Dear OncoLink "Ask The Experts,"
My mother was recently diagnosed with ovarian cancer. She had significant ascites, which caused her presentation to the hospital. She is to have two cycles of taxol/carbo combination and scheduled to undergo surgery in May. We want the most aggressive treatment for my mother. What are some questions to ask before the surgery to ensure she gets the most aggressive treatment possible?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
The standard treatment for advanced ovarian cancer is surgery to remove as much tumor as possible first, followed by chemotherapy with Taxol and carboplatin. In certain cases, physicians may recommend a few cycles of chemotherapy first, then surgery, followed by additional chemotherapy, as in your mother's case.
Be assured that your mother is being treated with the current standard of care, which is the best-proven treatment available. I would not recommend any different or "more aggressive" therapy given the lack of evidence. The Gynecologic Oncology Group is currently conducting a large, international clinical trial comparing Taxol/carboplatin to Taxol/carboplatin+a third chemotherapy agent (these agents include Doxil, gemcitabine, and topotecan). The purpose of this trial is to determine if adding a third drug is more effective in the treatment of ovarian cancer. No one knows the answer yet.
Please remember that "more" is not always "better". While we can be reasonably sure that using more drugs adds to a patient's side effects, we do not know if more drugs are necessarily more effective treatment for cancer. Since your mother has already begun treatment, she is not eligible for this trial, and I would not recommend treatment that is different from the standard outside of the supervision of a clinical trial.