what is the Best Treatment for Ovaria...

what is the Best Treatment for Ovarian Cancer ???

Posted in the Ovarian Cancer Forum

Hilda Loates

UAE

#2 May 15, 2007
Find an ovarian cancer oncologist (the best) also look into complementary treatments make sure that the practioner is qualified and registered with a professional board. Also keep abreast of
latest ovarian cancer news do your own research. It's a long and complicated journey. Good Luck!

Since: Dec 05

Vero Beach, FL

#3 Jun 14, 2007
Surgery is the Gold Standard (see a surgical oncologist first)

Ovarian cancer patients are now living longer than they did in the past, but this is almost certainly owing to better and more aggressive surgery. Surgery is generally used if it can cure the cancer. It is most useful in cancers that have not spread. Even if the cancer has spread to only one area or is small, then it may be possible to remove it completely with surgery.

It is recommended that patients with ovarian cancer undergo aggressive de-bulking surgery up front, prior to chemotherapy. It has long been observed that those patients whose tumors can be resected without any visible residual disease tend to live longer than those who are left with residual tumor after de-bulking surgery. Based upon this, up front, de-bulking surgery has become the standard of care.

Some researchers believe the reason for better survival for patients who could undergo complete resection without any tumor left behind is that these tumors are biologically less aggressive and would do better regardless of the type of treatment they receive, and that the removal of lymph nodes at the time of surgery may additionally contribute to a better outcome.

A study from Germany tested the role of surgery in patients with recurrent ovarian cancer and found that those patients who underwent resection without any residual tumor did better than those whose tumors could not be completely removed. The authors of this study identified four parameters that could predict the possibility of complete resection, which included:

--Good performance status
--No ascites (malignant fluid in the abdomen)
--No residual tumor after the first surgery
--No evidence of peritoneal spread of tumor on the preoperative tests

Patients who met all these criteria had an 80 percent chance of successful surgery with complete tumor removal.

Surgery is an integral part of the multimodality treatment of many cancers. In the case of ovarian cancer, proper patient selection will ensure the benefit of surgery for those who need it and avoid its morbidity and delay in the commencement of chemotherapy for those who are unlikely to benefit from it.

The line of reasoning frequently used to explain the value of surgical debulking included five points.

First, the surgery was thought to remove resistant clones of tumor cells and thus decrease the likelihood of the early onset of drug resistance.

Second, the removal of large masses likely to be associated with poorly vascularized areas of tumor improves the probability of delivering adequate drug doses to the remaining cancer cells.

Third, the higher growth fraction in better vascularized small masses enhanced the effect of chemotherapy.

Fourth, smaller masses required fewer cycles of chemotherapy and thus decreased the likelihood of drug resistance.

Fifth, removal of bulky disease enhances the immune system.

These five points support the use of initial surgical debulking followed by chemotherapy, rather than the reverse.

Mayo Clinic
Gynecologic Oncology 2005; 97: 74-79
tommy

Singapore, Singapore

#4 Jun 30, 2007
My mother is 63 years old and diagnosed ovarian/primary peritoneal
cancer stage 3c and went for a hysterectomy and first standard chemo treatment (Carboplatin and Taxol) 1 week ago.
However, an increasing amount of ascites are coming out from her vagina and a new
wound was developed in her abdomen area.
I am trying to find causes vaginal ascites discharge and if this is an indication that
the chemo treatment is working?
Many thanks,
TOmmy
[email protected]

Since: Dec 05

Vero Beach, FL

#5 Jul 2, 2007
The jury is still out on how ovarian cancer spreads. As less is known about this disease than other cancers this has not been definatively answered and there is controversy among the ranks of researchers and clinicians. Many believe it does not spread via the lymph and spreads through cells shedding into ascites in the absominal cavity and then seeding in distant sites.

It does spread this way but is probably not the only way as it is found in lymph nodes as well. It has long been believed that it does not metastasize to the brain, however in recent years, because of dose-intense combination chemotherapeutic agents (like Taxol/Carboplatin), more women are developing brain mets.

