Dr. Bhatia Jatin Vinod
Radiation Oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My wife has undergone tumor removal surgery along with uterus and ovary removal a week back. CA-125 test value is 13.32 U/ml. The doctor has advised to undergo 4 to 6 sessions of chemotherapy based on the biopsy report and below impression: Sex cord- stromal tumor– granulosa cell tumor. Capsule intact. Unremarkable endometrium and left ovary, chronic cervicitis, uninvolved omentum, uninvolved pelvic peritoneum. Ascitic fluid cytology, inflammatory cells– lymphocytes. No malignant cells. Please review the attached reports and advice accordingly. I need to plan further treatment. Is chemotherapy required? Even though the CA value is within the normal range. Is there any other treatment possible? Chances of cancer in future if any? Or Chance of spread? If chemotherapy is required: When should it be started? How many sessions are required? Frequency or gaps between two sessions. How long does a session take? Side effects?
Hi,
Welcome to icliniq.com.
I went through your reports (attachment removed to protect patient identity), I have a couple of questions. First and foremost, any other blood tests done, called as tumor markers, similar to CA 125, like AFP, bHCG, inhibin, estrogen? Based on the details provided, she may require chemotherapy because of large size and possibly high mitotic index (though not mentioned in the report). Usually, the chemotherapy is given every three weeks to be started 4 to 6 weeks from the date of surgery. In this type of cancer, CA 125 is normal. Other markers such as inhibin and estrogen are high. There is a 30 to 40 % chance of spread, however, to be certain I need to see the patient and CT scan images in person. Usually, each session is about 4 to 6 hours. There are multiple side-effects.
Patient's Query
Hi doctor,
Thank you for your prompt response. This clarifies most of the things. I even took opinions from TMH and other renowned institutes and waiting for their responses. No other tests have been performed other than ones attached in the previous document. A couple of more clarifications: How serious is this and how quickly we need to start Chemo? Is immunotherapy a solution in this case? Is Chemo procedure common across places? Can Chemo be taken only though infusion in this case? Can patient start her routine life (job - Professor) while she is undergoing Chemo treatment? How quickly she can join the College?
Hi,
Welcome back to icliniq.com.
Chemotherapy is to be started 4 to 6 weeks from surgery once the wound is healed. Secondly, I might wanna do some blood testsprior to starting chemotherapy. Immunotherapy is not an option as of now. Yes, the chemo procedure is common. Be sure you are going to a medical oncologist for chemotherapy. Having a DM in medical oncology. The treatment will be through infusion. However, these specific technical details you discuss with your medical oncologist. He or she will be a better person to reply.
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Radiation Oncology
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