What does stable actually mean?

[Hanuk1987]

Hi all, first post here.

My mom was diagnosed in the summer with 3b initially and then 3c OC. She had some dissemation on the peritoneum.

We were lead to believe that all of her cancer from the ovary was removed during surgery (hysterectomy) but due to the small size and wide spread of the dissenation on the peritoneum this could not be removed.

Mom has undergone 8 cycles of chemotherapy and is having Avastin every three weeks.

She's very up and down, which is very upsetting to us (selfish on our behalf I know).

Mom had her last consultant appointment last week where she was told her cancer was 'stable' and a partial response had occurred. She was told she made require more chemo in the future and she's on a 'watch and wait'. Her CA125 has reduced to 16 but wasn't particularly high in the first place (150 on initial appointment and we were told this was a good sign as it can be in the thousands).

I have a question, mom has been told she has a 'splattering' on the bowel lining, is this the peritoneum or separate tissue? There is no further spread.

Mom has been told no further ops will go ahead as it might not be advantageous for her although we keep reading about others having bowel resections and ops to remove cancer from the peritoneum. Moms oncologist is very very down beat and she always leaves the appointments very low. We had expected someone who might be positive and try to keep her spirits up but she is very very 'negative' in her tone and mom can't ask questions.

Advice would be appreciated x

[ssjmichael]

Hi Hanuk, and welcome. Stable usually means the disease is still there but hasn't progressed any further. That has to be assessed via a CT or PET scan however, not jus off of numbers or even symptoms.

I'm a little surprised that they seem to be holding off on giving her more chemo after just 8 cycles (unless that was a typo?). The typical regimen is 18 cycles. Based off the CA-125, it does sound like your mom has been responding well to the treatment.

My first impressions is that her doctor doesn't seem like the best person to handle her care. Is it possible to seek out another gynecologist? Preferably a gynecological oncologist. I say this because I feel your mom could benefit from more chemo, and she deserves someone with better bedside manner. I obviously don't know the whole situation, just basing this off my gut reaction of what you've written.

Some doctors are just like that though, so sometimes you have to speak up and express how you're feeling, and your intentions.

Edit: I made an error above. Typical chemo is usually 6 cycles every 3 weeks, or 18 weekly ones, so the 18 there threw me off. 8 cycles of chemo, assuming they were every 3 weeks is perfectly normal. Sorry for the misinformation

[Hanuk1987 in reply to ssjmichael]

Thanks for your reply.

Mom had a scan to determine what was going on and results of this were discussed at app. They did say that the small bits they can see on the scan could be scarring but without opening her up again they couldn't be sure of this and they don't want to do that.

Mom is going to ask for a referral to another hospital after reading excellent results on here for a second opinion. I have asked her to try and ask for another consultant as current one is very negative in her manner but she doesn't want to do this currently.

Thanks for your advice, I will speak to mom about cycles of chemo.

[Hidden in reply to Hanuk1987]

Reading down through the posts, I think your Mum is a wise lady and should go for a second opinion, None of us need an oncologist who is always downbeat and gloomy, we deserve better dont we?

[Empty_Nester]

So sorry for you mother and for your family. Your mother must be and you the care giver must mesh with your doctor. If you are feeling slighted at all in the care your family is receiving you must react. Broach it with your doctor 1st to give them a chance to redeem themselves. If there is no joy in the response you from them look for another. On the other side of the coin the doctor could be very good at thier job but bad bedside manner.

Step back, evaluate and if need be move on. Cancer waits for no one. It's a fight and your families corner must contain the best team available.

My wife was on the table an extra 4 hrs due to the doctor picking off the splatter from her bowel. Good luck and many prayers for you and your family.

[Hidden]

Any chance of a better discussion with the CNS?

I agree with the idea of asking for a second opinion.

Generally in the UK women seem to get 6- 8 cycles chemo, so nothing unusual there, I think.

Good luck!

[Hanuk1987 in reply to Hidden]

I'm glad you said that because everything we've heard so far is the same!

[ScardyCat40]

6 cycles is typical if you are having taxol every 3 weeks and 18 if you are having taxol every week.

I have always had some disease left over after treatment and it has often remained stable for months ie there has been no sign of growth or change on a CT scan and no change in my CA125.

The peritoneum is the thin lining of the abdomen and I have always assumed that if the cancer is small and widespread ie smattering, spotting, stranding then this would be impossible to remove and there could be a risk of causing further spread. With regards to the bowel it means the cancer is sitting on the surface of the bowel and as long as it does not penetrate the bowel. Every operation has its own risk

[ssjmichael in reply to ScardyCat40]

You're completely right, 6 cycles is the norm. I think I kept thinking 18 because that's how many weeks it is usually, regardless of whether you get weekly treatment or every 3 weeks.

Sometimes they extend it a little longer too, so the 8 cycles mentioned sounds fine

[Wiganw]

I would agree with the other comments, your mum seems to have had the correct number of cycles. I myself did go for a second opinion when I was unhappy with my oncologists attitude and some of my treatment, This was the best thing I did and wished Id done it sooner. I moved my treatment to the new oncologist and now have confidence in my treatment and am much more positive.

[Hanuk1987 in reply to Wiganw]

Thank you for your reply, I'm so pleased this has worked for you. Mom is going to go ahead with the second opinion x