Tuesday, April 24, 2012

Neoadjuvant Chemotherapy

Since more than a few people have asked me about this, I thought I'd do a quick post here to explain it.
Neoadjuvant therapy is the administration of therapeutic agents before a main treatment.
In my case meaning I am having a set number of chemo cycles before surgery.

Often this option is chosen to shrink existing tumors so that the surgery will hopefully be less invasive, and have a greater chance of removing the tumors with minimal destruction to surrounding structures.
Believe me. There is a world of difference between simply getting a colectomy, versus a colectomy with a colostomy or ileostomy.

In my case there really wasn't an option because of the pulmonary embolism, and other blood clots present in my legs. Immediate surgery just wasn't feasible due to this.
Most oncologists today are in agreement that there is no difference in the clinical outcomes of chemo done prior to the debulking and staging surgery, versus having the surgery prior to starting chemo.

I'll be seeing my surgeon later this week and hopefully will have an update on when I can have my surgery. I just completed my 2nd cycle of chemo and so far the plan remains to do 3 cycles pre and 3 cycles post, so I am more than a little anxious to see where things stand.
I take fragmin injections daily so I know that being able to safely stop this anticoagulant will be a huge consideration.

The only drawback to neoadjuvant that I can see, is that the cancer really can't be staged or even typed until the pathologist actually looks at it, I mean you can't say you are stage 1,2,3 or 4 with any certainty until you see that pathologist report. I can't even say with absolute certainty that my primary is ovarian. It could very well be peritoneal, which incidentally, is treated the exact same way as ovarian.

Right now my doctors are basing my diagnosis on my family history and all of the clinical signs being consistent with ovarian cancer.

So class adjourned-have a great week! :)

Love, Dixie

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