After her initial treatment is over, a woman should have follow-up treatments with her doctor. During follow-ups, doctors do thorough physical exams and may also monitor a patient’s blood for an elevated CA-125 level, other blood tests and imaging to determine if cancer has returned. Some patients have a sensitive CA-125 that will rise before their CT scan shows evidence of recurrent disease; a recent study suggests that it may be more useful to wait until a woman experiences symptoms of ovarian cancer before starting treatment. Women are encouraged to contact their doctor, if they experience any health problems between checkups.
Others will have evidence of the disease before their CA-125 rises. Doctors often use a combination of tests to monitor a patient because recurrent ovarian cancer has a wide spectrum of behavior making it difficult to monitor. In addition to physical exams and a CA-125 test, doctors may request CT and/or PET scans to look for tumor growth.
A patient should discuss a follow-up plan and survivorship plan with her physician, clearly outlining a plan of action post-treatment. A survivorship plan that addresses long-term issues is critical for a woman to have and discuss with her regular internist and other health care professionals outside of her cancer treatment.CA-125 plus HE4 have been approved by the Food and Drug Administration (FDA) for monitoring.
Many women report mixed emotions following treatment for ovarian cancer. While they are excited to have no evidence of disease, fears of recurrence are common. Often the hardest part of treatment for a woman with ovarian cancer is when chemotherapy is finished and she goes on with life. When she had surgery and chemotherapy she was in battle mode, fighting the cancer and taking active steps in her treatment. But the uncertainty about whether the cancer will return and concerns that every little sign or symptom may indicate a recurrence can be very anxiety-producing for many women. Support from family and friends is critical at this time.