When Ovarian Cancer Recurs
- Ovarian cancer may recur in women within two years
- The likelihood of a recurrence depends on the cancer’s stage
- Regular blood tests can monitor for a recurrence
- Treatments can extend the length of time before the cancer returns
"Unfortunately, for about 85% of patients, the disease is going to come back," says Dr. Kimberly Resnick, gynecologic oncologist at MetroHealth in Cleveland. "For the majority of ovarian cancer patients, their course with ovarian cancer is going to look like a wave, meaning there will be times when the disease rises, and when it has to be treated. And then there will be times when they're in the valley, when they're in a remission."
Read MoreHow Doctors Monitor for Ovarian Cancer Recurrence
Because the rate of recurrence is so high with ovarian cancer, you'll notice that how your doctor speaks about the disease is a little different than with other types of cancers. "When a patient is in remission…we will say that they are without any evidence of disease,” Dr. Resnick says. “This means that on examination, we cannot detect anything, and when we check their blood test called a CA-125, it is in the normal range." A CA-125 test is a measurement of a specific type of cancer antigen, a protein that is found in everyone's blood. High levels of CA-125 in an ovarian cancer patient can often be a biomarker, a warning signal for your doctor that the cancer may have returned.Monitoring CA-125 is considered one of the best ways to track cancer recurrence, so it's important for women who are in remission to stay on top of their follow-up appointments so their doctor can spot a recurrence as early as possible.
When the Cancer Returns
"It is not uncommon that within the first two years after remission a patient will have a recurrence," says Dr. Resnick. "Remissions can also begin to get shorter during the lifespan of an ovarian cancer patient."
A recurrence usually happens because there are cancer cells left behind after the first round of treatment that didn't respond to chemotherapy, which then start to grow again. When the cancer recurs, the recommendation is typically to repeat chemotherapy, though the type of chemotherapy drug may change based on the remission length and any side effects you had from the first round of treatment.
You may hear your doctor talk about the cancer as "platinum-sensitive" or "platinum-resistant." This simply means that the cancer is (or isn't) responding to platinum-based chemotherapy drugs. It doesn't mean platinum-resistant cancer leaves you with no options, however. There are different types of chemotherapy you can try, as well as clinical trials your doctor may recommend.
There are also a number of innovative drugs that can help treat ovarian cancer in patients who experience recurrence, or prolong the time in remission before a recurrence happens (called maintenance therapy). Drugs called PARP inhibitors prevent cancer cells from multiplying by blocking an enzyme that these cells use to fix their DNA. And the drug bevacizumab (Avastin) stops the blood flow to cancerous cells, preventing them from growing.
How likely your cancer is to recur often depends on what stage the cancer was at when you were diagnosed. Stage 1 and 2 cancers may have a higher likelihood of a cure, while cancers that were found at stage 3 or 4 may be more likely to recur. No matter what your stage, keep in mind that the treatment advances that continue to emerge are transforming how ovarian cancer is managed, and helping women go longer in between recurrences.
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