Ovarian cancer returned - only options are continue on Naraparib or have final chemo round?

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I was diagnosed with ovarian cancer stage 3 in October 2022. I have had 3 chemo sessions a full hysterectomy and then 3 further chemo sessions. I was then advised that I was cancer free in May 2023 but put on a maintenance drug Naraparib

However the cancer returned and was identified in a scan in December 2023. It  was in two of my lymph nodes in my pelvic area . I have been monitored since and in a recent meeting with my consultant they advised there is also two small cancerous  nodules in my lungs. i  am not suffering with any symptoms at the moment so the plan is that I will continue with the  Naraparib.

i understand the reason this is recommended is that once I have further chemo I cannot return to a maintenance drug or have further chemo after that it would just be scans from then on.

i am under no illusion that the cancer can be cured (unless we have a miracle breakthrough in medical science) but i was surprised there was no other treatments or further chemo . Just looking for another opinion on my options.

 
Val R

  • Hello Val R

    Thanks for getting in touch. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

    Welcome to the online community. I see you have joined the ovarian cancer forum and hope that you find it a warm and supportive community.

    I was sorry to learn that your ovarian cancer has returned despite the treatment you have undergone. I can imagine that has been a difficult thing to deal with and if you feel at any time that you would like to speak to our counsellors about the impact of this for you, you are most welcome to self-refer to our free emotional support service.

    You explained that your oncologist has recommended remaining on the Niraparib, despite the discovery of two new cancerous nodules in your lungs and you wondered if there was another treatment option.

    As a charity, we don’t have access to medical notes, so it is hard to judge why certain treatment decisions have been made without the full ‘evidence’ available, but I will link some information about treatments for ovarian cancers that have come back and hope they will help inform you enough to have the conversation with your gynaecology nurse specialist or your consultant when you next meet.

    Treatment options depend on what treatment you have already had and when you last had treatment.

    Ovarian cancers that return are labelled as either platinum-sensitive or platinum- resistant, depending on the time between completing initial chemotherapy (usually either carboplatin or cisplatin) and the cancer returning.

    It is possible that your cancer returned after more than six-months, which would indicate a platinum-sensitive ovarian cancer.

    That would mean you may be offered further platinum-based chemotherapy in the future, and this may be used in combination with another chemotherapy agent.

    If an ovarian cancer is platinum-resistant, it is unlikely that a platinum-based chemotherapy will be used again, and other chemotherapy drugs are offered.

    It is possible that while you are symptom-free, your team wishes to hold off further chemotherapy until such time that changes.

    I couldn’t find any other evidence-based treatments that are NICE approved that aligns with the medical information you have shared.

    However you might consider asking your team if there are any clinical trials running in your cancer centre that you are eligible to participate in. Sometimes a trial can access treatments not yet available on the NHS.

    You might wish to speak to the nurse team at Cancer Research UK about currently running studies (nurse helpline: 0808 088 4040) or contact the Target Ovarian Cancer team about their research studies.

    I am not sure how helpful my response has been to you but hope that what I have shared might be of some value.

    Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

    The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

     

    Best wishes, Helen

    Cancer Information Nurse Specialist 

     

    Ref HM/ AW