CA 125 response to initial chemo

Betty999

Hi everyone, new member. My wife was diagnosed with 3c clear cell ovarian cancer 6/1. Had hysterectomy and optimal debulking. Power port installed and began dose dense chemo (carbo & taxol). Pre dX ca 125 was 118. Pre chemo ca 125 was 55. Post cycle 1 chemo was 24 and post cycle 2 chemo was 7.4. Have completed cycle 3 but  a 125 results not back yet. Three more cycles remain for a total of 6. Does the ca 125 trend appear to be OK? Is there anything we should be focusing on? 

NoTimeForCancer

Hey Betty999, visitor from

Hey Betty999, I am a visitor from the Uterine board.  Dropping CA125 is always a good sign, and it will increase if she has an infection or cold.  Aggressive forms of Uterine cancer are treated similarly to Ovarian cancer.   Here is a link to a brochure on CA125 I hope you find helpful.  

http://www.foundationforwomenscancer.org/wp-content/uploads/FWC-CA-125-Levels-Your-Guide-website.pdf

 

LorettaMarshall

Seems Betty is responding WELL to her dose-dense chemo combo!

Hello husband of Betty ~

If I read you correctly, seems Betty first had the “debulking” surgery, and then started the chemotherapy regimen of Carbo/Taxol.  From the decreasing CA125 numbers, seems like everything is working fine. 

I know how taxing and tiring these chemo regimens can be as do so many on this forum.  Focus on enjoying your time together each day.  See my letter to “Brian from the North” for how I fared with my 6-regimen Carbo/Taxol treatments that were scheduled every 3 weeks. 

Advice - stay away from crowds as much as possible.  Be sure Betty doesn’t become dehydrated.  Don’t be afraid to request hydration.  My schedule included returning the following day after each treatment for hydration, steroids, and a Neulasta shot to build up white blood count.  The references below will be helpful in understanding the significance of decreasing/increasing CA-125 markers.

Wishing for you and yours, continued success!

Loretta (Stage IV Peritoneal Carcinomatosis/Ovarian Cancer Stage IV

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1.      https://csn.cancer.org/node/301620

Letter from “Brian from the North”

2.      https://csn.cancer.org/node/301646

My reply to Brian relative to chemo treatments

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3.      https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=322855

“NCI Dictionary of Cancer Terms

dose-dense chemotherapy

listen (dose-dents KEE-moh-THAYR-uh-pee)

A chemotherapy treatment plan in which drugs are given with less time between treatments than in a standard chemotherapy treatment plan.”

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4.      http://chemocare.com/chemotherapy/drug-info/Taxol.aspx

http://www.chemocare.com/chemotherapy/drug-info/carboplatin.aspx

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5.      http://www.medicinenet.com/ca_125/article.htm

“What is CA 125 test? What is a tumor marker?”

 CA 125 is a protein that is a so-called tumor marker or biomarker, which is a substance that is found in greater concentration in tumor cells than in other cells of the body. In particular, CA 125 is present in greater concentration in ovarian cancer cells than in other cells. It was first identified in the early 1980s, and the function of the CA 125 protein is not currently understood. CA stands for cancer antigen. CA 125 is often measured as a blood test…

The most common use of the test is the monitoring of people with a known cancer that elevates CA 125 level, such as ovarian cancer. Around 75% to 85% of women with epithelial ovarian cancer will have an elevated CA 125 level. In the patient who is known to have a malignancy, such as ovarian cancer, the CA 125 level can be monitored periodically. A decreasing level generally indicates that therapy, including chemotherapy, has been effective, while an increasing level indicates tumor recurrence. Because of normal test variation, small changes are usually not considered significant. A doubling or halving of the previous value would be important…”

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6.      http://news.cancerconnect.com/types-of-cancer/ovarian-cancer/surgery-for-ovarian-cancer/

“Surgery Overview

The successful treatment of ovarian cancer requires the involvement and coordination of several different treatment approaches, including surgery, chemotherapy and, in rare cases, radiation therapy. Nearly all women with ovarian cancer will undergo surgery and chemotherapy. The role of surgery in the initial management of ovarian cancer is to obtain a specimen for determining an accurate diagnosis, provide local treatment of the cancer in the pelvis and abdomen, and obtain other prognostic information to determine the stage of cancer and what additional treatment may be necessary.

Despite surgical removal of the tumor, many patients with ovarian cancer will already have microscopic cancer cells, called micrometastases, that have spread away from the ovary to other locations in the abdomen and distant parts of the body. These micrometastases often cannot be detected by currently available tests. Surgery is a local therapy and cannot treat micrometastatic cancer.

Therefore, additional systemic treatment using chemotherapy is required to treat micrometastatic cancer. Information obtained during surgery and from other tests determines whether additional treatment with chemotherapy is necessary. Because most patients with ovarian cancer have advanced disease at diagnosis, the majority of patients will receive chemotherapy as part of the overall treatment plan.

Often, patients with ovarian cancer are initially treated with surgery aimed at debulking (decreasing the size of) the tumor. This type of surgery, in which the goal is to remove the greatest volume of cancer cells possible, is also called “cytoreductive” surgery. After completion of the surgery, most patients are placed on a chemotherapy regimen.

