Maintence chemo - Positive or negative

[chopps]

My mother has her 6th round of carbo/taxol next week.  The gyn/onc mentioned maintenance chemo and seemed to be positive about it....we had a 2nd opinion with this gyn/onc about 3 months ago and very reputable.  We will contact again to get thoughts on maintenance.  Maintenance would be taxol for 12 months.

My mothers onc seems to be against it saying it might increase length of time for reoccurance but not life expectancy.
My mother has gotten some neuropathy in her hands and feet and this is a concern of the onc.  He lowered how much taxol she was getting for the 5th round of chemo.  She is now on glutamin.

I have a friend who is an onc and she says she is not big on maintenence chemo because neuropathy can get worse and studies have not really shown it extends life.  Benefit vs. risk

Other maintenence drugs?  Or do you save those drugs for a reoccurance to don't become resistent?

A few other notes:
Stage IIIC when diagnosed, surgery in september.  Suboptimally debulked, had to leave uterus.
She has a very aggressive cancer - the most aggressive
Sister who died of ovarian cancer at 50
In great health and has handled chemo very well with expection of neuropathy.  I understand it can get very painful.
Her CA125 numbers are normal and went from 450 to normal before 3rd round of chemo.

It seems because she has an aggressive cancer that might start spitting quickly, maintencence would make sense.  It also seems that you don't want it to spread to liver, lung or kidneys.  .  I get that, but if you catch it earlier it would be better than later.  

Benefit vs. risk

Please, I value you thoughts and comments.


Chopps

[Tealoak]

I do not have any useful information to add but I am in the same position. I finished carbo/taxol #5 today; had stage 4 ovca. My Onc wants me to consider a stage3 study looking at 12 months of maintenance Taxol or a new cousin of Taxol ( CT2103).  The Phase 3 trial in GOG-0212.

There have been a couple of other maintenance chemo studies using Taxol--somewhat mixed results. The study headed by Maurie Markman found significant benefits; the study by the Italian Team ( the video and slide show is on the web) found no benefit. I am coming up with questions for my Onc who works with Dr. Markman at MD Anderson.

I have a lot more research to do but it will have to wait until I recover from today's chemo.  I would be interested in what you discover and what you decide.

Take care

Teri

[Terrin2]

This is really a question for the Dr to answer.    Some maintenance chemos, can put you back into remission.  

[chopps]

Thank you for your comments.  It is a dilema and sounds like its a dilema for the doctors as well.

A friend of mine had PPC/Ovarian Cancer, went on maintenence chemo for 12 months of taxol, had a reoccurance.  She felt that the nodules were very small and because of the maintenence chemo didn't get bigger or spread to vital organs.  She got neuropathy and when it reoccured went back on carbo/taxol for 6 rounds.  She just finished her 2nd round of maintence chemo with doxil and her Pet/CT Scan is clear.

Good luck to both of you and your decisions.  I do know about Fermera and will be something to try down the road.

Thanks,
Chopps

[ladyjogger31]

Hi, My Gyn/Onc agress to what Jane does. I just had a friend who was at her 10 month of maintence chemo and her numbers started to go back up, she is now on Fermera and her numbers are comming back done. It's an estrogen pill.
Hugs and Prayers,
Terry

[jane65]

Dear Chopps, I appreciate your question regarding maintenance chemo, because I'm facing the same dilemma. i'm staged 111C agressive epithelial ovca with spread to lymph nodes. I had 6 rounds of carbo/taxol in '07 and relapsed 3-4 months after completing chemo, and it was a rough chemo.
I've been on Topotecan since June, a much easier chemo to tolerate, and I'll have scans next month to see if we can end the chemo. I asked my oncologist about a maintenance chemo, but he is not in favor of it because he feels the body needs to recover and rest, and the bone marrow needs to recover. I'm still not sure what I want to do, I guess it will depend on the scans.
Your Mom has an agressive form of ovca and my oncologist said I do as well. He said actually that is good because the cancer cells reproduce so fast that they don't have time to really develop and are killed off more easily.
I'm glad that Mom's Ca125 is normal, that's a great sign that the chemo worked, good for her!
Benefit vs risk, what a quandry for you, I sympathize with you and Mom. Let us know what you decide, I'll do the same.
Best wishes...Jane