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834

    It's the GRADE of your cancer, not the STAGE....
    My cancer cells were/are Papillary Serous, a rare Grade 3 cancer, just like Clear Cell, and Grade 3 cancers are aggressive and recurrent. Most women I know with papillary serous cancer cells in their pathology, even at Stage 1, take chemo as adjuvant therapy. You are so very blessed to have caught your cancer early, and have the opportunity to almost guarantee it will never come back. But if you wait, it can secretly make inroads and that chance for a cure can be lost. It is a very personal decision, but I know I'd do the chemo if I were in your position. I was Stage III-c at diagnosis and even with 6 rounds of chemo, my cancer returned. But I sure wanted to give myself my only (very slim at Stage 3) chance for a cure, and I don't regret taking the chemo, even in hindsight.

    I would have the chemo....
    Clear cell is characterized in part by its aggressive metastasis. I would elect to be safe, rather than sorry, and zap whatever might be left with any treatment available. Every cancer begins with a single cell that morphs out of control.

    I want to think my cancer (not clear cell) is gone, too. I have that "positive attitude" everyone keeps talking about. But I am pragmatic, too. I have elected to do monthly Taxol treatments after the completion of my six sessions of Carbo/Taxol next Monday. If something might give me an edge - even a small one - bring it on. That's my philosophy. However inconvenient or unpleasant the treatment might be, the possible alternative is worse - way worse.

    On the other hand, my doctor has had women who refused treatment because they did not want to lose their hair. My friend's mom actually told her physician she would rather be dead than bald. It's your body........your decision.

    Carlene
  • Shadow58
    Shadow58 Member Posts: 4

    Chemo
    From my understanding of clear cell cancer, it is rare and hard to treat.

    I was originally diagnosed with stage 1c ovarian cancer, which meant an ovary had burst. I had chemo following my hysterectomy, and have just finished my 5th round of chemo (out of 6) after having a small OVCA tumor removed from my abdomen in September. It was well defined, and no other cells were found in the samples they took, but the choice for chemo was made by me, my husband, and my oncologist to give me the best hope of getting any other cells that may be floating around.

    Your doctor really wants to see you have the best outcome. I fretted about having chemo the first time, but my gyn told me in one of my visits that doctors really want to "win" and beat cancer at the first opportunity. That woke me up-it isn't because they want to see you have chemo, it's the best option to get that win! My chemos have actually been done in a local facility, not at the hosptials where my oncologists have been, so I have no reason to suspect ulterior motives such as profit-making. The chemo protocol is the same, and it's saved me a two-hour trip for each treatment.

    I suggest you do some reading about clear cell OVCA and then seriously consider the chemo. I do believe your oncologist would like to win this time!

    thanks for your thoughts and


    thanks for your thoughts and kind words. I've had 2nd opinions about everything and now I want a 2nd opinion
    on the first surgery. I want to know how the pathologist determined it was a clear cell cancer. Maybe I'm crazy
    but I had two GYN's discuss the first surgery ....to remove the complex cyst, then talked with two surgeons
    to hear what they had to say and picked robotic surgery over the large incision to stage the cancer. I'm still in pain
    from the 2nd surgery but they said I had two major surgeries in 4 weeks and it takes time to heal.
    I then met with a radiologist and yesterday the oncologist. Which takes me to the idea of making sure it really was
    clear cell cancer. I need to make my decision and it must be a well informed decision. My problem is I believe the cancer
    is gone and I don't understand treating for no cancer. The dr said after chemo I will have a better chance....he also
    said we will never know if I really was cancer free..
  • yalena
    yalena Member Posts: 1

    Chemo
    From my understanding of clear cell cancer, it is rare and hard to treat.

    I was originally diagnosed with stage 1c ovarian cancer, which meant an ovary had burst. I had chemo following my hysterectomy, and have just finished my 5th round of chemo (out of 6) after having a small OVCA tumor removed from my abdomen in September. It was well defined, and no other cells were found in the samples they took, but the choice for chemo was made by me, my husband, and my oncologist to give me the best hope of getting any other cells that may be floating around.

    Your doctor really wants to see you have the best outcome. I fretted about having chemo the first time, but my gyn told me in one of my visits that doctors really want to "win" and beat cancer at the first opportunity. That woke me up-it isn't because they want to see you have chemo, it's the best option to get that win! My chemos have actually been done in a local facility, not at the hosptials where my oncologists have been, so I have no reason to suspect ulterior motives such as profit-making. The chemo protocol is the same, and it's saved me a two-hour trip for each treatment.

