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Question: When one has a recurrence, does the second and third and so forth recurrence happen at shorter intervals, or are there cases where your first recurrence happens after, say, 8 months, but your next remission might last longer???
Cancer Taxol Surgery Avastin Diabetes Ovarian cancer Taxotere Chemotherapy Pain Carboplatin
I think it varies with each individual. My wife had surgery followed by Carbo/Taxol and her numbers were flat for 2 years and then started doubling. She had a 2nd complete cycle of Carbo/Taxol and the numbers started going up in just 6 months. She is now on an Avastin Clinical Trial.
Tomd
If you read the literature, yes, there is evidence that each remission is shorter than the previous one
I'm sure it varies from person to person, but my experience has been the remissions are shorter each time. My first one was 6 years after initial treatment. The next one was only 10 months for my first recurrence, and now I'm still trying to get back into remission after 10 months of chemo with this second recurrence.
Usually each subsequent remission is shorter; however, occasionally the reverse is true -- such as a 5.5 year first remission, followed by a 7 year second remission. It may be related to whether you use a different regimen the next time around. My doctor told me that if I stay in remission for two years, they will use the same regimen again since it worked the first time. I've noticed some of the ladies go back on carbo/taxol, but Avastin is being added the second time around. I suspect they may get better results on this second regimen.
I'm hoping my remissions are long enough for new more effective treatments to be developed for use with each recurrence.
That's what I thought I was observing in all the threads I have read... I think, though, that it is VERY exciting all the new things they are discovering/trying! I'm with you; hope I am healthy long enough to benefit from some new tx.
Wow, I must confess that I am disheartened to hear the tone of this discussion. It sounds like recurrence is expected. I guess I've been living in denial especially since I recently celebrated 3 years cancer free. Here I sit trying to come to grips with the likelihood that symptoms that have just cropped up are going to lead to discovery of a recurrence. I'm scheduled for a CAT scan on Monday with the results expected Tuesday. I've never envisioned going through chemo. again. I pray that improvements in treatment are on the way for all of our sakes.
Don't be disheartened! Look at yourself! Three years in remission! That is awesome. Statistics are just that. They are numbers, not individuals. You are doing good. Yes, you may go through chemo again one day, but things are improving and changing so much -- just think, I (and probably you) went through chemo without barfing. That was not the case years ago! The picture is improving. Slowly. But improving.
Lynda
The longer remission you have the first time gives you a better chance of the second one being longer.
I don't know what the statistics are. I went three years without recurrence. I am in my first recurrence. I will fight this no matter what. I hate to sound negative because I am not, but this stupid disease is alway hanging over our heads. Most of us have recurrence and we just have to fight it.
Be glad for any remission we have, mine was only 6 weeks. I finished taxol/carbo in the end of May and recurred by the middle of July. I'm on Avastin/Cytoxan now and am hoping that I'll be able to just take a chemo vacation for a couple months at some point. Just a break would be wonderful since my Dr told me since I recurred so fast, remission probably wouldn't last more than 2-4 mons.... and probably less for me since I recurred so fast.
The good thing is that my quality of life is pretty decent, the worst side effect I have is fatigue. I can still work full time and do other things I enjoy...
In general, the second remission doesn't last as long as the first, and the third is shorter than the second, but there are always exceptions to the rule. If the recurrence is growing slowly, alternative treatments can help a lot, such as curcumin, quercetin, IP6, AveMar, ImmPower, low dose naltrexone, and a Chinese anti-cancer mixture called Fu Zheng.
My advice is not to dwell on "how much time", but just keep living life to the best and fullest you can. It takes a shift in perspective to do this, but "time" is irrelevant if it is spent worrying a life away. We have cancer, but we don't have to stop living because of it!
~AMG
For what it is worth, I remember reading about Patrick Dempsey's mother. She is I think 14 or more years out since diagnosis from Advanced Ovarian Cancer and I know she had a recurrence 2 or 3 years after her original treatment and I think has been cancer free since then. Also, there is a woman named Chris Bledy
(she has a website and Facebook page ) who had advanced ovarian cancer, had a recurrence, changed her diet around and is doing some other things and hasn't had a recurrence in 10 years. There are women who are able to go into lengthy remission after recurrence.
From the NOCC site:
Time to recurrence
“Platinum-sensitive”
As a general rule, if it has been 6 months or more since you received primary chemotherapy when your cancer recurs, you are considered to have “platinum-sensitive” or “chemotherapy sensitive” disease.
-If you fit this category re-treatment with a platinum-containing regimen is commonly the first choice of therapy. The longer it has been since previous therapy the more likely it will work.
