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Wednesday, August 24, 2011

My ovarian cancer recurs - What's next?

Unfortunately, majority of advanced stage ovarian cancers recur.   The usual scenario is patients undergo initial surgery to remove the cancer.  Then they receive the adjuvant chemotherapy (usually Carbo and Taxol IV or Cisplatin and Taxol IP IV chemo).   When the cancer recurs after this adjuvant chemo, the recurrence is classified to be "platinum sensitive" (if recurred more than 6 months after last carbo or cisplatin treatment) or "platinum resistant" (if recurred less than 6 months after the last carbo or cisplatin treatment).

If your recurrence is called "platinum sensitive", it is a better recurrence (if there is such word) than being "platinum resistant".    Being platinum sensitive means you are being retreated with either cisplatin or carboplatin combination.   In my opinion as the date this is being written in August 2011, carbo + Doxil combination has the best response rate in platinum sensitive based on the CALYPSO study.   Patients with platinum sensitive disease may live many years, albeit on multiple chemotherapies. Being platinum resistant means you are usually retreated with non-platinum drugs (Doxil, Topotecan, Gemzar, Avastin, etc).  Unfortunately, many platinum resistant patients die within a year or so after recurrence.  

As we continue our vigorous research in this disease, I am cautiously optimistic that we will hit a "jackpot" someday.   In my short professional life, I am fortunate to meet many highly intelligent men and women who are dedicated in finding the cure of ovarian cancer.   One of them, someday, would win that Noble prize for conquering this dreadful cancer.

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