A chemo-induced gene mutation can happen when the original chemo received does not work. The cancer comes back. When it does this, the cancer comes back more aggressively. The mutagenic effects (changes in form) of chemotherapy on a genetically-unstable tumor, drives the tumor into a state of more aggressive behavior.

Cancers that are a product of these genetic mutations release cells from the usual controls of proliferation and survival, making them so much harder to fight it. Following this mutation, the cancer cells acquire the ability to proliferate without the normal restraints.

As the cancer grows, it may infiltrate and destroy the surrounding tissue, and metastasize by penetrating into blood vessels, lymph nodes, and body cavities. Distant metastasis via the bloodstream may affect virtually any organ (the lungs, bones, liver, adrenals, and even the brain)
When treatment has already been given, possible indications of whether the chemotherapy is benefiting could be provided by Pet imaging. However, the outcome for metabolic responders and non-responders of a given therapy by Pet imaging is basically what is going on with Cell Culture Assays, showing what patients are benefiting from what drug agents, "before" they are put in the patient. It could have indicated whether the patient was "sensitive" or "resistant" to taxol + carboplatin combination.

PET imaging has the tremendous capability to image the biochemistry of tumors noninvasively. Previous research indicates that PET is playing a growing role in tracking the effectiveness of chemotherapy and evaluating early response to a selected drug. Usually, the level of tumor metabolism is compared on PET scans taken before and after chemotherapy. A successful response seen on a PET scan frequently precedes alterations in anatomy and would therefore be an earlier indicator of tumor shrinkage than would be seen with other diagnostic modalities (like an MRI).

A Johns Hopkins study had found that combined PET-CT is better at detecting ovarian cancer spread than PET alone. In their study, presented at the Radiological Society of North America, they reported that overall PET-CT improves the ability to distinguish cancerous from normal tissue and locate metastases where they have spread. The study used a scanner that fuses CT technology, which provides anatomical detail, with PET images, which detects metabolic activity of tumors.

Johns Hopkins was the first U.S. hospital to install a commercial combination PET-CT scanner for use with patients in a clinical setting. In addition to ovarian and colon cancer, the scanner is being used to detect a variety of cancers including breast, melanoma, and lung cancer.
Cathy Munsterman

Chantilly, VA

#6 Jul 5, 2007
There is light as you travel throught the tunnel of ovarian cancer. I am 61 years old and my surgery was performed twelve days after diagnosis. My CA-125 blood test showed a count in the 800's; normal is 1-35. Five days later while still in the hospital, my intestine perforated and I went back into surgery where a temporary colostomy was performed. My total days in the hospital numbered eighteen. Three weeks later I began the first of six chemo treatments. My CA-125 test now shows a count of 35, and I have two more treatments remaining followed by surgery to reverse the colostomy. Support of family and friends and a positive attitude are key to the recovery process. Take it a day at a time, and we'll walk through that tunnel together.
Jane Bishop

Schuylkill Haven, PA

#8 Aug 5, 2007
I just discovered this site. I have a blog that describes my whole experience. I had surgery June 6 and am currently 2 treatments into my chemo. More at the following

www.lastlegrev.com

Jane Bishoo
conquereor

White Hall, AR

#9 Aug 10, 2007
I was diagnosed in Oct 06 am now six month out from treatment and getting ready to do the Danskin Trianolon. This journey has brought me closer to all I love and a greater appreciation of life (which I found hard to believe at first since I truly have a great life) I am working hard to stay healthy

