My Four month check up with My Oncologist

What a week! 2 days gone and a hospital appointment on each day.
Today was my 4 monthly check up with Dr Bashir my Oncologist.
This was my first visit where I actually knew my
CA125 blood results before my internal examination
I also went armed with my notebook and pen and had a list of questions for him, poor man.
I did actually ask my previous Oncologist, who retired a few months ago, these questions but he mumbled and I really couldn’t understand him.

Anyway, my CA125 before surgery was 381 and after Chemotherapy it was 5.
It now fluctuates between 5 & 7 and today it was 7, he’s really pleased with my progress, as am I.
Apparantly I was a stage 1C Clear Cell Ovarian Cancer that was caught early, I’ll add a note at the end of this blog that says all about it. All I’ll say is its uncommon!! Trust me to be different hahaha.. What with having Ovarian Cancer then after my hysterectomy the Consultant discovering I also had Cervical Cancer, I just have to be different!!

I also asked Dr Bashir what size my tumour was and he told me it was 12cm x 12cm and 13cm deep.

Oh and he doesn't want to see me now for 6 months.. woop woop.

Here's all about my "Special Cancer"

Clear Cell Carcinoma of the Ovary

Clear cell cancer of the ovary is an uncommon
variety of epithelial ovarian cancer. It accounts
for about 1 in 25 patients (3-5%) in the Western
World and yet in the Far East, in Japan, Korea
and China, it may account for up to 20% (1 in 5
of patients with ovarian cancer). It is likely
that the cause of clear cell cancer is different
from the common variety. There are different
blood tests, which may help to distinguish it
from other types of ovarian cancer.

The prognosis for women with clear cell is
greatly influenced by the stage of the disease.
Whilst initial treatment will be the same as for
the common form, i.e. total abdominal
hysterectomy, bilateral salpingo-oophorectomy
(removal of the ovaries and uterus and tissue
called the omentum), postoperative treatment
may vary. In addition to the removal of the
pelvic organs, fluid will also be sampled from
the tummy cavity. In some situations removal of
the lymph glands in the pelvis and back of the
tummy may also be carried out. Following this
the pathologist will examine the tissues in detail
to try and decide how advanced the cancer is.
Many tumours are, in fact, confined to the
ovary and thus carry a much better prognosis.
However, in some cases there will be spread to
other organs including the womb, the lymph
glands and the omentum.

It is usual to recommend some form of back-up
treatment following hysterectomy and this
would normally involve some kind of
chemotherapy or drug therapy. The standard
chemotherapy for ovarian cancer is to use two
drugs called Carboplatin and Paclitaxel.
However, there is some experience from Japan
and the Far East that suggests that other drugs
may be as or more effective in clear cell
cancers. A number of specialists in the United
Kingdom are currently participating in a clinical
trial which is being carried out internationally in
which the standard treatment of Carboplatin
and Paclitaxel is being compared with Cisplatin
and Irinotecan. You may be invited to take part
in this trial and your specialist will give you
detailed information about this. All clinical
trials are voluntary and your participation is
therefore at your choice.

If you do not participate in the trial it is likely
that you will be recommended to receive the
two drugs Carboplatin and Paclitaxel, which will
be given as an intravenous infusion (via a drip)
once every three weeks for up to six
treatments.
The usual side effects will include tiredness,
nausea (feeling sick), hair-loss and tingling in
the fingertips and toes. Occasionally muscle
and joint pains may be noticed. You will
normally take three to six months to recover
from this.

Following your treatment you will need to be
carefully followed up by your specialist either in
the Gynaecology Clinic or in the Oncology
Clinic or sometimes in a joint clinic where both
your gynaecologist and your oncologist will be
present. You will normally be seen every three
months during the first year, four-monthly
during the second year and, if all is going well,
six-monthly thereafter. Your blood may be
checked for a chemical protein called CA-125
and you may be asked to have scans
periodically.

At the end of five years, if you are feeling well
and have no problems, you are likely to be
discharged from follow-up.
Written by Dr Nicholas Reed, Beatson Oncology Centre,
Gartnavel General Hospital, Glasgow, February 2008
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