Recurrent of ovarian cancer is usually not symptomatic. If you are not seen periodically by your oncologists who usually order Ca125 periodically, then by the time you have recurrence, you would have symptoms with your cancer recurrence. Ca125 blood test is still the most sensitive test in detecting ovarian cancer recurrence. This Ca125 test is commonly ordered every 3-6 months for patients after completing their adjuvant chemotherapy. However, a recent randomized trial study published in Lancet recommends no Ca125 should be ordered since no difference in survival is noted whether the patient is diagnosed early versus late for cancer recurrence. This study seems to be initially illogical. I would think that the earlier you are diagnosed, the smaller the tumor is found and perhaps the higher chances of curing the recurrence. However, this study found the opposite.
My medical experience seems to suggest that when my patient has early recurrence and localized, she has a better chance of cure if the disease is localized. Last week I have such patient that i discharged from my practice. She had cancer recurrence next to the spleen after her initial surgery and chemotherapy. I went back to debulked this cancer and retreated her with carbo and taxol (patient was platinum sensitive). Now she is cancer free for 5 years.
My current thinking is some patients with localized disease and platinum sensitve would benefit from regular check of Ca125. However, patients who are platinum resistant and wide spread recurrent, may not benefit from regular Ca125 as noted in the Lancet paper. Since medicine is an ever changing science, I wait for more study confirmation of the study's recommendation.
REFERENCE:
My medical experience seems to suggest that when my patient has early recurrence and localized, she has a better chance of cure if the disease is localized. Last week I have such patient that i discharged from my practice. She had cancer recurrence next to the spleen after her initial surgery and chemotherapy. I went back to debulked this cancer and retreated her with carbo and taxol (patient was platinum sensitive). Now she is cancer free for 5 years.
My current thinking is some patients with localized disease and platinum sensitve would benefit from regular check of Ca125. However, patients who are platinum resistant and wide spread recurrent, may not benefit from regular Ca125 as noted in the Lancet paper. Since medicine is an ever changing science, I wait for more study confirmation of the study's recommendation.
REFERENCE:
Early versus delayed treatment of relapsed ovarian cancer: a randomized trial. Rustin GJ,et al.
Lancet. 2010 Oct 2;376(9747):1155-63.
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