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2nd line chemo for ovarian cancer

Dear docotor,
I have been diagnosed with ovarian cancer Stage IIIc feb'08. i underwent surger+chemo with caroboplatin/taxol(6 cycles). Post chemo Ca 125 level was39. PET scan showed no evidence of malignancy.  3rd month followup ca 125 level was 460.
I opted to go to alternative medicine( Ayurveda), which have been using since jan'08. For past 2 wks I am haing watery discharge per vagina. so I got one more CA 125 level which is 1399 now.
My oncologist is suggesting Doxil/platinum drug combination.
My questions are two
1) since my diagnosis was platinum resistant ovarian cancer, will adding platinum drug to 2nd time help?
2) Should I wait or go right away for this treatment
5 Responses
322973 tn?1239904438
MEDICAL PROFESSIONAL
Hi,
If ovarian cancer recurrence is within one year of a platinum based chemotherapy, (and especially if it occurs within 6 months), it is more likely to be resistant to subsequent platinum chemotherapy.
Using cancer biology models, scientists have shown that chemotherapy is more effective when the number of cancer cells (disease burden) is lower. Thus, it is recommended that treatment should be begun as early as possible.
There are many lines of therapy still available for you. Ovarian cancer is known to be a chemosensitive tumor.
All the best, and God Bless!
Avatar universal
dear doctor,
thank you for ur reply. So for 2nd line platinum based drug should be avoided?
thanks again
322973 tn?1239904438
MEDICAL PROFESSIONAL
Hi,
You had a marker-only relapse about 3 months after first line chemotherapy. At this time, a proper re-assessment was not done, and alternate medicines were tried. The use of second line platinum is debatable in your case. What is the PET-CT report now? Has the cancer recurred locally? Are distant nodes or organs involved? Is ascites present?
Please discuss in detail with your oncologist.
Good Luck!


Avatar universal
I did have some pain abdomen at the time of marker rise.
PET-CT report says it has spread to the peritoneum( around the liver and intestine), lymph nodes in and around the vena cava  and many other abdominal lymph nodes. also recurrence in the vaginal vault and parametrium.no free fluid.
I have spoken with oncologist. he says combination of doxil and platinum because of their synergy. I read Mayo clinic website, it says doxil should be used as single drug in platinum resistant ovarian cancer. did I get it right?
322973 tn?1239904438
MEDICAL PROFESSIONAL
Hi,
You have understood correctly that in case of a platinum resistant ovarian cancer, subsequent chemo should not contain platinum as it is likely to be ineffective.
But as I said, things are a lot more fuzzy in your case because of alternative / complementary systems of medicines were tried and proper re-assessment was not done.
It may be worthwhile going along with a platinum. Perhaps your oncologist may like to try cisplatin this time. These drugs are usually well tolerated. You may repeat a PET-CT and a CA 125 level after 2 or 3 cycles and re-evaluate the treatment options.
Good Luck!

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