Is there a way for a person to know that a chemo cycle is successful? (excluding ca125 results)

gaylestorm

I am newly diagnosed with stage 3b high grade serous and have just completed my second cycle of chemo.   Are there symptoms following chemo that correlate to the cancer being stopped and tumours shrinking?  And do oncologists use the Ca125 to determine your prognosis?   

Fearless

@gaylestorm that's a good question and one many have as they go through initial stages of treatment. I'm 3C HGSC, although three years ago, and have to admit I know so much more now than I did then.  Scans (CT and PET) are the only really reliable way to assess the state of your cancer, but generally used judiciously through out your journey.  So the CA125 and your general blood work and health are the way oncologists generally measure progress. That said, hopefully you've told that th CA125 is not always reliable so one measurement is meaningless. The tendency is to look at how the scores track over a period of time. If the score is consistently declining then treatment is working, if rising then it could be the signal needed to explore further...usually with a scan. But when I say not reliable I can share that over the past, almost, four years the CA has actually been pretty accurate for me until this month.  I am in recurrence and on a clinical trial which means I'm monitored monthly with blood work and semi monthly with scans. My CA125 has been very slowly rising the past 6 months and scans confirm my cancer is very slightly progressing, but imagine my shock when my CA this week went from 186 to 440!  Yet, this also happened to be a scan month and low and behold my scan actually shows my cancer no longer progressing at all but quite stable again. Go figure! But it just goes to show not to rely on any one thing but allow your medical team to view your progress holistically.  I do wish, as most of us, do , that there was a miracle definitive quick and easy test and maybe some day we'll get there.  But in the meantime the best defense we have is good, clear, regular communication with our medical support.
Good luck with your chemo. And please continue to reach out to this forum for support as you need it.  We're all here cheering you on!

nadiaC

@Fearless thank you as always for sharing your story and your insight. I am glad that your scan results are favourable. If during or after chemo CA levels either don’t decline or start rising again would it be possible to request a scan, even if it’s not at a time when one should occur (as per normal follow up or trial protocol)? 

nadiaC

 hi @gaylestorm...I don’t have much to add to what @Fearless wrote. I’m also newly diagnosed 3C HGS and have had surgery followed by 2 rounds of chemo. My CA125 declined after the first cycle and my blood test next week will tell us what happened with cycle 2. I try an visualize a healthy abdomen and shrinking tumors as a way to stay positive about chemo. I haven’t heard of CA 125 being used for prognosis, but have heard from 2 OC survivors that small increases in their CA 125 signalled recurrence. 

Fearless

@nadiaC The significance of the CA125 seems to differ among medical professionals. Some place far more importance on it only as a "possible" indicator of tumor status...others see it as definitive and actually apply treatment protocols to changes in the score. I believe where they all agree though is that it's noticeable trends, up or down, over a period of time that is the most reliable means of determining status relative to the need for any further investigation.  I would suggest, but your medical team should explain their approach, that a rising CA above 35 over a 3 - 4 month period would probably suggest a scan to investigate the validity of the score and any necessity for intervention. That said, if over a little less time the upward change in scores is large..ie doubling or more each time, then a scan might be more appropriately accelerated.  Truly your medical team know best when appropriate to increase scrutiny and often a combination of CA plus physical symptoms prompt action, not just the score itself.  That said, advocating for yourself by monitoring your scores, your physical health and then using that to inform discussion and questions with your medical team is important; especially for your own sense of emotional security.  Keep us posted on your progress.  

tdubs17

My CA125 when started was 2200, 6 cycles and no surgery, ended at CA125 at 200.  This is were I remain. To hear of others under 35 makes me jealous.  I am 3 months post chemo now.  

Fearless

@tdubs17 Often it's the stability of the score that's more indicative of your state of wellness than the actual score itself.  Don't put too much credence to your CA125.  Just frustrating though that that's about all we have to lean on, isn't it