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My wife's ascites fluid is almost gone after first dose of chemo.......
almost 70 %
does this mean - the drug was affective ? However, her CA-125 rose drastically........
We have not yet measured CA-125 after second round of chemo ?
any thoughts ?
Many researchers believe that ovarian cancer spreads through cells shedding into ascites in the abdominal cavity and then seeding in distant sites. It does spread this way but is probably not the only way as it is found in lymph nodes as well.
If fluid in the abdomen (ascites) contains malignant cells, the outlook is poorer than average for this stage. So having ascites fluid almost gone after initial treatment is a very good indicator.
However, you give the patient drugs and wait three weeks and then give more drugs and then wait three weeks and then repeat tumor measurement (exam, scans, CA125, etc.). You could have had that done in the laboratory rather than in the patient.
But, if a chemo treatment was synergistc to the cancer cells, it would keep ascites under control but the tumor marker should fall. However, CA125 determinations do not have very good diagnostic value by itself.
The reasons for CA125's less than optimal potential is the test's low sensitivity and specificity. Tests must have reasonably high sensitivities and specificities in order to be considered reliable.
It may be helpful to repeat the test after a period of time when the result is mildly elevated, to check for an increase in the level. That would raise concern because a high abnormal level is more concerning than a barely abnormal level.
http://www.cancer.gov/ncicancerbulletin/060209/page2
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