debulking surgery

jadav1956
jadav1956 Member Posts: 95 Member
in Ovarian Cancer #1
Hello ladies. I posted here about a month ago. I had my surgery on 5/9/11. I had an awful time with this surgery. I was in hospital for 12 days. Doc removed my rt. ovary and entire omentum which was where the cancer was. He told me that he got about 95% but I am going to need some type of chemo. Today I went for a f/up visit and we discussed different chemo options. First option is to have chemo once a month x 6 months with a 70% chance of recurrence. Option 2 is the same except that there is also a once a month x and additional 12 months at a smaller dose. Third option is the IP directly into the abdomen every 3 weeks for 22 cycles with carbo/taxel. I have a ct scan scheduled for next week and another f/up visit the week after that to decide on my options. I guess a lot depends on what ct shows. I am also being scheduled to have a port put in, and bloodwork will be done also at some point. This is so confusing!!! I know for sure it won't be the first option. I am not about to sit around and wait for it to return ! I have to be proactive in this fight !! I don't know about the IP because doc said it could cause bowel blockage, so I am assuming this is the harshest of the 3. Please any and all advise is much appreciated. I learn so much from just reading in the discussion boards. I am at a total loss here. Please ADVISE. Thanks so much, Jackie

Comments

  • azgrandma
    azgrandma Member Posts: 609 Member
    #2
    I am so soorry your going through this
    I really am sorry your going through this. I was not given an option, my doctor decided on what treatment he thought was best for me. I will pray uou make the right choice and all will go well for you
  • kayandok
    kayandok Member Posts: 1,202 Member
    #3
    Hi Jackie,
    I'm sorry your recovery has been so tough, but thanks for checking in. Wow, tough call on the chemo choices. Choosing your chemo should be based on so many factors including your physical condition, and it would seem your doctor would know that best. I had 8 cycles of carbo/taxol, and my doctor chose that for me. I don't think I would have had enough knowledge and courage to choose myself.

    Given the option to do it over, I think I would probably would do the same regime with avastin added into the mix. I guess that is not an option? My concern about the IP causing damage and preventing further use of chemo if it became necessary. No matter how you cut it, it is a leap of faith.

    Take care,
    kathleen
  • LaundryQueen
    LaundryQueen Member Posts: 676
    #4
    kayandok said:

    Hi Jackie,
    I'm sorry your recovery has been so tough, but thanks for checking in. Wow, tough call on the chemo choices. Choosing your chemo should be based on so many factors including your physical condition, and it would seem your doctor would know that best. I had 8 cycles of carbo/taxol, and my doctor chose that for me. I don't think I would have had enough knowledge and courage to choose myself.

    Given the option to do it over, I think I would probably would do the same regime with avastin added into the mix. I guess that is not an option? My concern about the IP causing damage and preventing further use of chemo if it became necessary. No matter how you cut it, it is a leap of faith.

    Take care,
    kathleen

    Another option to think about
    Jackie: You weren't given the option that I would choose for you which is to take carbo every 3 weeks and low-dose taxol weekly. There was some research complaring low-dose weekly taxol to IP chemo that came to the conclusion that the survival outcome with low-dose taxol was NOT worse than IP chemo AND the quality of life was superior (less misery, pain, etc.). The researchers felt that the low-dose taxol had an anti-angiogenesis benefit (stopped the blood supply to the cancer).

    From what I read about the IP chemo, I would ONLY do it if it was heated chemo (called HIPEC)--and there are only a few places around the US where you can have that done.

    I think Avastin is an excellent idea, too, like Kathleen said. Avastin works on starving the cancer's blood supply through a different pathway than taxol.

    Other cancers are treated with combination therapy and ovarian cancer is only beginning to be treated with two or more drugs. The medical consensus of opinion in general is that cancer is very skilled at mutating to survive--the more different pathways that chemo can hit, the less likely it is to be able to organize itself to become chemo resistant. And chemo resistance is a big concern.

    When you look at some of the clinical trials for ovarian cancer, they are looking into using at least 3 drugs in combination now--unfortunately, women are dying waiting for the research results.

    I did really well on the low-dose taxol weekly routine initially but couldn't continue it--I think I had trouble detoxing the drug but chances are you would do really well, too.

    Good luck making your decision,

    LQ
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #5
    I had the carbo/taxol every
    I had the carbo/taxol every 4 weeks, then Taxol alone for a year. It wasn't a reduced dose, however. I was very fortunate that I could tolerate so much Taxol. Many women can't, but I have to say, it seems to have been a good choice. I have been NED for 15 months.

    I really wanted to do the IP chemo, but my doctor would not approve it because my surgery included a bowel resection. I did not realize that anyone did 22 cycles of IP, however. It is, indeed, very hard on you. My doctor says that only about 40% of the patients he uses it on are able to finish the whole protocol, in which case you have to stop chemo entirely and wait until you have recovered from the IP before you can continue treatment.

