<b>Letter from the ACOR LMS List</b>

I have been in your shoes, so I can really empathize with your dilemma.  After my first recurrence I had radiation, no chemo because there was nothing left to measure success or failure by.  Second recurrence, no one wanted to do surgery so I had chemo.  I still have the original abdominal tumor diagnosed in 9/01, plus lung mets.  I developed two new lung mets while on chemo.  I had Doxil (2 cycles) and Adriamycin and Cisplatin (3 cycles).  It didn't seem to do anything but make me sick, so I am off chemo for the summer.  If my Sept. scan shows significant growth I will try Gemzar, but in the meantime, my body is resting.  I am inoperable.  Chemo is my only weapon at this point.
  
YOU are not in that position right now.  YOU have no active tumors.  YOU have no symptoms.  YOU can make the decision.  If you have another recurrence it may be resectable.  Surgery is definitely a better option than chemo if you have the choice.  Why the rush?  I'd prefer to hold the chemo for when I REALLY needed it.  Chemo resistance develops in tumors.  You don't have life-threatening tumors, so why burn up your chemo options now??  Some also have lifetime maximums.  Food for thought.  In your shoes, I personally would opt for regular scans and deal with what comes up when it actually is there to assess.  I haven't seen much to prove that adjuvant chemo extends your life.  Having taken "industrial strength" chemo and being pretty miserable, I wouldn't do it unless and until I absolutely had to.  Then, I would gladly take it if it would help extend my life.  No one can decide for you.  It's a tough call, but trust what you have learned and how you feel about this treatment option at THIS time.  Ask for research that proves scientifically that adjuvant ifosfamide will help you long-term.  My best wishes to you.

L

[Recurrent uterine primary, Stage 4b, dx 8/96, total hysterectomy, recur 1/00, surgical removal of two large tumors and a foot of colon, 5 weeks of twice a day external radiation, 3 sessions of high dose internal radiation, recur 10/01, 6 cm tumor, Doxil 11/01 -1/02 no shrinkage, too much toxicity, new lung mets 1/02, 3 rounds of Adriamycin and Cisplatin, all lung mets inoperable]