I thought I was doing great back in 2008 . And I was . Until I had my 6month CT scan. My CA-125 was 16 up from 11. A number which is well within the range of a normal result. But the scan showed cancer on my spleen and liver. I had recurred two and a half years after finishing my initial treatment . Eighty percent of women diagnosed with late stage ovarian cancer recur.( Source: http://www.cancer.gov/cancertopics/pdq/treatment/ovarianepithelial/HealthProfessional/page6)
When a recurrence occurs within 6 months of finishing treatment the tumor is said to be refractory and the patient is said to be platinum resistant . When a women recurs after 6 months she is said to be platinum sensitive. The term platinum is used because the standard treatment for the initial diagnosis of ovarian cancer usually involves the use of carboplatin or cisplatin which are platinum chemotherapy drugs. If you are platinum sensitive you will be able to use those platinum drugs again. (Source : http://ovariancancer.jhmi.edu/treatment.cfm)
I already discussed the standard treatment for a majority of late stage ovarian cancers as surgery and then chemotherapy. There are a number of clinical trials looking at chemotherapy then surgery. This allows the oncologist to shrink the tumors before the surgery. The treatment you may be offered when you recur depends on if you are platinum resistant or sensitive you, the location of the disease, as well as the number and size of the lesions.
Options for women who have recurred are:
Biologic / immunotherapy
In my case, I was considered platinum sensitive and I had many options open to me. I could have surgery then chemo( carbo/taxol) , chemo than surgery, or a clinical trial . This time I chose to have the surgery and then chemo. I had my liver resectioned and spleen removed in November of 2008 and finished chemotherapy April 2009. I have been disease free since then. This plan worked for me but another woman in consultation with her doctor might have chosen a different path for treatment.
There are excellent online resources ( NCI, OCNA for women who have recurred including these brochures:
Ovarian Cancer Resource Guide for Women with Recurrent Disease- NOCC
The Patient Guide to Living with Ovarian Cancer - The Cancer Support Community ( formerly known as The Wellness Community)
Every Day is a Blessing!