    I had a lot of complictions from my surgery, too. I was in the hospital 16 days, unable to eat for most of that, and eventually ended up on TPN feedings.

    I don't know what I would do, if I were in your place. I can tell you that bowel obstructions are not fun. I had one just prior to my surgery and it was SO painful. The treatment isn't much better. They put an NG tube thru your nose and down into your stomach. No food, no drink for however long it takes to resolve it.

    Carlene
  • pattysoo
    pattysoo Member Posts: 170
    #6
    choices
    I think your choice would depend on how physically fit you are now that you've recovered (sort of) from surgery. If I had it to do over again, I'd ask about dense dose chemo. It seems to be pretty effective and also well tolerated. I initially wanted IP chemo, but like Carlene, my onc would not approve it. He felt that too many women had too many problems with it.
  • srwruns
    srwruns Member Posts: 343
    #7
    Good luck on making your
    Good luck on making your decision. I can't really add anything to the mix that the others haven't already except to say that the "dose dense" (weekly) chemo is supposed to be one of the cutting edge in therapies now. It is confusing and to be hit with such major issues while one is stunned and physically trying to recoup. Tough stuff. You have come to the right place however.
  • jadav1956
    jadav1956 Member Posts: 95 Member
    #8
    Thanks so much for all the
    Thanks so much for all the input. I have a lot to think about, and a list of questions for my onc when I go back. I am in this fight for the long haul, and I want to be proactive in making some decisions for myself. I am leaning towards the second option as of right now. I would like to continue to work if I can for as long as I can to keep my health insurance. I have a very understanding supervisor, and I am sure she would work with me on this. I could go out on long term disability but I really don't want to do that just yet. Does anyone know if you need a pet scan or some way to check the lymph nodes? That is one of my questions to ask my onc. I just wondered if that would change the treatment plan or not. Also I heard its more like the 3rd day or so after chemo that makes you feel so bad. I also wondered about vitamin supplements to help you through all the treatments like what is the most effective or helped the most? Thanks for all the replies. I will post again after ct and f/up with onc. I will be reading and learning as much as possible. Thanks, Jackie
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #9
    jadav1956 said:

    Thanks so much for all the
    Thanks so much for all the input. I have a lot to think about, and a list of questions for my onc when I go back. I am in this fight for the long haul, and I want to be proactive in making some decisions for myself. I am leaning towards the second option as of right now. I would like to continue to work if I can for as long as I can to keep my health insurance. I have a very understanding supervisor, and I am sure she would work with me on this. I could go out on long term disability but I really don't want to do that just yet. Does anyone know if you need a pet scan or some way to check the lymph nodes? That is one of my questions to ask my onc. I just wondered if that would change the treatment plan or not. Also I heard its more like the 3rd day or so after chemo that makes you feel so bad. I also wondered about vitamin supplements to help you through all the treatments like what is the most effective or helped the most? Thanks for all the replies. I will post again after ct and f/up with onc. I will be reading and learning as much as possible. Thanks, Jackie

    My doctor said no
    My doctor said no supplements, except a multi-vitamin with iron. I asked about my B12 injections and he asked, "Were you tested for pernicious anemia, or was it prescribed on a guess." I told him I had been tested, and he said it was okay to continue them.

    Be sure and ask your doctor before starting a regimen of supplements.

    Carlene
  • srwruns
    srwruns Member Posts: 343
    #10
    jadav1956 said:

    Thanks so much for all the
    Thanks so much for all the input. I have a lot to think about, and a list of questions for my onc when I go back. I am in this fight for the long haul, and I want to be proactive in making some decisions for myself. I am leaning towards the second option as of right now. I would like to continue to work if I can for as long as I can to keep my health insurance. I have a very understanding supervisor, and I am sure she would work with me on this. I could go out on long term disability but I really don't want to do that just yet. Does anyone know if you need a pet scan or some way to check the lymph nodes? That is one of my questions to ask my onc. I just wondered if that would change the treatment plan or not. Also I heard its more like the 3rd day or so after chemo that makes you feel so bad. I also wondered about vitamin supplements to help you through all the treatments like what is the most effective or helped the most? Thanks for all the replies. I will post again after ct and f/up with onc. I will be reading and learning as much as possible. Thanks, Jackie

    Ditto what Hizzy said.
    Ditto what Hizzy said. There were even certain multivitamins that were off limits or I had to take 1/2 a tab per day. If there is a dietian associated with your chemo center they are very helpful about diet and vitamins. Did they take lymph nodes during your surgery to check them? I had about 30 removed and luckily they were all clean. I think CT scans does pick up some stuff on lymph nodes if they become enlarged.
  • Best Friend
    Best Friend Member Posts: 222
    #11
    Don't know
    My mom does carbo/taxol every three weeks. There has to be more options. Have you seeked a second opinion

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