I actually live in Montreal and went through surgery one month ago for a massive ovarian cyst on the left ovary. During the surgery, they removed everything (including appendix, uterus, fallopian tubes) except the right ovary and the ganglions or ovarian nodes. 48 hrs after surgery, they told me the cyst was borderline.
However, I met my gyn last Thursday (one month post-op) and she told me that: the kyst was carcinogenic (stage 1A, I dont know about the grade) and that a comitee of doctors and oncologist had required that I have at least three cycles of chemotherapy. As all others, I am devasted and so scared by this news.
The thing is that my gyn didn’t tell me much on the severity of the cancer and the reasons why chemo was needed. I’m actually meeting the oncologist in 2 weeks (so long for me before further informations). For those reasons, I was wondering:
1. Is the cyst still borderline with cancer cells or has it changed to a complete cancer cyst after further test?
2. Can stage 1A be treated without chemo?
3. Can the chemo be less agressive (eg., only carboplatin and only three cycles) if the stage is 1A?
Thank you for your help; I’m quite lost at the moment.😶
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coconut123
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Hi Coconut, so sorry that you're having to deal with this, we all remember the feelings of having our world turned upside down.
There is a great deal of kindness, experience and knowledge on this forum, so do keep posting as the feelings of isolation on top of the diagnosis and treatments can otherwise be really difficult.
Ovacome have, what I think, is a really good factsheet about what 'borderline' means here: ovacome.org.uk/wp-content/u...
Do you know the subtype as this and the grade together may be relevant to being prescribed chemotherapy? Ovarian cancer is a collection of different subtypes eg serous, clear cell, mucinous etc and these can have both different origins and some treatment approaches are more effective as a result.
There is a really good guide by Target Ovarian Cancer called, 'What Happens Next?' which you can download from their website here targetovariancancer.org.uk/...
You can also access support from Anna OvacomeSupport via this forum.
Hi, there. I'm a Montrealer too, though I live in Sheffield (UK) now and have done for many years.
I was diagnosed with stage 1A mucinous adenocarcinoma of my right ovary back in 2011. They didn't give mine a grade, beyond saying that it was definitely malignant rather than borderline. I did not have to have chemo and have been in remission ever since my operation.
The standard treatment for stage 1A here is that chemo is only deemed necessary if the cancer is grade 3 or clear cell, though it is sometimes given for grade 2 tumours if the team treating you feels it is necessary. Usually the chemo given is carboplatin on its own, though some consultants do prefer to add paclitaxel. I think 3 cycles is fairly usual for stage 1A, though up to 6 cycles might be given.
I'm guessing that on first look your tumour appeared to be borderline, but on further examination parts of it proved to be definitely malignant. You will have to ask your oncologist to be certain.
Meanwhile, bonne chance - the outlook for women with stage 1A tumours is very good. Do keep in touch and let us know how you get on.
There’s lots of evidence to suggest that 3 cycles are enough as that is when the work is done with cell renewal. Making a further 3 cycles a lot of side effects. Currently trials are stil taking place
Some hospitals don’t offer chemo for 1A,B or C
Carboplatin only is common in the U.K.
I would ask your gynae what they would choose for themselves and why
Well said Lily-Anne; I used to ask 'What would you advise your Mum, partner, wife, daughter?' X
Hi there. I am sorry you find yourself in this position and I remember how scary at can be when I was diagnosed with stage 1a grade 3 over twenty years ago. I had radical surgery and then 6 months Carboplatin only. You have already had some good advice from others on the forum. I don’t know your exact details but it might be useful to know what grade your cancer is because as others have said in this country (UK) chemo is usually given in stage 1 a when it is grade 3 or clear cell only. It might be worth asking the oncologist what a difference in your particular situation having chemotherapy would make.
You have a lot to think about and digest at this monumental time in your life. My OC was huge and stage 1 (not sure about grade; must find my histology notes). I was expecting chemo but none was offered and of course I was delighted with that and I am still here 30 years on. But, I know (albeit very unhappily and reluctantly) I would have accepted the chemo. I remember the overwhelming need to survive whatever the treatment. Of course I'm saying this having never experienced chemo. But all these years on looking back it would not have been a massive trade off for years of life and certainty.
Get all the wise counsel you can and keep us posted.
Sunfleury and the other ladies have covered this totally I can’t add anything else, I just wanted to welcome you to our lovely gang and wish you well going forward ❤️Xx Jane
Hi coconut123,
First of all everything is gone and that is good.
I had a full hysterectomy 7 weeks ago because uterine cancer grade 1a was found while I was waiting for my hysterectomy to be done, which was planned originally for having a large 13cm ovarian cyst on my right ovary and one on my left and fibroids in my uterus.
When after surgery they checked everything in the pathology, the peritoneal wash fluid, organs etc. They informed me too,that the ovarian cysts/ovaries had begun to show signs of cancer, so borderline.
They then sent the pathology to the oncology team experts to again check who confirmed this for me,was still the case, borderline.
So in answer to query number 1. yes sometimes when checked again the prognosis may change.
But what is good is that things are double checked. You get a more definitive diagnosis and the treatment can then be targeted more efficiently.
I had a CT scan after my ovarian borderline diagnosis to ensure no other signs of cancer in other organs like the appendix as this can sometimes be an organ that indicates as a primary site of cancer or secondary site. Your appendix has been removed so that's good.
Ovacome has some really useful information on stage 1a ovarian cancer. Your organs have been removed so this is an early stage cancer that has been removed from you and is gone, and the chemotherapy will be to ensure if any more cells are in there, they will be nuked and stopped from becoming anything else.
I know you will be worried and it is good to ask as many questions as possible, just like you are doing.
It sounds more like they are trying to ensure nothing has the chance to present its self by a preventative course of chemotherapy.
They are nuking any little suckers away and helping rejuvenate you inner pelvic area.
Send your questions before you see the oncologist as they will be able to go through them and have answers ready and take a friend to enable them to note answers down, as like all appointments things can get lost in translation.
Just keep in mind everything bad is gone and the chemo is making sure of that.
xx keep positive and keep it real, always ask questions and tell them how your feel, this is your body and life and you are important in this world, always. x
Could it be that the 'only borderline' assessment was based on the initial quick tissue test during/after surgery and the more thorough pathological analysis found a couple of additional invasive / malignant tumour cells?
That's what happened to me (mostly serous borderline plus some few low grade serous invasive/carcinogenic cells diagnosed.. but stage 3a which is a different ball game from your 1a).
I would suggest you ask - as others suggested - what grade you've got.. and maybe get a second opinion e.g. from the Royal Marsden. And then see which recommendation you want to follow, if they diverge. That would also mean both option are viable and there is no wrong choice.
In any case, don't despair... you will make it through this!
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