New diagnosis low grade serous for my sister

[Luvmysister]

My sister was recently diagnosed and had surgery two weeks ago. Surgeon was pleased and said she scored a 0 which I am assuming means NED? She got the official pathology report and it was all low grade but two lymph nodes were affected near her bowel where they did resect. Clean margins on bowel! She also had the chemo wash during surgery. What can she expect going forward? Chemo? inhibitor? I've read a few posts that are very positive for the inhibitor! It's hard not to worry but I feel like her news is something we can work through together?! Any advice is appreciated.

Concerned sister

[thomas62]

Hi Luvmysister,

Welcome to the club people would not choose to join!! Low grade is one of the rarer types of Ovarian Cancer. Very good news if, as you say, your sister is NED. Moving forward her consultant may choose to put her on a hormone inhibitor but her cells would need to be tested first to find out whether they are oestrogen positive or negative. Having had a chemo wash during surgery they may or may not decide on chemo intravenously. However, low graders do not respond as well to chemo as those ladies who are high grade!! Alternatively, as she appears to be NED they may recommend "watch and wait". Please keep us uptodate. Best wishes to your sister and yourself. xx

[Luvmysister in reply to thomas62]

Thank you for the reply. I've been reading a lot on here. I hope she is a candidate for the inhibitors!

[thomas62 in reply to Luvmysister]

Hi again, I am 5 years on from radical hysterectomy - stage 3b. I was on Letrozole for abt. 15/18 months until it stopped working and later I was put on Aromasin, another hormone inhibitor. I have been on this one since abt. March this year and, to date, remain NED with a CA125 of 14.

[Maus123]

Hi Luvmysister. R0 would mean zero residual disease after surgery, which is a good thing.

I can only agree with Thomas62's response. My own treatment of stage 3a low grade serous OC included surgery (still one of the better treatment options) and now Letrozole (aromatase inhibitor; hormone blocker) + Avastin, here in Germany.

Especially if her tumour is found to be estrogen receptive, her medical team might put her on Letrozole or a some similar drug too (see MD Anderson research in Dallas TX).

But the final medical recommendation for next steps depends on her individual situation, and is hard for us (mostly non-medicals) to predict. They could recommend chemo too, possibly in combination with Avastin (even if low grade OC is said to be somewhat chemo resistant, it is still often part of the standard treatment path and it might work for her, to delay or prevent a recurrence), or just watch & wait. It also depends on what is allowed/available and what's covered by insurance in your country. You could always remind her that she could obtain a second opinion, if the initial recommendation doesn't sit right with her.

All the best. Maus

[Luvmysister in reply to Maus123]

Thank you. She goes to the doctor on monday.