Oncology (General Cancer)/is it partial response?

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Question
hi dear doctor
respectfuly
my mom has a history of ovarian cancer(clear cell carcinoma)
after a long treatment with several chemo drugs
her liver is involved with multiple metastatic tumors
so her dr change the treatment from topotecan to carboplatin+taxol+avastin
and after 3 cycle her dr recommend a pet/ct scan
and now we have a problem with the pet scan result
beacause it stipulates that lesions size increased but there is a significant decrease in FDG uptake(previous SUV was 9.7 and now its about SUV=2.3 !!!) in favor of partial response(in liver), and another part of report: there is a significant decrease in metabolic activity and SIZE! of intraperitoneal seeding
in favor of partial response
i ask from radiologist who did the pet scan about false negative result
but he said that everything was good in the time of test
and the FBS of your mother was normal and good etc.....
and there was a delay between using of glocouse and taking the graph(90 min)
so this report is amazing for her oncologist because she believe in decrease of lesions size...
you know in the previous pet ct scan we had many problem in the liver and pelvis
but in new pet scan many of these problems is not seen
but in liver reported that lesion size increased this ia our main question
is it possible? increase in size and decrease in SUV (metabolic activity)
do u recommend that we continue the last regimen (taxol+carboplatin+avastin) of chemo?
my mom had pain in the region of liver 3 month ago but now the pain is very lesser
and there is an important sign:
the liver tumors are liquefacting
thats very kind of u  dear dr
and please forgive me about my bad writing
i contact u from asia
sincer
peryman

Answer
In general, with the drop in SUV and the shrinkage of tumors outside the liver, as well as the drop in pain, I would consider that she had a response and continue the current regimen.  When tumors in the liver (or the brain) liquify as a result of tumor death, the liquification forms a cavity, and that can actually draw fluid into itself and appear to be increasing.  That's what it sounds like is happening in your mother's case.  Ultrasound tests might help decide if this is liquid, and if so, it could be drained through a catheter; but if she were my patient and her pain was gone I'd probably continue the current treatment and see where things were after two more cycles of treatment.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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