CT not clean before chemo

Palor

Hello, all

I underwent debulking surgery more than a month ago and was dx stage 3 high grade ovarian cancer.  

Before the chemo, the CT scan shows scattered peritoneal implants and 2 soft tissue nodules 1.7*1.4 cm and 2.2*1.6 cm,

base on the close location to the cancer site and the fact that the blood marker is still elevated (went from 50 to 40), 

they concluded those are most likely cancers. But they will go ahead with chemo and watch it afterwards.

By comparing the CT taken right before surgery, the first one is likely pre-existing and the second one is probably new. 

 

My question is:

1. Can a new nodule grow into more than 2 cm in less than 2 months?

2. Anyone has residual nodule before chemo, how normally it is handled? 

(I read some reference saying non-optimal surgery will affect the survival rate, is it too late to fix this?).

Tethys41

CT results

Hi Palor,

Sorry about your diagnosis.  I understand your concerns.

I am not certain how you know that one of the remaining nodules has grown since surgery.  Did you get a copy of your surgical report?  It would identify any remaining tumors, left behind during surgery.  

In answer to your questions, yes, it is possible that a tumor can grow to 2 cm in two months.  I had a clear ultrasound 8 weeks before another ultrasound, which showed tumors throughout my pelvis and abdomen.  So, aggressive cancer can grow quickly.

It does sound as if your surgery was suboptimal.  It is only considered optimal if all tumors 1 cm or larger are removed.  Statistics for suboptinal surgeries are not as good as if the surgery is optimal.  The protocol is to treat with chemo and the chemo is aimed at resolving the remaining tumors.

I, myself, had a suboptimal surgery.  There was quite a bit of cancer left behind because it was in places that made it risky to remove.  Despite the suboptimal surgery, however, I completed treatment, cancer free, in 2010 and I have not had a recurrance.  I have worked very hard to get my body as healthy as possible, and I think that has helped keep me in remission.

I think chemo works better on aggressive cancer because it consists of faster growing cells, and this is what chemo targets.  

I know how terrifying this whole thing is.  I was terrified too.  But I also didn't believe what the statistics said because everyone is different.  

I hope your treatment goes well.  Good luck. 

Palor

thank you Tethys41

Hi, Tethys41,

Thank you for your reply! This is such an encouragement as you offer a real case where suboptimal surgery can be treated effectively by chemo.

I am in the process of sorting things out: get surgical report as you suggested, bring my latest CT to my surgical doctor for a discussion, as she told me and everyone else that everything is removed. My chemo doctor read all 3 CTs, before surgery, after surgery, and before the chemo, the first nodule seems to be present in all 3 CTs, the second nodule: in the first CT there is one nodule that is a 2.7*1.4 cm soft tissue, we wonder if that is the one, but in the secnod CT the 2.7*1.4 cm nodule is not present as there is extensive infammatory stranding throughout the lower abdomen and pelvis right after surgery, I wonder if it gets blocked that way. So the 2nd nodule in my original eamil could be a entire new growth. But none of these two are grown into any organs so I wonder if they were there why they were not removed.

I notice you said you did 2 rounds of ultrasound to examing pelvis and abdomen, I also want to do ultrasound or MRI instead of CTs in concern of radiation exposure, but so far I failed to pursuade my chemo doctor to do so, the current plan is to do CTs every 3 months for the first 2 years, and every half year for the following 3 year, and every year afterwards.

I read many of your posts and they are all very helpful. I totally agree with your approach, as cancer is an immune system disease, the best way to tackle it is by boosting our own immune system, using a holistic and integrated approach. I plan to take the same path as you.

Best wishes to all of us fighting this disease ...

Tethys41

CT scans

Hello again, Palor,

That is odd, about the new activity showing up on your scan.  I think your surgical report should tell you a lot.  Regardless, whether there is a new growth, or not, the chemo will hopefully resolve it. 

