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Question re: 6 Cycles vs. 8 Cycles Question re: 6 Cycles vs. 8 Cycles

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Unread 04-17-2003, 05:34 PM
Question re: 6 Cycles vs. 8 Cycles

My doctor has said that he sometimes extends the 6-cycle treatment to 8 cycles. I have tried to figure out when he makes this determination, but all I've been able to get is, "When things are going really well, I like to extend it for two more cycles."

He apparently can't be any more specific than that, as I suppose overall ability to take chemo -- and how your levels are doing -- has a lot to do with it.

I've seen that some people here have gone through 6 cycles of Carboplatin/Taxol, while others have gone through 8. Is there any reason to not do 8, or to push for 8? Would going through 8 increase my chances of not having to go through more chemo ever again?

Does more chemo help? I'd rather go through this all at one time, but I don't know enough about the pros and cons. Your thoughts are appreciated. :-)
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Unread 04-17-2003, 07:13 PM
Question re: 6 Cycles vs. 8 Cycles

s SirenSong

You are asking an excellent question. Also a very controversial question. There is no clear answer.
For my doctor at Fox Chase Cancer Center the answer was based upon three things.
Was I considered optimally debulked at the time of surgery. Meaning no visible residual disease greater than l cm.
Was my CAT scan, done after chemo number six, clear.
How low was my ca 125.
My answers for those questions were yes, yes, and eight.
Therefore he chose to stop my treatments at six. He felt that to put additional poisons into my body at that time would serve no purpose.
Had I not been optimally debulked, had a higher ca 125, or an unclear CAT scan, then I would have received eight.
As you travel on this ovarian cancer journey you will find there are no clear answers anywhere. Depending on where you are treated, the answers are different.
You will also hear about consolidation therapy. This is when women continue with taxol on a monthly basis for up to one year.
There are many pros and cons to this approach. Some doctors feel it maintains remissions longer, others say you give up too many healthy months when thus far survival statistics have not shown improvement.
I have attended a couple ovarian cancer conferences this past year. A good form of consolidation is an area that is being researched currently. Hopefully it will easier on patients than taxol, without depressing our bone marrow too much.
Sounds like you are really out there educating yourself.
I hope I have a future advocate companion.
The Ovarian Cancer National Alliance is having their annual conference in San Francisco this Sept. I attended their conference last year in Washington DC. They are the brightest bunch of ovarian cancer women to be found. Excellent speakers fror top notch hospitals. I will be there again this year.
Maybe if you are up to it.......?

Unread 04-17-2003, 09:11 PM
Question re: 6 Cycles vs. 8 Cycles

As always, thank you so much for your incredibly informative response. I just read it to my mom (a retired RN). Neither of us know what we would do without you (or the other great women on this board).

Your note makes complete sense to us. But my chemo doctor said that he goes for 8 cycles if the patient is doing really well. So we're confused.

I did have optimal debulking (yay! they didn't leave anything behind except microscopic hiding thingies!). And my CA125 is 17 (and hopefully will continue to fall as the chemo progresses). I guess I'll look forward to that CT scan.

I was basically trying to plan, since I still have weddings scheduled, starting in late September. I don't mind canceling them, but I would feel silly canceling them if I could, in fact, shoot. Which is why I'm trying to figure all this out now.

As for joining you in advocacy, fear not. I've already been talking to the Ovarian Cancer Coalition of Greater California about volunteering (when I'm up to it). The more I find out, the more upset I get about what I *didn't* know. As a doctor's child, I somehow feel I should have known more than the average bear. Alas -- I didn't.

I would love to attend the SF conference. If my last chemo treatment is at the end of July, I may be able to. If it continues, I probably wouldn't be able to go, as my counts would probably be a bit low for travel. First hurdle: Get through the next treatment in some sort of normal fashion! :-)

s for you, Karenann!
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Unread 04-18-2003, 10:08 AM
Question re: 6 Cycles vs. 8 Cycles

Hi Siren..

I had 6 treatments of taxol and carboplatin. Had I gone into a trial study, which my gynocologist was hoping I would, then there would have been 8 treatments.

I have read many of your posts and thought long and hard on some. I am definately NOT a superwoman and did have my share of complications with the chemo and the meds. However, instead of giving into the pains, I tried very hard to live my normal life. I am a teacher and did continue to work while getting chemo. When school ended, I worked in a summer camp and still continued to receive chemo.

Throughout this whole ordeal I planned a bridal shower for my daughter in law, hosted a rehearsal dinner for 40 people, and had the time of my life at my sons wedding in September.

My oncologist told me that people who continue with their normal daily lifestyles, tolerate and do better with chemo... I certainly do believe this. I know that everyone reacts differently to chemo but if you sit around feeling sorry for yourself, then all you are doing all day is thinking of the worst situations.

No one has a magical crystal ball and no one knows what the future will bring for any of us but I will not let this minor setback get to me. I am a strong willed person and my strength comes from my "want to live".

Unread 04-18-2003, 08:58 PM
Question re: 6 Cycles vs. 8 Cycles

Dear Rosalie,

I also am not a "feeling sorry for myself" person. :-) While I had to cancel all my wedding photography contracts through August, I am doing technical writing for several clients, assisting with creation of several web sites and answering all customer e-inquiries for a major West Coast photo lab. It's helping that my surgery recovery is now further along. I really wasn't recovered when the chemo started, which made things more difficult.

