Dear OncoLink "Ask The Experts,"
I've never really understood how or why my ovarian cancer could come back, but I'm well aware of the risk. I've had a negative second look and am in remission. Is recurrence due to undetected cancer being left behind, or is it due to cells dividing uncontrollably again once chemo effects wear off. Or could it indeed be either/ or? Does anyone know the answer to this?
Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:
In patients with advanced stage ovarian cancer who have completed initial chemotherapy and have had a second-look operation with no evidence of cancer detected, we know that the risk of cancer recurrence is approximately 50%. Obviously, this means that there are cancer cells present that were not killed by the chemotherapy, and were not detected by the second-look operation.
A great deal of research has gone into attempting to identify additional therapy that can decrease the risk of recurrence after initial chemotherapy, both in patients who have had second-look, and in those who have not. Most recently, efforts have focused on prolonged chemotherapy utilizing paciltaxel or other agents. You should discuss with your gynecologic oncologist whether or not such therapy might be appropriate for you.