Since: Aug 07

UAE

#10 Aug 12, 2007
Home Testing Kits for Predictive Genetic Test in Middle East
The Human Genome Project has made one of the biggest contributions to the medical diagnosis by revealing an individual’s potential susceptibility to specific diseases and analyzing one’s risk to various diseased conditions. The prediction of various diseases is a quite common thing practiced among the people in Europe and USA. Eastern Biotech & Life Sciences introduces, for the first time in the Middle East, the similar highly accurate gene-based “traffic report” called GENOVATIONS which can clearly pinpoint health risks which previously would have been hidden out-of-sight “over the horizon”. With this new information, you and your physician can chart an alternate route, a smart health “detour”, so you can avoid the health conditions you could to encounter otherwise.
Genetic profiling which uncovers potential genetic susceptibility to various diseases like Gastrointestinal, Immunology, Nutritional, Endocrinology and Metabolic assessments. This highly accurate genetic diagnostic testing called Genovations™ can clearly pin-point health risks which previously would have been lurking out-of-sight. This can also be termed as "Advanced Risk Reporting" so that we can travel down life's road more relaxed, and more confident of better health.
None of us are perfect and neither are our genes. Within your genetic makeup, there are slight “variations” called Single Nucleotide Polymorphisms (commonly called SNP s, pronounced “snips”). Although they don’t cause disease, SNPs are associated with almost every human disease. The “expression” of one’s genes into an actual disease isn’t inevitable, as many people think. The genomic variations make a person particularly susceptible to a specific type of disease when exposed to certain, often modifiable factors, such as your environment, diet and lifestyle. It isn’t the “fate” of any of your genes (even your SNPs) to express themselves as a disease. It is a combination of both your genes and modifiable environment which are responsible for various diseases which we encounter during our life time. And that’s where Genovations comes to help us. By taking a simple test, it can inform you and your physician of the specific SNPs you have, making it possible to plan a way “around” your potential risk. Since it takes your genes and their “environment” to trigger most disease, you can easily take your personalized “alternate route” to avoid the risks, and enjoy a healthier journey in life.
When conditions “run in families” they often have a genetic component. This test can show what specific genomic factors might pose a potential problem for You. If you learn you have a modifiable genetic variation, Your Family Members can also be tested to see whether they have it. The sooner it’s known, the sooner you and/or they can begin changing course toward a healthier future.
In primary care practice, Genovations™ will significantly improve healthcare interventions for patients in three major areas:
Predictive Assessment
Genetic testing provides the foundation for more effective, timely, and customized preventive strategies based on each patient’s unique genetic predisposition. This provides all health-conscious patients with the expanded insight they need to adopt more effective and focused risk-minimizing strategies to improve and protect their health.
Familial Associations
Patients with family history of a certain disease can learn if they have inherited a genetic predisposition for this condition and, if so, what they can specifically do to "break the pattern" and better prevent it.
Challenging Patients
Genetic testing provides insight into individual genetic variations that can help explain why certain patients may not be responding to clinical interventions that normally produce favorable outcomes

Since: Dec 05

Irvington, NJ

#11 Dec 2, 2008
Results provided by the laboratory test ChemoFX may improve survival among patients with ovarian cancer. These findings were published in the Journal of Clinical Oncology and presented at the 2008 annual meeting of the American Society of Clinical Oncology.

If ovarian cancer is detected prior to spread and completely removed with surgery, cure rates for the disease are high; however, the majority of ovarian cancers are detected once the cancerous cells have spread from the ovary. Once the cancer has spread, cure rates with standard therapies remain very low. In fact, ovarian cancer remains the most deadly gynecologic cancer in the United States.

Another factor that contributes significantly to ovarian cancer’s low survival is that it does not respond to standard therapies. A significant portion of these cancers do not respond to chemotherapy or will progress following therapy. Women whose cancer does not respond to treatment experience severe side effects of therapy without gaining anticancer benefits.

It is now recognized that individualized treatment options provide optimal outcomes for patients with cancer. Because each patient has varying personal and disease characteristics, they respond differently to therapy, including ability to tolerate certain treatments.

ChemoFX is a laboratory test that can help individualize therapy by measuring how a patient’s cancer cells respond to specific types, doses, and combinations of chemotherapy. The ChemoFX test uses cancer cells obtained from the patient through biopsy or surgery. The cells are collected and sent to a laboratory, where they are exposed to various chemotherapy agents; this most often includes treatment that the physician has prescribed. If the cancer cells are not responsive to a specific therapy, the patient may be spared ineffective treatment and its associated side effects. Ultimately, these patients may be treated with agents that kill the cancer cells.

Researchers recently conducted a study to determine if information obtained from ChemoFX may result in changes in survival among patients with ovarian cancer. The study included 206 women with Stages II-IV ovarian cancer who were tested with ChemoFX and received at least one course of chemotherapy between 1997 and 2003. In the following results, level of response to therapy was determined by ChemoFX:

Patients who were considered non-responsive to therapy that they had received had a median overall survival of 39.2 months.

