When is your oncologist able to determine the stage of your ovarian cancer?

Question

During the last 6 months I have had several sessions of chemotherapy to treat ovarian cancer. Three weeks ago, I had surgery: removal of ovaries and omentum. My post operative appt. is in a couple of weeks. What questions should I ask my doctor regarding "stage" of cancer? What exactly does "stage" mean and what are its implications? Thanks for any help you can give me.

Answer 1

Your doctors have known your stage for months if they started out with multiple cycles of combination chemotherapy before surgery. They probably knew the stage after the initial evaluation six months ago from CT scans through the chest, abdomen, and pelvis.

ASK

1. What was the stage of my ovarian cancer when treatments began?

2. What were the findings of the pathologist at the recent surgery? Was there residual malignancy in the specimens removed - the ovaries, the omentum? Could a copy of the pathology report be provided?

3. What did the surgeon see in the abdomen at the time of surgery? Could a copy of the operative report be provided for the patient and family?

4. Are there any blood test tumor markers that can be followed in my case such as the CA125? Has this been elevated? What is it now?



I realize cancer medicine is practiced differently in various places. I tried to supply all of this information to my patients as they were going through treatments. Maybe it has been provided, and you have been in too much shock to understand it. In any case, these are the questions I would want answered if you were my family member.

Best of luck to you.

Answer 2

Stage is just a method of classifying the cancer and estimating survival and recurrence statistics.



Honestly, it serves no useful purpose, other than to give people something to worry about after finding all sorts of inapplicable information on the internet that they don't understand.



Important things to ask are: has the chemo worked, how do you know if it has worked, will it continue to work, what did the pathology report say from the surgery, will the chemo put me into remission. Those, and anything else you don't understand and can't think of.



They were only able to guess my cancer stage because I had chemotherapy before surgery. Staging is based on tumor size and number/location of lymph nodes involved, as well as whether and where the cancer has spread. The more nodes/organs involved, and the more distant they are from the primary tumor site, the worse the prognosis. However, response to chemotherapy is the best prognostic indicator.

Answer 3

Spreedog gave you the most important and relevant questions to ask your oncologist regarding your disease. So I will only address your question and some of the misconceptions regarding staging.



Anyone diagnosed with cancer in a country that is a member of the United Nations must report and stage their cancer cases. It is required by law with few exceptions, every hospital in the United States must report their cancer cases and staging is part of this process. Any hospital with a cancer program that diagnoses or provides first course treatment to any cancer patient must have a staging form completed by the managing physician. Additional rules are expected next year also requiring proof of staging information being used in the patient’s treatment planning. This in itself should indicate that it must have some useful purpose.



Staging information is used in statistical information, it is a prognostic factor, it is used in research and it is necessary for an oncologist to answer their patient’s questions in any meaningful way and to help determine the best treatment for them. However, it is only one piece of several pieces of information needed to do this.



Staging is based on three things the tumor, nodes and metastases (TNM). Each one is staged or graded individually in a way that is meaningful to a particular type of cancer and all of them together determine the stage.



I hope your appointment goes well. Best wishes.

Answer 4

The stages of cancer imply the seriousness of the cancer, and basically how long it has been there. Stage 1 is the lowest form of cancer, this means it pretty new, and has remained in the location of where it was found. Stage 2 is a little more progressed, a larger form and it has spread somewhat, but still in the same location. Stage 3 is when the cancer has begun to metastisized (spread) to the surrounding areas of where it was originally found. Stage 4 is when the cancer has spread into other organs. You can read more about the stages of cancer on cancer websites, this is just what I remember from researching with my mother's Stage 4 cancer.



You need to do the research on your cancer in order to ask the correct questions to your doctor.