When Cancer Recurs

When cancer recurs, or comes back, treatment options expand significantly. Gone are the days when we had little to offer these women. Topotecan, Doxil, Gemzar, Hycamptin, Vespid and Tamoxifen are just a few of the drugs in our arsenal. Unfortunately, though there are many choices, the chances of success begin to decline significantly. The chances of response to chemotherapy after the initial surgery approach 75-80%. Second-line agents all have response rates on the order of 15-25%, with none clearly superior to the others. Frequently, the most effective agents are the ones given initially, usually Taxol and Paraplatin. The longer the period of remission, the greater the likelihood of a second remission. Second remissions are usually shorter than the first, and almost invariably are followed by another recurrence. Surgery is occasionally of benefit, especially when the disease seems to be relatively limited in extent on a CT scan and the chances are great for removing all grossly evident (i.e., to the naked eye) tumor growths or when patients have signs and symptoms of intestinal obstruction (an inability to eat or drink without vomiting). Most patients lose their strength slowly over the course of several months and at the end, slip into a restful sleep.

Research into new drugs, approaches and technologies continues. The standard therapy for this disease has already changed in the last decade. As more information becomes available, we will hopefully make inroads in both the diagnosis and management of this disease.