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I am so sorry to hear what you've been through and your diagnosis. It is an extremely scary time and all too familiar that you had to be so proactive to get the right treatment. But well done you for not wasting time and going and getting that surgery abroad. You did the right thing. It's terrible that we have to resort to such drastic measures, but that's a rant for another day.
I am nervous about replying to you because I've never replied to anyone before, but I felt that I just had to share my experience with you, in the hope that it may help. I am also stage 2 clear cell ovarian cancer, scared but very optimistic too. It sounds strange to say this, but we caught it early and have a chance of a cure. I was diagnosed on June 1st 2012, age 35, after a laparoscopic ovarian cystectomy for what had been assumed was a benign ovarian cyst. My hospital told me that it was a relatively rare diagnosis, so not much research into most effective treatments etc. They see about 1 case every ten years, so not very experienced with it either. I was offered a choice of fertility sparing surgery (I had yet to have children), or a full hysterectomy. Because of the choice, I felt like I really had to understand what I was dealing with, so did a lot of research. I found an article that had been published in Canada in May 2012, with results that show that surgery followed by 3 cycles of the chemo drugs carboplatin and paclitaxel and then 6.5 weeks of whole abdominal radiotherapy showed 20% overall survival benefit over 6 cycles of carboplatin and paclitaxel alone. It was difficult reading all the medical articles and I don't want to scare you, but I would urge you to discuss this study with your oncologist at your appointment. I went on to receive a full hysterectomy, 3 chemo cycles and whole abdominal radiotherapy. My treatment finished 11 months ago and I have had no significant problems since. I feel lucky that the study was published just the month before I was diagnosed because personally I feel that the radiotherapy has given me a better prognosis. I believe that I was the first person in the UK to receive this type of treatment in the knowledge that it was likely to be more effective than chemotherapy alone. I hope that this info is now widely known by all the medical oncologists throughout the UK, but it wasn't a year ago.
Below is the link to the study. We can only access the abstract, but your oncologist should be able to access the whole study. Please don't read it if you don't want to go into the realms of prognosis statistics, because they can always be scary. But do mention it to your oncologist so that you can discuss the optimum treatment for you.
Feel free to ask me any questions you want. Hugs, Sam xxx
hello sam my name is sue i am at victoria hospital mcmillian in blackpool when i was sent to my gynacologist i was told i had a cyst on each ovary and kept going back as you do i felt they were getting bigger because they cause me pain but i had another ct scan and they said the right size would be 5 cmtres and then they would do keyhole surgery as it happens they went to 5cntres and the dr mr steel said he would do keyhole surgery but we made arrangements to go to hospital and when we got there mr steel wasnt in so they sent us back home my stomache was ballooning up until i couldnt even cross my legs this was 2009 and in 2010 they took me in for emergency drainage and straight after that i had blood transfusion and bulk hysterectomy 3 days after that i had chemo for six mounths and ended xmas 2010 since then i have been going back and fourth to hospital i would love to meet poeple who have had same as me do you know how i dot hat i feel so isolated on my own as my husband and son dont like talking about it and i need some poeple that do i hope you are feeling ok yourself thankyou love sue if you would write back to me please do my email is firstname.lastname@example.org lots of hugs to you xxxxxxxxx
Hi,Sue. I have had ovarian C I had chemo then a full hysterectomy then more chemo. 7 tumors were removed, one as big as a grapefruit. The C has returned 3 times since. Twice on the stomach lining and once in a lymph node under my arm, which was removed - the lymph node, not my arm lol I am now on my 3rd round of chemo since 2011. I have had a terrible day today. Very down, cried a lot. My family are fantastic but I don't like to tell them too much of how I feel because I don't want to upset them more than they already are. If you would like to talk to me about how you feel that would be great.. My email address is email@example.com. Look forward to hearing from you. Sometimes you need to talk to someone who is in the same boat, so to speak. Take care. xx
Yes, I'm still here and fingers crossed am OK. Sorry that you've had to find yourself in this situation, but am glad to hear that you have an appointment to discuss radiotherapy. The study my treatment was based on showed a 20% improvement in 5 year disease-free survival for stage 2 OCCC patients following chemo then whole abdominal radiotherapy, as opposed to chemo alone - so pretty significant. The way I understand it is that there needs to be no evidence of disease and the cytology negative for the whole abdominal radiotherapy to stand a chance and the goal is to try to get a long period disease free following front-line treatment. If there is evidence of disease then whole abdominal radiotherapy won't be appropriate as the risks outweigh the benefits (so no good for a recurrence scenario). As for hitting a particular spot with radiotherapy upon local recurrence then that's a question you can ask at your appointment, but it was pretty much spelt out to me that it was about doing everything we could up-front to try to prevent a recurrence in the first place and even (dare I say it) offer a chance of a cure.
Another thing that was discussed at my appointments was just pelvic radiotherapy versus whole abdominal radiotherapy, but again the studies I read were firm in stating that pelvic radiotherapy may miss a significant portion of the fluid that is swooshing around in the whole abdominal cavity, so the potential to miss blasting some cells was increased. One thing I'd question is the length of your radiotherapy at 5 weeks. Mine was 6.5 weeks, with shielding of kidneys after a certain point.
With regards to radiotherapy side-effects - yes the potential list is quite scary, but so far I have not suffered any long-term problems. My bladder was fine during treatment, my bowels took a battering (diarrhea, but controllable throughout and helped with immodium) - it was just very sore, but it did settle down eventually. Otherwise personally I found the chemo harder than the radiotherapy. It took about 6 months to fully recover from all treatment.
I'm two years out now and truly believe that the radiotherapy has been key for me so far. The first thing my oncologist told me on diagnosis was about the concerns of the effectiveness of chemo on clear cell so I guess I had that in my head all along. But there really aren't many of us stage 2 clear cell ladies and everyone is unique.
Anyway - I hope that helps a bit. Feel free to get back to me with any more questions - let me know how you get on. Best of luck,
Hi Randoma, how did the chat with your radiologist go? I'm going for my 5th (out of 6) cycle next Monday and really hoping that it won't be worse than the 4th. I began to have a bit of neuropathy this week but it wasn't too bad. My biggest problems had been lost of appetite, fatigue and drop in neutrophil, which means I might need a booster next week. I was told as much as possible not to reduce dosage and stick to 6 cycles, but my oncologist tends to be more aggressive. I haven't heard about evidence around 6 cycles not better than 4 but I guess it depends on individual circumstances and how bad the side effects are? Hope the neuropahty goes away and you get some clear answers from your medical team!
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