Patients who were considered to have an intermediate response to therapy that they had received had a median overall survival of 62.5 months.

Patients who were considered to be responsive to therapy that they had received had a median overall survival of 80.4 months.

Through mathematical modeling, it was determined that the non-responsive and intermediate-responsive patients, as determined through ChemoFx, could significantly improve their survival if they had been treated with therapy that provided greater anticancer activity.

“People with cancer often require additional treatment after receiving the standard of care chemotherapy. ChemoFx Assay can provide valuable information that could spare the patient from unnecessary toxicity associated with a potentially ineffective treatment,” said Sean McDonald, CEO Precision Therapeutics.“The goal of ChemoFx is to empower patients and physicians with additional diagnostic information to help determine the most appropriate course of therapy for each individual patient.”

Patients with ovarian cancer (recently diagnosed and recurrent) should speak with their physician regarding their individual risks and benefits of utilizing ChemoFx as a helpful tool in choosing the most appropriate treatment.

Source: Herzog T, Fader A, Fensterer J, et al. A chemoresponseassay and survival in primary ovarian cancer. JournalofClinical Oncology. 2008; 26: May 20 supplement. Abstract #16522.
Marilyns Daughter

Munster, IN

#12 Oct 20, 2010
My mom was diagnosed with stage IIIC ovarian cancer 9-2-10-she had debulking surgery on 9-17-10 The surgeon had to do a temporary cholostomy.She started Chemo on 10-14-10-
I don't know where to turn for help-I know her odds aren't good, but her doctors are telling her that her cancer can be cured and of course she belives them-do I let her believe or tell her what I have read? She is a retired teacher, 74 years old and has a good outlook.
Fred Porter

Brentwood, TN

#13 Nov 18, 2010
Marilyns Daughter wrote:
My mom was diagnosed with stage IIIC ovarian cancer 9-2-10-she had debulking surgery on 9-17-10 The surgeon had to do a temporary cholostomy.She started Chemo on 10-14-10-
I don't know where to turn for help-I know her odds aren't good, but her doctors are telling her that her cancer can be cured and of course she belives them-do I let her believe or tell her what I have read? She is a retired teacher, 74 years old and has a good outlook.
Wy wife, 59 was also diagnosed with IIIc. She had an optimal debulking, 2 rounds of chemo and 4 rounds of IP chemo ending 1/11/10. Her hair is back and she has a great attitude. We're relying on our great oncologist and backing it up with diet/lifestyle changes by David Servan-Schreiber (book on Amazon.) I would suggest this book or similar readings. We live in a rough environment nowdays.
Ayesha Shaukat

Pakistan

#14 Nov 19, 2011
my mother is suffering from cancer at last stage.she is suffering from overy cancer. after 1st chemo she is suggested for 2nd chemo. after 1st chemo her hair is back but no progress in her health. plz pray for her.
LUIS THOMAS

Riyadh, Saudi Arabia

#15 Oct 31, 2012
my wife ,she undergo for utres removal on 08-10-2012. due to verian cancer,now started chemptherapy,PARAPLATIN and TAXOL are using for chemo (three week intervel and 6 course ).how effective this medicines and what will be the result?what can i do for the best?
Jolene

Santa Fe, NM

#16 Mar 21, 2013
Marilyns Daughter wrote:
My mom was diagnosed with stage IIIC ovarian cancer 9-2-10-she had debulking surgery on 9-17-10 The surgeon had to do a temporary cholostomy.She started Chemo on 10-14-10-
I don't know where to turn for help-I know her odds aren't good, but her doctors are telling her that her cancer can be cured and of course she belives them-do I let her believe or tell her what I have read? She is a retired teacher, 74 years old and has a good outlook.
I am 58 (almost 59) and was diagnosed in 2004 with stage 3c, now, after almost 9 years of on and off chemo, I am still here, stage 4, getting ready to start another round of chemo. Statistics are statistics, but can't always be applied. From the beginning, I decided I would not be part of those statistics! Encourage your Mom's positive outlook. I'm not sure there is a "cure", but there can certainly be life with cancer. Best wishes to you both.

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