1. < Gynecologic Cancers

Chemo or Not after oophorectomy

Posted by jixs @jixs, Dec 29, 2023

I had an oophorectomy.. including removal of fallopian tubes. I have PALB mutation. They found lesions on my fallopian tubes. My doctor suggested chemo treatment or regular ultrasound with blood work... CA125.

Anyone in this position? Going in for consult with doc nxt wk... What are some good questions to ask as I consider what to do?

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val64 | @val64 | Dec 30, 2023

I haven't been in this exact position, but I have learned something through my experiences with endometrial cancer that may be relevant.

As far as I know, ovarian and endometrial cancers can spread in three main ways: through the bloodstream, through the lymphatic system, and directly into the inside of the abdomen (aka the peritoneum) either straight from the ovaries or via the fallopian tubes. Apparently intravenous chemotherapy drugs have access to cancer cells that have spread via the blood or lymphatic system, but mostly do not reach cancer cells that have spread into the peritoneum. I had 6 rounds of chemotherapy late last year, but recently learned that I have numerous tumors in my peritoneum. Sometimes women with ovarian cancer are treated with intraperitoneal chemotherapy during their surgery (look up "HIPEC") because if this issue.

Maybe you should ask your doctor about the likelihood of peritoneal spread in your case and whether IV chemo would be likely to help.

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1 reply
jixs | @jixs | Jan 5 6:19am
In reply to @val64 "I haven't been in this exact position, but I have learned something through my experiences with..." + (show)
@val64

I haven't been in this exact position, but I have learned something through my experiences with endometrial cancer that may be relevant.

As far as I know, ovarian and endometrial cancers can spread in three main ways: through the bloodstream, through the lymphatic system, and directly into the inside of the abdomen (aka the peritoneum) either straight from the ovaries or via the fallopian tubes. Apparently intravenous chemotherapy drugs have access to cancer cells that have spread via the blood or lymphatic system, but mostly do not reach cancer cells that have spread into the peritoneum. I had 6 rounds of chemotherapy late last year, but recently learned that I have numerous tumors in my peritoneum. Sometimes women with ovarian cancer are treated with intraperitoneal chemotherapy during their surgery (look up "HIPEC") because if this issue.

Maybe you should ask your doctor about the likelihood of peritoneal spread in your case and whether IV chemo would be likely to help.

Jump to this post

Thank you so much for your reply.

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Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jan 5 8:19am

@jixs Considering the PALB mutation I wonder if you might ask your doctor about meeting with a genetic counselor. Perhaps you've already done this given your past experiences that you shared in other posts here. I'd like to suggest that you write your questions down and have them ready to ask. This will make good use of the appointment time and you will feel prepared. Leave space below your questions so that you can take notes. Will you be accompanied by your spouse, partner, or a loved one? This is an appointment that shouldn't go to on your own. I know in my case I could barely "hear" what the doctor was telling me and I needed my partner present to listen and take notes.

I have a cancer surveillance appointment coming up next week (endometrial cancer diagnosed in 2019; recurrence in 2021). Like you, I live my life between these appointments and try not dwell on the possibility of another recurrence or a new cancer. As I come closer in time to the next appointment I can feel the anxiety ramping up again.

When is your next appointment?

REPLY
2 replies
jixs | @jixs | Jan 7 10:53pm
In reply to @naturegirl5 "@jixs Considering the PALB mutation I wonder if you might ask your doctor about meeting with..." + (show)
@naturegirl5

@jixs Considering the PALB mutation I wonder if you might ask your doctor about meeting with a genetic counselor. Perhaps you've already done this given your past experiences that you shared in other posts here. I'd like to suggest that you write your questions down and have them ready to ask. This will make good use of the appointment time and you will feel prepared. Leave space below your questions so that you can take notes. Will you be accompanied by your spouse, partner, or a loved one? This is an appointment that shouldn't go to on your own. I know in my case I could barely "hear" what the doctor was telling me and I needed my partner present to listen and take notes.

I have a cancer surveillance appointment coming up next week (endometrial cancer diagnosed in 2019; recurrence in 2021). Like you, I live my life between these appointments and try not dwell on the possibility of another recurrence or a new cancer. As I come closer in time to the next appointment I can feel the anxiety ramping up again.

When is your next appointment?

Jump to this post

@naturegirl5 Thank you for responding. My appointment is in one week.

REPLY
1 reply
angierivas1 | @angierivas1 | Jan 8 5:25pm
In reply to @naturegirl5 "@jixs Considering the PALB mutation I wonder if you might ask your doctor about meeting with..." + (show)
@naturegirl5

@jixs Considering the PALB mutation I wonder if you might ask your doctor about meeting with a genetic counselor. Perhaps you've already done this given your past experiences that you shared in other posts here. I'd like to suggest that you write your questions down and have them ready to ask. This will make good use of the appointment time and you will feel prepared. Leave space below your questions so that you can take notes. Will you be accompanied by your spouse, partner, or a loved one? This is an appointment that shouldn't go to on your own. I know in my case I could barely "hear" what the doctor was telling me and I needed my partner present to listen and take notes.

I have a cancer surveillance appointment coming up next week (endometrial cancer diagnosed in 2019; recurrence in 2021). Like you, I live my life between these appointments and try not dwell on the possibility of another recurrence or a new cancer. As I come closer in time to the next appointment I can feel the anxiety ramping up again.

When is your next appointment?

Jump to this post

Keeping you in my prayers for a great surveillance appointment Helen. 🙏🏼

REPLY
2 replies
Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jan 8 7:45pm
In reply to @angierivas1 "Keeping you in my prayers for a great surveillance appointment Helen. 🙏🏼" + (show)
@angierivas1

Keeping you in my prayers for a great surveillance appointment Helen. 🙏🏼

Jump to this post

@angierivas1 Thank you so much. Your prayers are so appreciated.

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Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jan 8 7:46pm
In reply to @jixs "@naturegirl5 Thank you for responding. My appointment is in one week." + (show)
@jixs

@naturegirl5 Thank you for responding. My appointment is in one week.

Jump to this post

@jixs Thanks for letting me know. Will you please come back and let me know what happens at your appointment?

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Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jan 11 8:20am
In reply to @angierivas1 "Keeping you in my prayers for a great surveillance appointment Helen. 🙏🏼" + (show)
@angierivas1

Keeping you in my prayers for a great surveillance appointment Helen. 🙏🏼

Jump to this post

@angierivas1 Your prayers went to the source for all love and healing. My appointments showed nothing new and no evidence of disease. I go back again in 3 months for the next round of cancer surveillance appointments. I feel blessed to be monitored so closely.

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