Pathology Consult with University Colorado Hospital

Colorado University November 7, 2008
Dr. Kian Behbakht and 5th year attending resident, Embry

Louise C. Young (40 years old)
Type of Cancer is a well Differentiated Serous Carcinoma with Papillary Serous Carcinoma with Psammomaodies.
Stage Four - The cancer moved to the outside of the abdominal wall.
Grade One - How the cells look and behave. Grade one is a low Grade or Well Differentiated cancer cells still look a lot like normal cells. They are usually slow growing which is good!
My cancer has not affected my liver, lung or brain which is the first areas of migration.

My cell type is a typical type of ovarian cancer but the new location (outside abdominal wall) is unusual in Ovarian Cancer pattern of migration. It has been called Sister Mary Nodular.

My cancer which was outside the abdominal wall near the bellybutton region was removed. It's size was about 3x2x1 centimeters, not including the small sample piece from the previous biopsy (3 weeks ago).

The cancer found outside of the abdominal wall is the same cell type as the approximate hundred nodules found inside. The nodules that were attached to the abdominal wall were less than ¼” in circumference. They where all removed by shaving them down to the surface (less than 5 millimeters in depth).

Dr. Behbakht believes my current cancer is a different type of than my previous occurrence of twelve years ago. My sample slide from back in 1996 were not kept past 10 years so there will be know way to test.

Dr. Behbakht feels I am not a candidate for IP (direct chemo to the inside abdominal cavity) for my additional cancer located outside the abdominal wall would not be treated sufficiently. Which he believe would grow out of control.

His suggested treatment plan is Carboplatin/Toxol. This chemo would start six weeks from my operation (1st week in December).

There is a clinical trial at CU for an extended chemo (Taxol or similar) for an additional 12 months called GEG212. This trial has been researched only for a year half and there are no results. After chemo I would be monitored by CT Scans or Petscans.

Dr. Behbakht recommends that I stay off all Estrogen. I have been prescribed a low dose synthetic estrogen which I've been taking for the passed twelve years. I started taking Orthofes and a few years ago I switched to Prefest (estradiol / norgestimate tablets). These are a 1mg estradiol and 1mg estradiol/ .09mg norgestimate tablets.
Dr. Behbakht told us that the ovarian Cancer cells have an estrogen receptor which may or may not aid in the growth in cancer cells. He feels I should not continue taking estrogen for this reason. His thought are "why risk growing the cancer".

Dr. Behbakht's team feels it's a good idea for me to have the Genetic test for ovarian cancer. The thought is that if it comes back positive, then I can have my daughters tested. This would be done at the Breart Center which is a Hereditary Cancer clinic 970.848.1030.