Re: second look laparotomy for ovarian cancer

From: ainsron@sbcglobal.net
Mon Apr 29 15:11:52 2002


I don't understand why you are considering a second look. In my understanding, a second look is offered to patients who have undergone chemotherapy and in whom the decision to continue or change therapy hinges on the findings at 2nd look. In fact the gyn oncs I've talked to recently only recommend them as part of research protocols, not simply to satisfy idle curiosity. Here you have a patient with no evidence of disease, who irrationally refused chemotherapy and gyn oncology referral one year ago. What is she going to do when you look in and find papillary studding or have positive cell washings? Or for that matter, what are you going to do?

>I have a patient with Stage IB high grade serous adenoCA of ovary CA 125 was
>8 before surgery( nl < 35). She refused chemo or even consult with the
>oncologist. Instead, she stopped smoking and went on herbs. Now one year
>later she has no evidence of disease by MRI and exam. Ca 125 undectectable
>( I know the tumor does not make any of this marker). She does not want a
>laparotomy. Any suggestions?
> In a general sense, if a woman has a tumor that makes a marker and it
>remains neagative after chemo; does she still need a second look?
>
>--
>Greg Le Toubib
>





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