I am sincerely hoping that this next chemo goes much better for me, and that I'm only laid up for a few days. I was actually going to photograph a bris earlier today, but the new baby's brother had a cold . . . and my nurse (who I saw when I had my blood drawn) said I shouldn't go. But! The mom wants me to come photograph her new baby as soon as I can. I've appreciated how people have tried to keep me connected and working.

It's awesome that you're working as a teacher. I love kids! Your messages are always so supportive and informative, and I appreciate them so much. Did you mention that you're writing a book? I would love to know more about it.

Thanks for your note! I will let you know if it's 6 or 8 treatments, and how #2 goes. :-)
Unread 04-19-2003, 12:42 PM
Question re: 6 Cycles vs. 8 Cycles

ladies would it be so rude of me to ask you what your symptons were when you were diagnosed with ovarian. how big the mass, ca 125 counts. you would think i would know better but im panicking a bit. my mom had ovarian but the peritoneal kind and it was to late for her. what makes me more anxious is when i hear about the "debulking" they did that to my mother during surgery and she ending up living her last year with an illiostomy bag ( like a colostomy only worse). my surgery comes up wednesday and im scared to death.
Unread 04-19-2003, 01:00 PM
Question re: 6 Cycles vs. 8 Cycles

Hi Macc..

Boy can I understand your concern...I do not know how long ago your mom had ovarian cancer but I do believe that treatments have changed alot over the years.

MY symptoms of ovarian cancer were bloating of the stomach. A few months before the bloating I did feel a small bump, under the skin, by my belly button, when lying flat on my back. I did call my gyno and mention it to him but he told me that it did not sound gynocological and more like a hernia. Boy was he wrong.

Then my stomach started to blow up like i became pregnant overnight. Went to my regular family doc, he sent me immediately for an abdominal cat scan and the rest is history. (one year ago)

The tumor on my ovary was very big and fluid filled. In fact the fluid was also going into my lungs and making it hard to breathe. My oncologist gynocologist ( the only kind of doctor you shoud use) said that he got everything visible out. There was very little debulking to do but I did have chemo just to get rid of any minute invisible particles that may be lingering.

My ca125 number, after surgery, but before treatments was 454. After my first chemo it went down to 43 and steadily down since then.

Hope this helps answer some of your questions. Good luck on your hysterectomy and keep in touch.

Unread 04-19-2003, 01:53 PM
Question re: 6 Cycles vs. 8 Cycles

Dear Macc,

Like Rosalie, my only symptom was abdominal swelling and a general sense of tiredness and not feeling right. I thought, however, that the abdominal swelling was due to a post-appendectomy surgical infection. I had night fevers, but those started *after* the appendectomy.

The first time I called my surgeon (who did the appendectomy on January 3rd), he prescribed Cipro over the phone. After five days, there was no change, so I requested a same-day appointment with any doctor who would see me. An internist had an opening, and he requested an abdominal CT scan . . . which revealed a lot of ascites (fluid that builds up due to a variety of situations, including tuberculosis, heart disease, liver failure and cancer).

All the blood tests came back negative, and the doctor said my CA125 -- which was 161 -- was only *slightly* elevated. The last test was a barium-assisted CT scan, and that's when the 9-cm tumor next to my uterus (and 5cm tumor on my omentum) were visible. I was then sent downstairs for a mammogram (clear, thankfully), and then met with the gynecological oncology team the following week. I was scheduled for surgery the week after. So from tumor discovery to surgery was two weeks.

My surgeons got everything out (optimally debulked), but since my cancer was Stage 3C, I am undergoing chemo to kill anything microscopic that might have been left behind.

I know that they do everything they can to avoid any "ostomies." It all depends on what your doctors find. I know that I had a long hard talk with my doctors about not wanting to live my live with a colostomy bag. Happily, they didn't have to do anything related to my bowel, so other than losing my reproductive organs and having a big scare, I'm mostly none the worse for wear. Still recovering, but that's to be expected.

I don't think I've seen your name before. What did the doctors find? What do they think it is? We will pray that they find nothing! The women on this board are great and can offer you a lot of support before and after surgery, and during any treatment that you may have to go through. Just know that you're not along.

Unread 04-19-2003, 06:09 PM
Question re: 6 Cycles vs. 8 Cycles

how did you stomach feel when you say it was swollen? hard?
thats how my mom's that what you mean...or like when your due for your menstral period? my ca did not come back elevated its 7 so i guess thats one good sign. all i know the cyst is about 5 cm, they didnt feel any fluid in the belly, but the cysts are complex. the docs said they do not think its cancer but cant say for sure until they biopsy. they also told me if it was that ists probably very early? can they tell this before surgery?
Unread 04-19-2003, 08:25 PM
Question re: 6 Cycles vs. 8 Cycles

Hi Maria...

Yes, my stomach felt swollen and hard....a ca125 number of 7 is totally normal and excellent. 35 is the norm and anything under 20 is excellent. My number, right now, is 12.

I am not really sure if they can tell if the mass is cancerous before the surgery but I do know that my abdominal cat scan did seem to reveal the possibility.

Try not to get too worked up.


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