Dear OncoLink "Ask The Experts,"
My mother (63 y.o.) was recently diagnosed with a multi-mullerian ovarian tumor. She had a complete hysterectomy and 21 biopsies. The tumor was on her right ovary and spread to her fallopian tube. She is staged at 2-a. I am aware that this type of cancer is rare and that there aren't a lot of statistically significant studies on it. Even less frequently is it caught in stage 2a.
Her doctor has recommended a treatment plan of 8 cycles of Chemo. The plan he has recommended is known as "doubling." She will alternate in her 8 treatments between the gold standard of Taxol / Carbo and a second set of drugs know as Ifos / Adria. She will receive four treatments of each.
My mom is obviously scared about Chemo because of the fact that there is no concrete evidence that her body isn't currently free of cancer. Is there any light that you can shed on the type of treatment that her Doctor has recommended? Also, is there any advice that you can give on this situation or on where I can go to get good literature on it? We want to get educated as a family so that we can get my mom comfortable with the final treatment program.
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
Malignant mixed Mullerian tumor (MMMT) of the ovary is very rare. These tumors more commonly occur in the uterus, but even then are rare. We know from clinical trials that several chemotherapies have activity against this tumor including the drugs that your physicians recommended: paclitaxel (Taxol), adriamycin (also known as doxorubicin), ifosfamide, cisplatin and carboplatin. These drugs can be given in various combinations and schedules, which should be discussed in detail with your physicians. However, because these tumors may be very aggressive, I agree that your mother should receive additional chemotherapy. If you wish to investigate more about this type of tumor, I would advise that you research MMMT (also known as carcinosarcoma) of the uterus, which is more common. We believe that any information regarding chemotherapy effectiveness for tumors of the uterus should also hold true for tumors of the ovary.
Mar 18, 2010 - The decision to perform prophylactic bilateral oophorectomy at the same time as hysterectomy should be taken with caution as it may do more harm than good, especially in women not at high risk for development of ovarian or breast cancers, according to a review published in the March issue of the Journal of Minimally Invasive Gynecology.