How soon is too soon for chemo after surgery? - My Ovacome

My Ovacome

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How soon is too soon for chemo after surgery?

FtMwithOC profile image

Hi,

This is my first time posting here. I'm 37, trans (ftm), though with all the "lady parts" of my reproductive system until this winter.

I was diagnosed with stage 2a ovarian cancer (grade 2 endometrioid type) after an emergency oophorectomy in November and a successful abdominal hysto (etc.) 5 weeks ago (early January). At my follow-up appointment last week they told me I'd be starting chemo this coming Wednesday.

The thing is, two surgeries in a row is a lot. I'm still dealing with lots of discomfort, swelling and minor but chronic pain from the second operation. I'm worried they're starting me on chemo too soon and that it will cause the surgery pain to last for months. Has anyone else started chemo while in the midst of surgery recovery? Has anyone successfully negotiated for a later start date on chemo?

Any tips and insights appreciated!

19 Replies

I had an op for a stoma creation due to complications after my 2nd chemo. My chemo recommenced 3 weeks after my discharge. I had 2 more chemo then my tah and bowel resection 3 weeks after my 4th chemo. I started chemo 4 weeks after the 2nd op. They wanted to restart at 3 weeks but I wasn’t strong enough so delayed it a week. I understood it was better to start sooner to mop up any rogue cells. It was tough but I was in remission at the end so it was worth it for me. Hope this helps x

Hi and welcome

Sorry you are not feeling well.

I was quite ill after surgery and my chemo was delayed for a few months. However this was five years ago and protocols may well have changed plus each individual’s Ovarian Cancer is different.

I would contact my CNS if you have one ( or the Ovacome Helpline) to discuss the feasibility postponing your chemo until you feel better.

In my experience to manage chemo the best you can you need to be in the right place both physically and mentally when you start it.

Best wishes

Juliax

I had full debulking surgery 3rd July 2014 and started chemo early August 2014. I’m not sure what your time frame is but I believe the earlier the chemo starts the earlier any potential stray cells can be zapped. Obviously it’s important you are physically able to attend for chemo and also given that chemo reduces our immunity any possible residual infections or inflammation from surgery should be dealt with.

I hope your recovery is as speedy as possible. ❤️Xx Jane

If you genuinely don’t feel able to tackle chemo yet then please speak to one of the team and ask if they can squeeze you in for a chat and they should also be able to answer your questions.

Maybe they want to start so soon because the removal was in two separate ops several weeks apart. I had my op on 15 April and started chemo on 10 July and I was at the very border of the latest timeframe they want to start treatment in, but my pathology was very slow coming back hence the delay.

Good luck with the treatment and do check in if you’re struggling, there’s bound to be at least one of us who has experienced something the same or similar xx

I resumed three more sessions of chemo four weeks after my surgery. Didn’t feel at all up for it , but the prof assured me that it would be ok . After the first one I just wanted to get it over with . Good luck x

Hello... sorry to hear that you are on this journey! As others have said, you can negotiate starting chemo, particularly if you are not feeling well. Be aware that chemo is cumulative, so your first one could be relatively straight forward. You will be tired and it’s a lot to deal with.

Ask them why they feel that a quick turn around is important.. it may be that what they have seen inside you makes them feel that getting on with it is the right thing... or it may be that it’s just down to when they have a chair available.

Best of luck xx

There is a timeframe for how soon they start chemo after surgery. This is timed as if you have been through a chemo cycle. I.e. The cycle is usually 4 weeks, so the operation then is followed by chemo four weeks later. .For some people they have the operation first, and for others you start with chemo, to try and shrink the tumours and clear the ascites so it is safe to operate, followed four weeks later by the next chemo and so on. This gives the best chance of mopping up the cancer which could not be removed, and cancer cells floating around the body, and before it has time to ramp up again. In my case they could not remove the extensive nodules on the right side of my diaphragm, as they were too small and extensive. Hope this helps. If you cannot cope with the chemo so soon, then you need to raise this with your Oncologist. They will explain any risks either way. Therese