Over the past several years, there has been increasing interest in administering chemotherapy both before and after surgery. Chemotherapy given before surgery is referred to as neoadjuvant chemotherapy, and the surgery that follows is referred to as “interval” cytoreductive surgery. By administering chemotherapy first, micrometastatic cancer cells may be more easily destroyed and chemotherapy may reduce the amount of cancer, thereby allowing for more complete surgical removal of the cancer. The use of neoadjuvant chemotherapy remains controversial, but it may be considered for selected patients with advanced disease who do not appear to be candidates for initial surgery…[1]”

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7.      http://foundationforwomenscancer.org/wp-content/uploads/CA125levels.pdf

Understanding CA 125 Levels A GUIDE FOR OVARIAN CANCER PATIENTS

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8.      http://www.womenscancercenter.com/info/articles/ca125.html

“…Will my CA125 count tell me if my treatment is working?

CA125 counts can be particularly important once a cancer diagnosis is made, to help determine the effectiveness of treatment. Declining levels of CA125 often represent a positive response to treatment while increasing levels denotes a poor response, but not always. Dependent on the individual being tested, CA125 results can be used by a doctor to continually monitor and improve treatment options.

How frequently should my CA125 levels be evaluated?

The frequency of CA125 monitoring during or after cancer treatment will be influenced by the type of cancer, size of the tumor(s), type of treatment, and the patient's baseline CA125 level. Your doctor should discuss this with you…”

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Betty999

Thank you for your response.

 

 

paddison

CA125

I was diagnosed on July 25, 2016.  My CA125 at that time was 16,000.  I went down every time we checked it...last time in May 2017 it was 12!  I went back a month ago, and it was 295...I did the test again and had a CT 4 days after.  My number was 460.  They didn't see anything on the scan, but had me do another CA125 in 2-3 weeks.  I went last Tuesday, and it was 2645.  I am scheduled for a PET scan on Saturday the 16th. 

Has anyone else had that drastic a change and it not be the cancer back?  I am really worried about it, but probably won't know anything for a whole week. 

LorettaMarshall

paddison said:

CA125

I was diagnosed on July 25, 2016.  My CA125 at that time was 16,000.  I went down every time we checked it...last time in May 2017 it was 12!  I went back a month ago, and it was 295...I did the test again and had a CT 4 days after.  My number was 460.  They didn't see anything on the scan, but had me do another CA125 in 2-3 weeks.  I went last Tuesday, and it was 2645.  I am scheduled for a PET scan on Saturday the 16th. 

Has anyone else had that drastic a change and it not be the cancer back?  I am really worried about it, but probably won't know anything for a whole week. 

Paddison~Continued large increases in CA-125 marker is suspect!

Dear Paddison:

According to the reference #5 in my CA-125 article, it would appear that the number is indicating increasing cancer activity. 

• ·           http://www.medicinenet.com/ca_125/article.htm

“…A decreasing level generally indicates that therapy, including chemotherapy, has been effective, while an increasing level indicates tumor recurrence. Because of normal test variation, small changes are usually not considered significant. A doubling or halving of the previous value would be important…”

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My CA-125 count last Thursday went from 183 to 212.  In December last, it was down to 8.  But soon after it began to grow by double figures.  But my highest numbers never exceeded the mid-300 range when I was diagnosed with my Stage IV cancer.  It just goes to show that one doesn’t have to have a CA-125 count in the thousand range for it to be malignancy.  A PET scan will tell the tale.  I know that scans are always accompanied with anxiety, but we have to face the facts whatever they are.  If you care to write again, can you tell us your exact diagnosis, and how you’ve been “treated” so far.  It just broadens our knowledge of how differently we here respond to the very same treatments.

While easier to say than to do, try to not “get in that tube” before Saturday.  Thinking about it for the next 4 days will rob you of any peace you’ve had up till now.  As a Stage IV, I go into every test anticipating a possible increase in cancer activity.  If the increase falls within a range that comes in the category of “gradual”, I don’t always panic, even though it’s never really what I would call “good news.”  And while my numbers have increased substantially, I am not going to “jump into some other kind of treatment” because I don’t want to “forfeit” the “health” I have now for something that will make me feel much worse, and possibly not do any good.  So I’m “stretching” out my “vacation” from more treatments as long as possible. 

While I haven’t been much of a help, I just hope you can focus on something else besides the upcoming test.  It’s a mental battle, fighting fear, but with God’s help, it’s possible to have peace of “mind” believe it or not.

Loretta

Peritoneal Carcinomatosis/Ovarian Cancer Stage IV

 

 

paddison

Thank you Loretta.  I am

Thank you Loretta.  I am trying not to think about it.  It makes me feel a little better that there was nothing they could see on the CT scan.  I am hoping that there is something else making the number go up.  When I saw the number was 2645 it was a shock.  I know that other things can make it go up, but that is a lot higher than I ever expected. I am trying to stay positive.  I have already decided that if it is a recurrance, depending on where it is, I willl not fight it.  My family won't be happy, but I am not going through it again.

 

I am having Cataract surgery tomorrow, so that will make the time go faster.