Hello doctor, My wife has undergone tumor removal surgery along with uterus and ovary removal a week back. CA-125 test value is 13.32 U/ml. The doctor has advised to undergo 4 to 6 sessions of chemotherapy based on the biopsy report and below impression: Sex cord- stromal tumor– granulosa cell tumour. Capsule intact. Unremarkable endometrium and left ovary, chronic cervicitis, uninvolved omentum, uninvolved pelvic peritoneum. Ascitic fluid cytology, inflammatory cells– lymphocytes. No malignant cells. Please review the attached reports and advice accordingly. I need to plan further treatment. Is chemotherapy required? Even though the CA value is within the normal range. Is there any other treatment possible? Chances of cancer in future if any? Or Chance of spread? If chemotherapy is required: When should it be started? How many sessions are required? Frequency or gaps between two sessions. How long does a session take? Side effects?
Hi.  I went through your reports (attachment removed to protect patient identity), I have a couple of questions. First and foremost, any other blood tests done, called as tumor markers, similar to CA 125, like AFP, bHCG, inhibin, estrogen? Based on the details provided, she may require chemotherapy because of large size and possibly high mitotic index (though not mentioned in the report). Usually, the chemotherapy is given every three weeks to be started 4 to 6 weeks from the date of surgery.  In this type of cancer, CA 125 is normal. Other markers such as inhibin and estrogen are high. There is a 30 to 40 % chance of spread, however, to be certain I need to see the patient and CT scan images in person. Usually, each session is about 4 to 6 hours. There are multiple side-effects.