Sent home to basically die in 08/09 with inoperable endometrial tumors and told chemo would only have 1/3 chance of even possibly reducing. CA 125 level was 305. I did only 3 chemo treatments of Carbo/Taxol and then re-did a CT. CA125 level is now 56.
New CT shows "markedly decreased" tumor mass and ascites. On this, the Dr. declared me in remission. However, due to mix-up, he didn't see one pg of report which says "Mediastinal windows demonstrate multiple lymph nodes in the superior mediastinum, supraclavicular area, aorticopulmonary window and precarinal space." Also, "some enlargement of the hilum" and "evidence of some axillary adenopathy" and "these findings are suspicious for nodal metastases."
Are there any thoughts as to what this CT language means? Can you comment on general practice of next steps in this kind of situation? It's been preliminarily suggested that I maybe do a round of 4 more chemo treatments, which seems excessive to me, but I don't know. Your thoughts?
You seem to be suffering from the recurrent endometrial cancer which has resurfaced again in August 2009 now as the initial surgical treatment in the form of hysterectomy in 2007 probably was found to be enough for you and no adjuvant therapy in the form of radiation,chemotherapy or hormone therapy was advocated at that time.
At the moment, your CT findings are suggestive of advanced disease with spread even to thorax with multinodal metastasis.You probably fall in the Stage IV of disease where usually only palliative therapy is recommended and besides that the prognosis is not so good as reflected by the five year survival rate of only 9%.Chemotherapy has some role for the disease that has spread beyond uterine cavity but the decision regarding the further chemo cycles can only be taken by your gynec oncologist depending upon the initial response to chemo,grade of tumor and the side effects of chemotherapy.Chemotherapy is usually given in six 21-day cycles (the treatment is given once every 21 days for a total of 6 treatments). However, the optimal number of cycles is unknown. Side effects are significant with this treatment.The chemotherapy regimen of carboplatin and paclitaxel used in your case may have fewer side effects than doxorubicin, cisplatin, and paclitaxel.
Another option is the hormonal therapy with progestational agents which you can discuss with your doctor.The response to hormone therapy depends on the expression of progesterone receptors on the tumor cells.The role of radiation therapy is even less as the disease has already spread beyond uterine cavity to the thoracic cavity in the form of multinodal metastasis.Brachytherapy may have been useful in disease limited to uterine cavity only.
You can discuss all the above treatment options with your gynec oncologist depending upon the effectiveness and side effect profile of each and he may suggest the best in your case taking all the factors in consideration.
Hope this helps.Take care.
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