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Join Us Now, July 2nd for an Ask Me Anything with Dr. Chapman-Davis.

Maem
MaemAdministrator
35 Replies

The doctor is in, bring your burning questions!

Guidelines for Ask Me Anything (AMA):

1. While we always strive to provide useful, up-to-date information on Ovarian cancer, the information posted in this Ask Me Anything session should not be used as a means of diagnosis or determining treatment. For diagnosis and treatment options, you are urged to consult your physician.

2. Please try to keep questions general, and not overly specific to your personal clinical situation. We want these questions and answers to provide useful information to the entire community.

3. Please try to limit your questions and responses to three sentences.

4. As always, please be respectful of other members and their questions

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35 Replies
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GwenHP

Thank you for joining us!

Was there anything new or exciting pertaining to ovarian cancer that came out of the two recent oncology conferences? (SGO and ASCO)

DrChapmanDavis

There were updates regarding use of parp inhibitors as maintenance after first line chemotherapy

SBlau
SBlauAdministrator
in reply to DrChapmanDavis

What has been learned and what do those developments mean for patients?

DrChapmanDavis

Many women may already know of the benefits of olaparib (lynparza), rubraca (rucaparib) or niraparib (zejula). what we are not completely sure is when is the best time to use it and if you fail one can you try another. there is ongoing research to determine what is the best time, best dose and side effects/ safety

Maem
MaemAdministrator

Does chemo port is required for stage 1c ovarian cancer?

DrChapmanDavis
DrChapmanDavis
in reply to Maem

sorry for the technical difficulties!! just seeing these questions. chemotherapy is definitely recommended for Stage IC ovarian cancer and usually at least 6 cycles. A "port" which can be placed to help make administrating chemotherapy easier can but utilized but not mandatory if you have good veins

GwenHP

Speaking of maintenance treatment, who should and shouldn’t go on maintenance drugs when they get to NED? What drugs are being used for maintenance, and what are the long term risks for being on these drugs for extended periods of time.

DrChapmanDavis

When you hear "maintenance" it usually means giving drug at the time you do not have active disease. The optimal time to give it can be after first line treatment if you are in remission and are a mutation carrier ( BRCA) but also can be given if your tumor also shows a mutation. Otherwise waiting to use maintenance after second line treatment if your cancer has returned makes more sense

GwenHP

Besides PARP inhibitors, what other drugs are being used as maintenance drugs?

DrChapmanDavis

Sometimes Avastin ( angiogenesis inhibitors) are used as maintenance

GwenHP

How long do you need to stay on a maintenance drug and are there long term side effects?

DrChapmanDavis

most of the data now utilizing parp inhibitors show benefit for at least 2 years (3 in select populations) after 2 years I think it depends on your quality of life and if it makes sense to continue

Maem
MaemAdministrator

@ca125 My name is Samuel, recently closed one diagnosed with stage 1 c Ovarian cancer, prior hysterectomy ca125 level was 358, and post hysterectomy it was 18, Dr suggested 6 cycles of chemotherapy and post with they will monitor ca125 every month. Today had first chemotherapy and it went well. I need to know when is the best time to do CA125, and do we need to do 6 cycles of chemotherapy?

DrChapmanDavis
DrChapmanDavis
in reply to Maem

It is a good sign that your CA 125 has already decreased after surgery. The chemotherapy is absolutely recommended ( 6 cycles typically) and usually they will monitor your CA 125 the first day of each cycle. after completion of treatment you should continued to be monitored at least every 3 months with CA125

Maem
MaemAdministrator

@bl21 What do you think about oral chemotherapy? I am just starting a new one Zujula.

Thanks BL21

DrChapmanDavis
DrChapmanDavis
in reply to Maem

the oral chemotherapy that has been recommended Zejula , when well tolerated and for the right candidate is a good option. I have had many patients on Zejula and as long as your platelets , blood work remain good, most have tolerated it.

GwenHP

Have any advancements been made regarding a screening test for ovarian cancer? I keep seeing press releases and google alerts suggesting something, but not seeing the data.

DrChapmanDavis

There are many studies evaluating screening tests but usually in conjunction with CA125, ultrasounds, and other combination tests including HE4, ROCA, OVA 1 but again none have been proven to be a great "screen" meaning that it has not been shown to lead to early detection!. We are doing our best with managing over testing and "screen" but there has not been anything specific across all populations.

Maem
MaemAdministrator

@smithgirl44 I've been on rubaca a parp inhibitor for nine months with all ca 125's 10 or under. I need a knee replacement as I am bone on bone. Do you recomend getting the surgery while taking this drug?

DrChapmanDavis
DrChapmanDavis
in reply to Maem

I think you need to talk to your provider and your knee surgeon to determine how long they may want to hold it. As these drugs can still affect your ability to heal, sometimes holding it for a month or so is warranted and wont affect your ovarian cancer status

GwenHP

What are checkpoint inhibitors and how do they work? When do you use them in treating ovarian cancer patients?

DrChapmanDavis

check point inhibitors or the so called "immunotherapy" are a class of drugs aimed at increasing your immune response that may otherwise be dampened by cancers that are very smart at suppressing your body ability to detect it

DrChapmanDavis

These drugs are not miracle drugs but have been shown to be helpful in combination with some other types of chemotherapy in ovarian cancer. drugs like "keytruda" are consider immunotherapy but usually have not been proven to work in ovarian cancer as a standalone drug. there are lot of studies looking into using check point inhibitors in combination with other drugs for ovarian cancer with some success

GwenHP

After surviving multiple recurrences are there any clinical trials that I would be eligible for or am I out of luck? How do I find out about clinical trials?

DrChapmanDavis

There are ongoing clinical trials even for patients like you with history of multiple recurrences I suggest you go to clinicaltrials.gov

as well as look at SGO foundation for womens" cancer

Maem
MaemAdministrator

@emilyjaycosta My mother had her first round of chemo on Monday. She is back in the hospital. She has a lot of fluid in belly and fluid in her lungs.Could the chemo have made everything worse?

DrChapmanDavis
DrChapmanDavis
in reply to Maem

no unfortunately it may take time for the chemotherapy to take effect ( 2-3 cycles) and she may continue to need ongoing drainage until it does work. many of my patients still need abdominal drainage ( weekly) until chemotherapy takes effect

Maem
MaemAdministrator

@abhinavranvakas Is chemo port required for stage 1c ovarian cancer?

Earlier I thought chemo drugs can be given through IV. I am bit scared for another surgery,

Thanks

DrChapmanDavis
DrChapmanDavis
in reply to Maem

you can see how you tolerate the first 1-2 treatment without a port and then reconsider if it becomes harder to get IV placed

Maem
MaemAdministrator

@cancerfighter42 I’m on my 3rd occurrence of Ovarian cancer. Originally Ovarian cyst stage IiB, then Mets to lungs, now two nodes in pelvic region (right external iliac/groin and pre-sacral area). Had surgery to remove the tumors so currently NED but radiation is recommended. What are the side effects of radiation in pelvic? Thank you in advance for your help and support!

DrChapmanDavis

I would recommend you have a consult with radiation oncologist just to discuss side effects. The side effects of radiation depend on the specific location being radiated as well as the type of radiation being given. Sometimes side effects are not as bad as you think if it is localized and given " IMRT" or short course only

DrChapmanDavis

Keep up the fight ladies!! continue to be ovarian cancer warriors

Maem
MaemAdministrator

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