-Response rates vary from 20-60%
-For women who have been off therapy for more than 2 years, response rates to re-treatment approach that of primary therapy, 70-80%
-Platinum agents, carboplatin or cisplatin, have been around the longest, so there is more information about re-treating with these agents than with a taxane, such as taxol or taxotere.
-Considering toxicities, and quality of life, most doctors will re-treat at recurrence with a single chemotherapy agent, usually Carboplatin, because it is so well tolerated.
-Carboplatin is usually given once every 3 to 4 weeks IV over one hour.
-The major toxicities of Carboplatin are nausea and lowered white blood count or platelet count. Hair loss rarely, if ever, occurs
-There are no studies to show that re-treating with both Carboplatin and Taxol is better than either agent alone, and toxicity, especially hair loss and neuropathy certainly increase with the combination
-If Carboplatin alone is used but does not work taxol or taxotere alone is often the next best choice.
-Taxol can be given on the usually every 3 week schedule, or on a weekly schedule.
- The weekly schedule of taxol reportedly causes less lowering of the white blood cell count and less hair loss, although hair loss is still common
- Taxotere, is another taxane which has less neuropathy that taxol, slightly less hair loss, but more lowering of the white blood cell count and changes of the nail beds, including loss of fingernails or toe nails
-Taxotere can be given every 3 weeks or weekly, similar to taxol
“Platinum-resistant”
If your cancer recurs within less than 6 months of completing primary therapy, or grow while on primary therapy, or platinum therapy for recurrent cancer, your cancer is considered “platinum-resistant” or chemotherapy resistant.”
If you fit this category, it is unlikely that re-treatment with chemotherapies that have been used before will work.
This is a category where many new agents have been found in recent years
All of these new agents have similar response rates.
The response rate is about 20-25%.
The average duration of response is 6-8 months.
This means that for 20-25% of women treated, their cancer will decrease in size by at least 50% for an average of 6 to 8 months.
Conversely for 75-80% of women, the treatment will not work and the cancer will continue to grow.
There is no proven way to determine which treatment will work for which person
So, when trying a new treatment for platinum-resistant ovarian cancer it is very important to consider:
* Previous toxicities
* What is important to you for quality of life
* Choosing a treatment that works through a different mechanism
* Choosing a treatment that does not have cross-resistance with what did not work before
Link to page with further info:
https://www.ovarian.org/Faqs/FaqContent.aspx?Pid=445
Thank you SO much for posting this. I am platinum resistent and this was helpful for me.
I agree. I'm just learning. This was VERY informative. Thank you so much!!!
Freedomfighter: I know where you come from. I am now 4 years post-op, 3.5 years post-treatment and I have no signs of cancer as I write this. I had many scares during this time, one being unexplained headaches leading to an MRI looking for possible brain lesions but it came back clear (1.5 years ago). Then pelvic/bladder pain that led to CT scan also clean, ultimately it was just a bladder infection. Incidentally, they thought a tiny liver spot had increased from 3 to maybe 5 mm over the past 2 years and recommended to keep an eye on it. Just had another scan 9 months later and it was clean.
This it how it goes, any pain or symptom I have my onc takes seriously and follows up, even if the marker is normal. So far, I always lucked out. I hope this will be the same in your case.
Unfortunately my marker has been climbing to 26 so that is my new scare. I am now mentally and physically preparing for the next chemo, whenever it may come (next year) - while still hoping that this is just yet another scare.
We both have good responses to our initial treatment, and therefore the best chance that the next remission will be as long or maybe even longer, especially since they can now add Avastin, which I will ask for if it comes down to it.
BTW because many womena relapse DURING initial treatment, my onc measures "remission" from the date of surgery - that will be Nov 23 for me (4 years).
Hang in there and give it at least one more fighting chance IF needed.
Please keep us posted how the scan goes.
Okay I'm confused. Does this mean there is a high likelihood that my remission won't last that long? I know it varies from person to person but it seems like just about everyone has had recurrence
That's what the statistics say. BUT: There have been women whose second response was better than the first. I guess it all depends on where the cancer recurs and in how many places, and many other factors.
My GYN/ONC told me after my first recurrence (after 4 years) that I should think of Ovarian cancer as a chronic disease. That it does return and we'll treat it when it does.
I, of course thought I would be the exception. 2 years later I have to acknowledge she was right as I seek treatment for my 2nd recurrence. It is encouraging to see the advances in treatment. I appreciate AMG's post. It is too easy (for me anyway) to let worry take over, while life slides by.
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