CT scan results as a measure of response to treatment

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Barneygirl
Barneygirl Member Posts: 90
edited December 2011 in Ovarian Cancer #1
I have had 3 rounds of Taxotere/Carbo for a recurrence. CA-125 is no longer a good measure for me, so we are using scans. My recurrence is primarily in my lymph nodes (mediastinal, supraclavicle, & axillary) and after 3 treaments the CT results show improved and decreased size of nodes. I also have 2 small soft tissue densities under 1 cm. How does one know when the nodes are the size that would indicate NED? In the past, Ca-125 was used and it normalized after 3 treatments. Just wonder how a normal Ca-125 after 3 treatments would look like on a scan. I also wonder how many more treatments I will get. If you show improvement do they keep you on the same chemo until NED is reached, like 6-8 treatments? I just received these results in the mail and haven't met with my dr.

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  • snowbird_11
    snowbird_11 Member Posts: 160
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    A PET scan would provide
    A PET scan would provide better info as being NED over decreased size of nodes (per a CT scan) as PET shows the level of metabolic activity. Increased uptake indicates abnormal level of activity with a certain level usually indicative of the cancer being active. However, radiation treatment will continue to show increased activity in target area for up to 4 months post-treatment. That's tough not being able to use ca 125 as indicator. But, great news on the decreased size of nodes!!!

    Annie
  • LaundryQueen
    LaundryQueen Member Posts: 676
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    A PET scan would provide
    A PET scan would provide better info as being NED over decreased size of nodes (per a CT scan) as PET shows the level of metabolic activity. Increased uptake indicates abnormal level of activity with a certain level usually indicative of the cancer being active. However, radiation treatment will continue to show increased activity in target area for up to 4 months post-treatment. That's tough not being able to use ca 125 as indicator. But, great news on the decreased size of nodes!!!

    Annie

    You are gonna need a PET
    You are gonna need a PET scan eventually. Doctors seem to avoid using those even though it seems to be the best test for us.

    The CA-125 is just a rough indicator--although I think a low CA-125 is better even in the presence of recurrence. The CA-125 is a mucous protein also known as MUC16. Somewhere I read that cancer kind of slides thru tissues on this mucous...so less is better.

    I wonder if mets that ONLY show up in the nodes tends to do so despite a low CA-125. Maybe when the cancer is spreading around the peritoneal cavity, it can make more CA-125 than when the cancer is confined to lymph tissue. Just wondering...
  • Barneygirl
    Barneygirl Member Posts: 90
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    A PET scan would provide
    A PET scan would provide better info as being NED over decreased size of nodes (per a CT scan) as PET shows the level of metabolic activity. Increased uptake indicates abnormal level of activity with a certain level usually indicative of the cancer being active. However, radiation treatment will continue to show increased activity in target area for up to 4 months post-treatment. That's tough not being able to use ca 125 as indicator. But, great news on the decreased size of nodes!!!

    Annie

    That makes sense. I'll push
    That makes sense. I'll push for the PET scan next time. CA-125 has always been a good indicator of recurrence for me, but that was when I had disease in the abdomen. This time it was not and I discovered the recurrence myself when I noticed a lump above my clavicle and my CA-125 was 10. Go figure!
  • carolenk
    carolenk Member Posts: 907 Member
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    That makes sense. I'll push
    That makes sense. I'll push for the PET scan next time. CA-125 has always been a good indicator of recurrence for me, but that was when I had disease in the abdomen. This time it was not and I discovered the recurrence myself when I noticed a lump above my clavicle and my CA-125 was 10. Go figure!

    Lymph node involvement
    Has anyone else had a recurrence that showed up only in lymph node(s) but CA-125 was low?
  • Barneygirl
    Barneygirl Member Posts: 90
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    carolenk said:

    Lymph node involvement
    Has anyone else had a recurrence that showed up only in lymph node(s) but CA-125 was low?

    My doctor was not surpirsed
    My doctor was not surpirsed that my ca-125 was normal given the location of the recurrence-extra-abdominal. Most of the time ovarian recurs in the abdomen. He also said that CA-125 is not a perfect test and is used in combination with imaging to detect recurrence. I was putting too much stock in the number and was refusing to get frequent imaging due to concerns about over exposure. I was diagnosed in 6/04, so I've had alot of scans. Perhaps if I had had the scan 6 months ago, my recurrence could of been caught earlier. Would it have made a difference in the big picture, probably not, but who knows.
  • LaundryQueen
    LaundryQueen Member Posts: 676
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    My doctor was not surpirsed
    My doctor was not surpirsed that my ca-125 was normal given the location of the recurrence-extra-abdominal. Most of the time ovarian recurs in the abdomen. He also said that CA-125 is not a perfect test and is used in combination with imaging to detect recurrence. I was putting too much stock in the number and was refusing to get frequent imaging due to concerns about over exposure. I was diagnosed in 6/04, so I've had alot of scans. Perhaps if I had had the scan 6 months ago, my recurrence could of been caught earlier. Would it have made a difference in the big picture, probably not, but who knows.

    I can totally understand
    I can totally understand your reluctance to get overexposure to radiation. At least you had a longer chemo break which is a very good thing.