Tumor shrinkage may sometimes be delayed, even if chemo is effective. What is more important is that active viable cancer cells within the tumor mass should decrease. Thus, measurement of metabolic activity of the tumor mass using PET scan is important; it is also helpful to measure the physical size of the tumor by CT scan.
In second line setting, many oncologists continue to give chemotherapy as long as there is evidence of clinical benefit. One evidence of clinical benefit is a fall in tumor marker levels, and the second evidence is that the tumor has not grown since last 9 months.
Anthracyclines (including Caelyx) have cumulative toxicity on many organs, and you need regular evaluation.
Please feel free to ask follow-up questions if you need additional information.
All the best, and God Bless!
Hello Dr. Kamal S Saini,
Many thanks for answering my question.
Since being diagnosed in September 08 i have never had a PET scan, i have only ever had CT scans. Is a PET scan something i should ask for?
How would the medical team looking after me conduct an evaluation on me? since starting chemo i have seen my chemo specialist on regular 3 month intervals but it is only to discuss how i have been in general and CT scan results.
I have been very fortunate not to have had any side effects from Caelyx so far and am aware that each session of chemo i have is a top up on the previous, but with the build up on the toxicity what organs are most likely to be affected and how, does this normally occur once having a certain amount of sessions ?
All anthracycline drugs (for example doxorubicin) cause some amount of cardiac toxicity, apart from other side effects. Caelyx contains a liposomal form of doxorubicin, with a better toxicity profile as compared with the regular form of doxorubicin. Yet is is of course not free from cumulative toxicity. Please discuss with your treating oncologist.
Getting a PET CT may be a good idea, as you have a stable size lesion, with falling Ca125 levels.
A related discussion, caelyx side effects