    I suggest you do some reading about clear cell OVCA and then seriously consider the chemo. I do believe your oncologist would like to win this time!

    body scan
    I was diagnosed with stage 1a ovarian cancer in jan. 2010. I just completed my 6 chemo treatments. I thought I was going to have a body scan following but the Dr. said it was not necessary. Has everyone with this diagnosis had a scan following their chemo treatments or is it no longer necessary?
  • katie.bug
    katie.bug Member Posts: 14
    yalena said:

    body scan
    I was diagnosed with stage 1a ovarian cancer in jan. 2010. I just completed my 6 chemo treatments. I thought I was going to have a body scan following but the Dr. said it was not necessary. Has everyone with this diagnosis had a scan following their chemo treatments or is it no longer necessary?

    ct scan
    yalena

    I had a ct scan after I completed my 6 rounds but I was stage 4 so maybe they are watching me closer. I get a ct scan every 6 mo.
  • susi3
    susi3 Member Posts: 2 *

    In early September I went to the doctor with a tummy ache and ended up getting a surprise exploratory laparotomy and staging for cancer and spent a week in the hospital. They removed my uterus, cervix, ovaries & fallopians, omentum, pelvic nodes samples, and as a precaution my appendix. It was a rather traumatic event, and very worrisome not knowing the extent of the cancer.

    After seven weeks I am feeling much better and recovering well. The good news is that the tumor was caught at early stage pt1A pN0, and it involved only one ovary with no spread, no ruptures, and no positives on any other samples taken.

    Estimated three-year survival in my case is around 93.5%, which is considered to be an excellent prognosis. The bad news is that the cancer type is ovarian clear cell carcinoma (OCCC) which has a very poor prognosis upon recurrence.

    Last week I got a second opinion from a pair of UCSF gyn/oncology doctors. Their pathology report is still in process and will go before the Tumor Board today to confirm the diagnosis. I brought a list of questions and clinical study references to discuss the treatment plan. They advised that in my case chemotherapy would not provide any statistical benefit or improve my survival outcomes, and they recommended observation instead.

    This opinion contrasts with the first doctor who insisted on chemo, but it appears his approach is based on standard treatment for the most common type of epithelial serous cancer which does respond to chemo. OCCC is chemo-resistant. The data is pretty clear on this, and I’m opting for no chemo.

    In late 2022 the NCCN changed their guidelines to recommend observation for early stage 1A OCCC. This aligns with ESMO guidelines in europe, and is based on decades of clinical evidence that in early stage OCCC there is no statistical difference between observation and adjuvant therapy.

    The treatment decision for early stage OCCC is individual to each case, and should be an informed decision made with professional consultation. As we know, most ovarian cancers are caught in a later stage, and many are more platinum-responsive than OCCC.

    It is not that I am anti-chemo, I wish that it was an effective treatment for my case, but at the same time i dont want to take chemo if there is no statistical evidence demonstrating it's effectiveness.

    Are there others here who have made a similar decision, and would like to compare notes? I have found no support group for my particular situation.

  • NoTimeForCancer
    NoTimeForCancer Member Posts: 3,358 Member

    susi3, I am a visitor from the Uterine/Endometrial cancer board.

    I completely understand you wanting to do everything you can do to prevent a recurrence. I would (and did) feel the same way. My dx years ago would probably not be treated the same way today than it was then.

    I would suggest requesting genetic testing be done on your cancer to determine if it has any markers that make it more / less successful with chemo or immeunotherapy. OCCC's are not all the same and it might be the sequencing that will provide insight.

    As you are seeing, you have to be your own advocate. Not all doctors are equal and any good one will not have an issue with you asking for another opinion. Afterall, you want to give yourself the best chance in the end.

  • susi3
    susi3 Member Posts: 2 *

    Thank you for your reply, NTFC (*

    We are living in an age of great possibility for new targeted therapies, and I believe it is only a matter of time. I absolutely agree that genetic testing is the next step for me in planning for a recurrence, if it happens. I am under no illusion that I am out of the woods. I've got an appointment for genetic counseling in December, and with luck there will a marker that will match up with one of the new targeted treatments under study.