Can ovarian cancer recur after a total hysterectomy?

Question

Hello doctor,

I am sending the details of my relative, who had a total abdominal hysterectomy and then took six cycles of chemotherapy. Her recent CA-125 result was 89 units/mL, and her USG reports also observed a few new lesions.

Would you please guide us on what shall be her subsequent treatment?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com

I have gone through your query and have looked at the reports you have provided (attachments removed to protect the patient’s identity).

A 53-year-old woman was diagnosed with stage III ovarian carcinoma. And received neoadjuvant chemotherapy, debulking surgery, and six cycles of adjuvant chemotherapy.

Now, follow-up after nine months shows rising CA-125 (cancer antigen 125) and an abdominal ultrasound showing lesions, which raises suspicion of recurrence.

I would like to know the following:

Is there any family history of breast or ovarian cancer?
Does she have any neuropathy from previous chemotherapy?
Is she symptomatic currently?
What was the date of her last chemotherapy cycle?

I would suggest the following;

To get a CT (computed tomography) scan to know the exact extent of the disease.
To get testing for BRCA (breast cancer gene) and HRD (homology recombination deficient).

If still symptomatic, I would suggest

Restarting chemotherapy for six cycles.
Maintenance PARP inhibitor (poly adenosine diphosphate-ribose polymerase) and Olaparib if BRCA is positive and Rucaparib if only HRD is positive
Take Bevacizumab if both BRCA and HRD are negative.

If you have any other questions, you can always revert here.

Thank you.