surgery before chemo

[georgiageorgia182]

hi all

My mums been diagnosed stage 3 HGSC - and the treatment plan has been determined to be surgery before chemo. My understanding was that chemo first was preferable - has anyone else had it in this order?

(know I should trust the doctors but am overthinking a bit here! ☺️)

thanks in advance

[Lind58]

my mom has two surgeries (first and second reoccurance) and then chemo. I assume the doctor would know best but I would always go for a second opinion.

[Boot1947]

Hi Georgia, when I was diagnosed 10 years ago (stage 3a) the protocol was much more likely to be surgery first, followed by chemo. Not sure why it changed to chemo/op/chemo, but I’m still here! I am generally inclined to trust doctors, but you might find a second opinion reassuring. Hope all goes as well for your mother as it did for me. Deb x

[Katmal-UK]

Hi, I had my op first followed by chemo nearly 17 years ago. Diagnosed stage 3b HGS BRAC2. My understanding is if they can op first they do so then chemo is used to ‘mop up’ any stray cells.

[Yorkiepudd]

Hi Georgia, I think a lot depends on what other symptoms/issues someone may be having and what is seen on scans. Sometimes they feel it beneficial to try reduce tumours first to make surgery easier and obtain a better result. Surgery first gets rid of the source and allows chemo to then work on anything possibly left behind and any microscopic cells which may have escaped.

I had surgery first (no biopsy so no grading and staging known) and recovery was a breeze really.

Absolutely right to question things but try not to overthink it ❤️

[Mammi]

I had my surgery first then started chemo 5wks after. Worked for me!DeeX

[Doglover1410]

I too had surgery first followed by chemo. Good luck to your mum x

[Seal004]

I was diagnosed July 2018 and had surgery first then chemo. My surgeon said he usually does surgery first but there was the chance that when I had surgery that he would close up and opt for chemo first but it all depends on the stage and how advanced or not the cancer is. I was HGSOC 3 and my surgery was 10-12 hrs. If you are not confident in your doctor then I would recommend getting a second opinion. Best of luck.

[SuffolkJen]

Hi

I had surgery first then 6 chemo sessions. This was because my diagnosis was unexpected so there was no choice.

Best wishes to your mum xx Jen

[Numi]

Yes, I had surgery first (8 years ago) as it was considered urgent, as OC was already confirmed in my omentum (Stage 3)and the surgeons thought they could probably get all visible cancer. Once I had recovered from the surgery, I had 6 rounds of chemo.

[bamboo89]

It used to be standard practice to do surgery first, that's certainly how it happened with me, though if the cancer was quite large and widespread on the scans, they would do chemo first, then surgery. I may be wrong, but my feeling is the reason why so many women now have chemo first is because of waiting lists for surgery following Covid, and giving chemo is better than doing nothing whilst they wait.

[Tiny_dancer]

My understanding is that it depends where the cancer is present. In my case I was originally told I was inoperable but I responded so well to the chemotherapy and it shrunk enough to allow surgery to go ahead. I then had chemo afterwards to catch any rogue cells.

I had bowel cancer a number of years ago and in that case I had surgery first and chemo afterwards as a mop up.

Hope things go well for your mum x

[ZenaJ]

Hi Georgia, I had the surgery first then 18 weeks of chemo back in 2013. I was stage 3C with no maintenance drugs after and I'm still here to tell the tale.

Good luck to your mum with it all. x

[Bookclublover]

I agree with Bamboo89. Surgery first if possible ( Primary Debulking) followed by chemo was the gold standard for treatment. That’s normal practice in the States. Interval Debulk- 3 chemo, surgery, 3 chemo - as others have said, was used when there was too much disease. Here in Scotland the surgery wait times are so long that we don’t even have interval debulking. Women can wait up to 3 months after 6 rounds of chemo before they get surgery.

Having said all that, a recent study showed that interval is no better/ worse than primary debulk in terms of progression free time. Like many Scottish women, I went to Christina Fotopoulou in London. She is a big advocate of Primary Debulk where possible. I was terrified of this, but both she and my oncologist said it’s much easier to face and recover from the surgery when you are not weakened by chemo. I wish your mum all the best. Great that she has such a supportive daughter ❤️

[georgiageorgia182 in reply to Bookclublover]

Thanks Bookclublover - this is really helpful. We'd actually been considering a second opinion with Christian Fotopoulou but not sure we will get it in time, so really useful to hear that she's likely to advocate for this approach too (although I'd still love to get my mum in for surgery with her as she sounds fantastic!). Do you have a link to that study by any chance?

Wishing you all the best too and hope you're doing well post surgery and chemo! <3

[Bookclublover]

Thanks, just started Niraparib so fingers crossed.

I think CF offers online consultations privately.

Sorry, I haven’t seen the study. I was told about it by a nurse from Target OC. I contacted them to help me decide about surgery first.

[georgiageorgia182 in reply to Bookclublover]

No worries that's still really helpful - I'll reach out to Target OC, but generally all sounds like doing surgery first is positie. Thanks for your help and wishing you all the good fortune with Niraparib! xxx

[Bookclublover in reply to georgiageorgia182]

😀🤞🏼

[Betti99]

I was diagnosed in 2020 with stage 3c and had surgery first followed by 6 sessions of chemo. Now taking a Niraparib for about 3 years. Best wishes to your Mom!

[thejoannabell]

I think it depends on the situation. Sometimes they do chemo first to shrink tumors if necessary. I think they do surgery first if they believe it will be successful without first doing chemo.

[georgiageorgia182]

Thanks so much everyone who responded. I appreciate i haven't replied to anyone individually, but I really appreciate all those who took the time to reply to me - they've made me feel far less anxious! (which in turn means I can be less anxious for my lovely mum) xxx

[Flora3]

I had chemo, surgery, chemo (Stage 4). That was in 2016!

Best wishes and good luck to your Mum.