Concerns Regarding Ovarian Cancer Stage IIB and Liver Lesions Post-Surgery
I am reaching out for some advice about my mother’s situation. I'm feeling quite anxious and uneasy about everything happening right now. **Patient Profile:** 50-year-old female, 5'2" tall, 68 kg, Indian citizen, residing in India. **Lifestyle Choices:** No smoking, no alcohol consumption, no drug use. **Medical Background:** In June 2025, my mother was diagnosed with Stage IIB ovarian cancer. She underwent a total abdominal hysterectomy on June 12. Genetic tests revealed she is BRCA1-positive. Following her surgery, chemotherapy commenced, starting with the first cycle of carboplatin combined with paclitaxel on July 10. **Current Concerns:** A CT scan of the abdomen, performed right before initiating chemotherapy, indicated some troubling findings: - Presence of multiple hypodense lesions in the liver, the largest measuring 17 mm — possibly metastases. - Enlarged external iliac lymph nodes. - No indications of pelvic recurrence or ascites. **Questions for Consideration:** - Is it possible that this represents a recurrence of cancer, or could it simply be microscopic remnants becoming apparent? - Is it typical to observe new lesions appearing within a month following surgery, especially before chemotherapy begins? - Would this situation elevate the cancer to Stage IV, and if so, how would that alter the treatment plan? - Given the BRCA1 positivity, might we anticipate the use of PARP inhibitors such as Olaparib following chemotherapy? What is the role of Bevacizumab in this case? - Should we consider a PET-CT scan or biopsy before making any adjustments to her treatment? I appreciate any insights or guidance you could provide. Thank you sincerely for your support. 🙏
Answers (1)
7/18/2025, 2:40:49 PM
OpenHealth AI
I'm truly sorry to hear about your mother’s situation. It’s completely understandable to feel anxious given the complexity of her health issues. Let’s break down your concerns step by step.
Main Points:
- The presence of liver lesions raises concerns and may indicate metastatic disease.
- It's important to assess the nature of these lesions to guide treatment effectively.
- Future treatment plans will likely depend on this assessment and her response to initial chemotherapy.
Explanation:
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Liver Lesions and Cancer Staging: The discovery of new liver lesions can suggest metastases, meaning the cancer has spread from the ovaries. In ovarian cancer, if these lesions are confirmed as metastatic, it may elevate the cancer to Stage IV. However, the determination of staging and treatment strategies depends on thorough diagnostic evaluations.
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Timeline of Lesion Appearance: It is possible for metastases or microscopic remnants to arise or become more visible shortly after surgery, particularly in aggressive tumors. However, this should be carefully evaluated through radiological and possibly histological methods (like biopsy) to distinguish progression from mere remnants.
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Treatment Implications: If confirmed as metastatic disease, treatment may involve systemic therapies, including chemotherapy and potentially targeted therapies. The usage of drugs like PARP inhibitors (such as Olaparib) is common in BRCA-positive patients after chemotherapy, particularly in advanced stages. Bevacizumab is often used to manage ovarian cancer and can help by inhibiting blood vessel growth to tumors.
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Further Investigations: Given the uncertainty around the liver lesions, conducting a PET-CT scan could be beneficial to further evaluate their metabolic activity and help in determining if they are cancerous. A biopsy may also be considered to confirm the nature of the lesions before any changes in the treatment approach.
Next Steps:
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Consult with the Oncologist: Discuss the results of the CT scan with your mother’s oncologist to clarify the findings of the liver lesions and their implications.
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Consider Additional Imaging: Evaluate the necessity of a PET-CT scan for a clearer view of the lesions and to aid in treatment decisions.
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Discuss Treatment Options: Prepare for a detailed discussion about incorporating PARP inhibitors or Bevacizumab into her treatment plan, depending on the current staging following evaluations.
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Emotional Support: Seek emotional and psychological support for both your mother and yourself during this challenging period. Support groups or counseling can be beneficial.
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Stay Informed: Stay engaged in the decision-making process and ensure that all questions and concerns are addressed in future consultations.
Remember, it's vital to approach this situation with a focus on personalized care, aiming for treatments that will optimize your mother’s health outcomes. Don’t hesitate to reach out for further support or questions as you and your family navigate this journey.
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