Patient: Description of the condition (time of onset, main symptoms, hospital visited, etc.): Preoperative CA125 lab result was 1470. Postoperative lab result was 40. Pathology report showed: plasmacytic junctional papillary cystadenoma with regional carcinoma on the surface of bilateral ovaries and in the right ovary. Cancerous mass implantation was seen in the greater omentum. I was given a stage 1 ovarian cancer. Six chemotherapy treatments were done 21 days after surgery and the six chemotherapy treatments ended on January 20 this year. CA125 result was normal. The doctor told me to review regularly, and the review was normal in 2 and 3 months. The doctor told me to review regularly. In June of this year, the ultrasound showed ascites and the ca125 figure was over 121. The doctor told me to continue the chemotherapy and changed it to docetaxel plus cisplatin abdominal chemotherapy. As a result, the ca125 dropped to 45 and the ascites was gone. He is currently receiving chemotherapy with paclitaxel, cyclophosphamide and cisplatin. After two rounds of chemotherapy, the ca125 is now down to 20 and 24. I am currently off chemotherapy and my doctor has asked me to follow up every month. What is the reason for my recurrence nine months after surgery and five months after chemotherapy? Was the surgery incomplete? Or is the chemotherapy regimen inappropriate? Is it necessary for me to go to Beijing to see a doctor in my current state and treatment? If so, is it easy to register? How much time do I need to get tested? Do I need to take some Chinese medicine besides chemotherapy? How can I be treated if I have a relapse? Can I go to Beijing to get a treatment plan for recurrence? What is the cause of my severe insomnia and night sweats at the end of chemotherapy? What should I do? We can’t say how thorough the surgery is, it depends on the surgery record. Recurrence within six months after surgery may be because the tumor is not sensitive to chemotherapy. The chemotherapy regimen is the same all over the world, and the first-line chemotherapy regimen is paclitaxel + carboplatin. You can’t be sure it is recurrence now. There are many factors for ca125 increase, we need imaging evidence of your recurrence, such as ultrasound or CT results. A review every three months is sufficient. Chemotherapy is not needed. You can decide your own Chinese medicine, Western medicine is not very understanding, but to increase appetite to enhance body resistance is still helpful, as to whether there is a direct anti-tumor effect I have no say. The reason for insomnia and night sweats is that you have had your ovaries removed. If the symptoms are serious, you can supplement hormone therapy. Patient: Thank you very much for your prompt and exact reply. You said I can’t be sure it is a recurrence, but is the ultrasound showing ascites and ca125 index over the limit a sign of recurrence? Do you think it is necessary for me to go to Beijing to see a doctor? The presence of ascites along with a rise in tumor markers can be considered as evidence of recurrence. There are many drugs that can be used for second-line chemotherapy, such as platinum oxalate, liposomal adriamycin, TOPTICON, etc., which are available in major hospitals all over the world, and the protocols are similar. The need to come to Beijing is not great. The cost of food, accommodation and travel is very high and there is no special treatment plan. Unless a resectable lesion is found, your situation will be re-evaluated at the time of another tumor cytoreductive surgery. Patient: Thank you very much for your reply which is very helpful. You are welcome. My answer is not always 100% correct. It would be best for you to communicate closely with your doctor to determine your treatment plan. Every hospital has a different treatment plan for the same patient with the same condition, and there is no right or wrong. For example, our hospital generally does not advocate chemotherapy until there is imaging evidence of recurrence, but many hospitals will give chemotherapy to patients, each has its own advantages and disadvantages, and there is no evidence to prove that method is better. Patient: Understandable. At present, there is no cure for cancer in the medical field, only surgery and chemotherapy and experience to control it. As a patient, it is very gratifying to get a serious and timely answer from the doctor in Beijing through the Internet! What you have done is a good deed. I am very grateful to you. I don’t know if the biological therapy that some hospitals are currently promoting is credible and effective? Biological therapy should be the hope of curing tumors in the future, and gene therapy will cure cancer from the root. But at present the world has not yet overcome this problem. And you should be cautious about the propaganda in China, especially in private hospitals. Even if it is a public hospital, playing the brand of the Chinese People’s Liberation Army Academy of Military Medical Sciences, it is not always effective. Nowadays, economic interests are tempting to all people. It is not that biological treatment is not good, but it is still immature, the efficacy is not sure, in order to make money, some efficacy is not sure things also into the clinical.