The ultrasounds I mentioned were form before my diagnosis.  I had a CT scan after I completed treatment and then one a year later.  SInce then, I have opted to decline them, for the same reason you mentioned.  I do think it is wise to check on the results of chemo, with a scan, once you are finished with treatment.  After that, it is a comfort thing.  If you want to know what is going on in there, scans are better than ultrasound.  On the other hand, depending on how you want to proceed and what your doctor believes, some women do not do treatment for a recurrance unless they are experiencing symptoms, whether tumors remain, or not.  I know a woman, who was diagnosed with stage IV ovarian cancer.  She was never in remission, but held off doing more chemo for 5 years after her first treatment ended.  I believe a study was released in 2011 or 2012, which indicated that doing chemo before symptoms developed did not improve survival.  So, if I were to develop symptoms, then I would opt for a scan.  Otherwise, I don't see much point.  There is a homeopathic, that helps remove the radiation from your body, if you have a scan.  You take it for a few days before and after the scan.  It is called radium bromatum.  I've used it.  I can't tell you whether it actually works or not because there is no way to measure its effectiveness, but I have used other homeopathics and they are very effective, so I trust that this one works. too. 

Good luck with your treatment.  Keep us posted. 

Palor

Tethys41 said:

CT scans

Hello again, Palor,

That is odd, about the new activity showing up on your scan.  I think your surgical report should tell you a lot.  Regardless, whether there is a new growth, or not, the chemo will hopefully resolve it. 

The ultrasounds I mentioned were form before my diagnosis.  I had a CT scan after I completed treatment and then one a year later.  SInce then, I have opted to decline them, for the same reason you mentioned.  I do think it is wise to check on the results of chemo, with a scan, once you are finished with treatment.  After that, it is a comfort thing.  If you want to know what is going on in there, scans are better than ultrasound.  On the other hand, depending on how you want to proceed and what your doctor believes, some women do not do treatment for a recurrance unless they are experiencing symptoms, whether tumors remain, or not.  I know a woman, who was diagnosed with stage IV ovarian cancer.  She was never in remission, but held off doing more chemo for 5 years after her first treatment ended.  I believe a study was released in 2011 or 2012, which indicated that doing chemo before symptoms developed did not improve survival.  So, if I were to develop symptoms, then I would opt for a scan.  Otherwise, I don't see much point.  There is a homeopathic, that helps remove the radiation from your body, if you have a scan.  You take it for a few days before and after the scan.  It is called radium bromatum.  I've used it.  I can't tell you whether it actually works or not because there is no way to measure its effectiveness, but I have used other homeopathics and they are very effective, so I trust that this one works. too. 

Good luck with your treatment.  Keep us posted. 

Dear Tethys41, Thank you for

Dear Tethys41, Thank you for providing so much useful information to solve my doubt, I will keep you posted once I know more...

Palor

updates

HI, All,

After reading the surgery report and talk to the surgeon, there is no new information found. The report did not say it left anything behind. The surgeon did not tell me she examined the preexising one and found it not suspiciou (which I had hoped that was what she would say)...

Chemo is going on well, after 2 out of 6 cycles, I did not experience any side effects except hair loss. I am working full time and exercise a lot.

MSKCC offers integrated therapy, which I indicate I would like to join and they already put me in. Is that all I need if I want a holistic approach? But it would be at the end of the chemo, not during the chemo.

Palor 

 

Tethys41

Integrative treatments

Hi Palor,

I'm so glad your treatments are going smoothly.  It's great that you can work through them.  

Holistic and integrative treatments cover a wide range of options.  It just depends on how you want to approach them.  Some practitioners offer integrative treatments that you receive throughout your chemo treatments.  It sounds like your hospital opts for integrative therapies after you are done with chemo.  There are certainly more proactive approaches than that, but you would probably have to pay out of pocket for them, because most aren't covered by insurance.  

If you want to receive integrative therapies before finishing chemo, you would have to find a functional medicine doctor of naturopath, who has oncology experience.  It's always good to support your body at whatever point you are able to.

Palor

Update

Hi, Tethys41,

Thank you for your explanation and reminder.  I talked to the hospital again and they are working on moving my appointment much earlier if possibe, the reason they scheduled my appointment so late is because that is the first available spot.  Now they put me into a waiting list and hope someone canceled their appointment.

Palor

 

Tethys41

Good luck

Hi Palor,

That's good news.  I hope they get a cancellation and you get in sooner.  Hope things are going well for you.

WarriorS1

Good luck with treatments

Hi Palor,

I hope that all goes well for you. Keep positive, continue to be active and eat as clean and healthy as you can.  

Palor

Hi, Tethys41 and WarriorS1, 

Hi, Tethys41 and WarriorS1, 

Thank you both for your nice words.  I saw the integrative doctor this week and he recommended 4 supplements for immune and digestion system during chemo.  He said "stress" is extremely harmful for this disease, but he does not think I have stress.  So as you said WarriorS1, stay positive, very important.