Hi! I had a total hysterectomy end of November. I was due to start chemo in first week of January but was still experiencing a lot of post operation pain so my doctor put back the chemo until end of January. However the senior oncologist disagreed and said I need to get on with it. I also have cancer trapped between my liver and diaphragm. So I had first chemo session on 13th Jan. I have experienced severe pains ever since. They don't go away with oramorph. I had an abdominal x-ray yesterday but nothing showed up. I'm just guessing that the pain is still post op but with added chemo effects. However I still wouldn't delay chemo if I was you. I hope you are in a position to just rest and have someone to care for you so you don't need to do too much. Good luck x

Hi . it is a worry but I had big operation and I was worried about chemo a few weeks after but u will be looked after you just need to rest when you need too and get support when your ready take care x

Hi! My first chemo was in October 8, 2015. Carbo/Taxol. I had my debulking surgery on November 4th. Spent 9 days on the surgical floor of the hospital and then I was transferred to the cancer floor where I had to have a blood transfusion and the next day had a chemo treatment. It surprised me but I figured my Doc wanted to stay on schedule? I don't remember having a particular harder time with the chemo so soon after surgery. In total, I was in the hospital 12 days. I hope you feel better!

Hi. I started chemo 4 weeks after surgery. My dr said it was best to get the stray cancer cells. However you should discuss how you feel with your team. Good luck!

Thanks for all the advice. It's really helpful to hear how wide the range of everyone's experiences have been! I meet with my medical oncologist tomorrow so I will definitely bring this up with her as you all have advised. I'm wondering, for those who had chemo right after surgery, how many of you were still experiencing pain, inflammation and difficulty doing daily tasks. I know everyone's healing is different (my first surgery was laparoscopic and I had almost no pain afterwards, versus the TAH which has been miserable).

Mommoo65 profile image
Mommoo65 in reply to FtMwithOC

Since I was in the hospital so long after surgery, I really had no trouble at home even with having the chemo while still in the hospital after surgery. I work from home, so just got back on the computer! One huge problem cropped up at my post surgery Drs visit. He opened a 2 inch wound along my stitches line and cleaned and packed it and told me I had to do the same. So I was dealing with surgery recovery, chemo recovery and now an open wound issue that didn't heal for 4 months! That dang thing give me more pain that the surgery did.

FtMwithOC profile image
FtMwithOC in reply to Mommoo65

Yikes! Four months of wound healing sounds vile. Sounds like you are doing better now?

Mommoo65 profile image
Mommoo65 in reply to FtMwithOC

Hi FtM...! yes, it was brutal. The fluid buildup is very painful and not relieved til it drains itself. I have to admit I did help that along at times. It provided some entertainment. LOL. But I am fine. The Dr looked at it right before my last chemo and said, "oh, good. It has healed". I told him yes, February 11th, I put all the gauze and tape away. Done! He laughed and said it was funny I knew which day.

I am fine now. on Leap Day it will be 4 years since my last chemo. The only lasting effect has been Peripheral Neuropathy which is manageable because mine is not so bad. . I wish you the best with chemo. Take good care of yourself and please check in with us. There is a lot of wise and sage advice from many who go through this walking beside you. HUGS , Jill

They started me on chemo six weeks after surgery but would have started me at 4 weeks after surgery had they not wanted to put me on a particular drug that would have made healing a little bit more difficult. Get a second opinion if you're concerned or if it's just impossible for you to take out anymore I suppose you could put it off but there may be reasons the doctor wants you on that chemo as soon as possible. After debulking it helps clear up any cells that might try to form tumors and you do not want anything to turn into stage 4. It becomes very difficult to get rid of entirely.

I just had my first ( of my second round ) chemo Friday - three & half weeks after my major debulking surgery.

The chemo has wiped me out this weekend but I keep feeling that it will only be for a few days then I should perk up again 🤞🏼

You’ve got to listen to your own body & listen to the advise from your oncologist. Hopefully you’ll manage whatever is decided. Sounds like you’re a tough cookie.

Best wishes for the best outcome xxx

My mum needed time to recover from surgery & additional complications and we asked to delay and they gave us a few more weeks (she had 3c diagnosis). Being in the right place on your journey is important so if you feel its too soon then I would say something 😊

Thanks again for all the insights. I felt a lot safer going into chemo knowing you all had survived it.

Started yesterday and so far, so good. The doc said carbotax doesn't slow healing too much after the 4-week window (maybe the later cells don't grow as fast?). Actually, a really nice unexpected side effect has been from the steroids which have really helped with the post-surgical swelling. Crossing my fingers that I still feel okay once I'm done with them.

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