6 or 8 cycles of Chemo?

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May 26, 2016 at 6:02 am  #1274156    

grace5

My wife has been undergoing treatment for Ovarian Cancer (stage 4);
– She had 1st cycle of chemo before Surgery in Hospital “A” (home)
– She then did the surgery in Hospital “B” (abroad) where 5 cycles of chemo was prescribed for her. She did 2nd cycle in Hospital “B” abroad, then 3rd – 6th cycle in Hospital “A” (home)
– Now the Oncologist in Hospital “A” (home) is saying she should do 2 more cycles (7th & 8th). When we contacted Hospital “B” they say what was prescribed (5 cycles after surgery) is what is appropriate.
PLEASE WHAT SHOULD WE DO?
-The CA 125 results have been fantastic have crashed from about 12,000 U/ml in Dec. 2015;
– 14.8 U/ml in March,
– 1.8 U/ml in April
– 4.6 U/ml in May
Her Present Condition:
– She is very stable; gaining back her stamina
– Itches at night
– Sleeps averagely well
– Eats well
Her platelet count is very low “49” range is 150 − 450 x 10^9/l
Haemoglobin is also very low “8.0” range is 12.0 − 16.0 g/dl

May 26, 2016 at 7:19 am  #1274158    
catdander forum moderator
catdander forum moderator

Hi grace5,

Welcome to Grace. I’m very sorry to know of your wife’s condition. Unfortunately we don’t have an expertise in ovarian cancer and won’t be able to give much help. However from what I’ve gathered on the ncbi there have been studies that include data on the number of platinum/taxane based cycles given in stage IV ovarian cancer that showed over six cycles can cause more harm than good.

In this study the main topic of research is IP vs IV which in your wife’s case is a moot point but the study does delve into the conversation of too many cycles of platinum based therapies. About a 1/4 way down the page this paragraph begins the topic of too many cycles. “This series of randomized phase III studies established carboplatin/paclitaxel as the standard chemotherapy regimen in advanced ovarian cancer and suggested that a plateau has been reached for IV chemotherapy. In patients with advanced ovarian cancer (stages III–IV), six cycles of chemotherapy are recommended [Bertelsen et al. 1999]. Randomized trials have failed to demonstrate an additional benefit from extending the duration of adjuvant chemotherapy to 8–12 cycles, although these trials utilized platinum-based chemotherapy that did not include taxanes.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126016/

The practice is similar with lung cancer treatment in that more that 6 cycles of platinum tend to cause hypersensitivity reaction to the treatment. Dr. West describes it here, ” With carboplatin, cumulative cytopenias (low blood cell counts) and a rapidly escalating risk of a severe and potentially dangerous hypersensitivity reaction (which can also occur with ongoing cisplatin but is notorious and almost inevitable with carboplatin) make indefinite carboplatin too challenging and inadvisable.” http://cancergrace.org/lung/2011/12/24/beyond-4-cycles-1st-line/

I hope she does well.
All best,
Janine

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