Advice

[Trisha58]

I am getting ready to start Doxil chemo tomorrow because I am having recurrent ovarian/peritoneal cancer.  I was in remission for almost 2 years but my CA 125 count the last time it was drawn was 704 which was early March.  My last CT scan didn't show anything and I was wanting to know since I am feeling fine, if I should wait to start chemo until something is detected on a CT scan or I should go ahead and start treatments right away?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
The treating doctor is the one who knows about all aspects of the case, and is thus in the best position to decide which tests are suitable.
Good Luck!

[Trisha58]

Thanks for your response.  My last CT scan was 1/15/09 and my dr hasn't said anything about another CT scan.  Should I insist he order one?  I have asked him before about PET scan and he said I didn't need one of those because the CA 125 and CT scan are telling him what he needs to know.  

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
A Ca125 level of 704 raises strong suspicion of relapse. You should undergo a PET-CT which may detect the areas involved even though the CT scan was unable to locate any tumor. Once you document the location and size of a lesion, it will be easy to measure your response to chemotherapy by repeat imaging after your courses are completed.
You were in remission for 2 years, and are likely to be platinum sensitive now. I hope you will have another long remission.
All the best, and God Bless!