Maintenance

[Cindy809]

Dear Dr. Goodman ... What is your opinion on maintenance after chemotherapy.  I just completed my 6th treatment of gemzar/carbo for recurrence.  Prior to my second treatment I had complete secondary cytoreductive surgery.  My CA125 is now in the single digits.  My CT scan will never be clear.  It shows all kinds of problems due to the radical surgery.  My doctor is using them to see if any change has occured.  I do not want to go on Avistan.  Does anything work?  I have a meeting with my doctor next week and also have a call to my recent surgeon Dr. Spirtos on the subject.  I want to be prepared for my meeting.  Is time off any of the drugs more important than keeping this disease under control.  I was dx 3/06 3c grade 3, surgery, 6 rounds of carbo/taxol ... recurrence started around 5/07 and was finally discovered 8/07 with mets everywhere.  Had my liver, pancreas, lower, upper bowels resectioned and my spleen removed.  Second surgery was 9/07.  I responded very well to chemo.  Is femara used in cases like mine with NED after recurrence?  I'm so worried that it will come back with a vengence like it did last August.  It almost took my life in less than two years.  Thank you for your help ... Cindy

[Annekathryn Goodman, M.D.]

Dear Cindy
I apologize for my delay. Please let us know how your meeting went.

You ask the million dollar question. we all worry that once a person has a recurrence of ovarian cancer, it will come back again.  There seem to be two general philosophies and no good data:

1- as Ang stated - placing someone on a fairly non-toxic therapy that has shown some effect in ovarian cancer like femara.
2. acknowledging that we do not know what to do and adding more chemo stresses your bone marrow. This philosophy would suggest a watch and wait policy and to save therapy for such time as when a recurrence happens.

There are no wrong answers but no definitive information either
best wishes

[Ang80]

My mum has been given femara after chemo for a reoccurence.