After initial treatment, unfortunately CA125 starts climbing again. Usually this means recurrence. The question is what to do and when to start treatment again.

New research about to be presented at the American Society of Clinical Oncology by Dr. Karavasilis and colleagues introduces the concept of doubling time, which may help in treatment decision-making. They looked at 933 of their patients with ovarian cancer, 525 of whom had CA125 elevation after treatment. Most had this elevation occur within about 9 months. Of the 525 patients, 298 had their CA125 level double within 3 months and this was related to a much shorter survival after this point. Actually, there was a clear pattern. Those who had a CA125 doubling of 30 days survived 9 months, those with 60 day CA125 doubling lived 20 months and those with a doubling time of 90 days lived 26 months, on average.

The take-home message is that aggressive cancers behave aggressively and there may not be much one can do about that in the long run. However, to give the best chance of the longest possible survival after recurrence it may be prudent to pay close attention to how fast the CA125 is climbing. Focusing on a few points here and there can take a psychological toll and is likely not too important. But when the CA125 starts climbing rapidly, doubling in relatively short periods of time, it is time to consider action.