One of the important tools for follow-up after ovarian cancer treatment is regular monitoring of CA125 levels. A number of studies have found that elevated CA125 can be elevated months before clinical detection of tumor recurrence and metastasis. The questions that need to be faced are: 1. Is the patient immediately informed of the actual status of CA125? Clinically, we often encounter patients who are nervous, anxious and insomnia in the night before the follow-up examination, in fact, they are worried about their condition and CA125 elevation. Some of them are even reluctant to go to the hospital to check CA125, and if they are told that CA125 is elevated, they worry about relapse or even death, which is called “CA125 anxiety disorder”. Doctors and patients’ families should communicate with each other. 2. Is it necessary to deal with elevated CA125 level immediately after it is found and how to deal with it? It is generally believed that regular monitoring of CA125 level and early treatment can improve the symptoms related to tumor recurrence, such as ascites and intestinal obstruction, but early chemotherapy does not improve the survival time of patients significantly, and chemotherapy has toxic side effects, which will affect the quality of life of patients. The ultimate goal of treatment for patients with recurrent ovarian cancer is to improve symptoms, improve quality of life and prolong survival time. Measures after elevated CA125 level alone If elevated CA125 alone is found in the follow-up after ovarian cancer treatment, the patient should be informed of the situation, or if the patient himself is nervous or predicted to have poor tolerance then his family should be informed and the significance should be explained; as mentioned above, elevated CA125 often indicates tumor recurrence, and it was found in the era of secondary exploratory surgery commonly used in the clinic in the past that even CA125 is mildly elevated and no tumor lesions are found clinically (including various imaging examinations and gynecological and careful whole body examinations), tiny tumor lesions can be found during secondary exploratory surgery. And tumor load (tumor size) is related to treatment outcome. Therefore, after finding elevated CA125, especially more than 2 times of the basal value, further examination should be performed, including comprehensive physical examination, ultrasound, CT, bone scan, etc. Recent studies have found that PET or PET-CT has high sensitivity and specificity in detecting tumor lesions. Timing of treatment for elevated CA125 alone As mentioned earlier, the aim of treatment for patients with recurrent ovarian cancer is to improve the patient’s symptoms, improve survival quality and prolong survival time. Patients with elevated CA125 alone do not have any clinical symptoms, so it is important to choose the timing of treatment. Many studies have found that advancement of treatment does not extend the overall survival time of patients, and the latest findings reported at the 2009 annual meeting of the American Society of Clinical Oncology (ASCO) also showed that advancement of chemotherapy did not significantly increase the overall survival time of patients. Meanwhile, the effect of re-treatment after ovarian tumor recurrence is related to the length of chemotherapy-free interval after the initial treatment. If recurrence occurs within 6 months and treatment is needed, it is called platinum-resistant ovarian cancer, and the efficiency of re-treatment is low and the treatment effect is poor; if the chemotherapy-free interval is more than 12 months, the effect of re-treatment is good. Treatment of recurrent ovarian cancer If the chemotherapy-free interval is longer than 6 months, the original chemotherapy regimen, i.e. paclitaxel combined with platinum-based chemotherapy, can be chosen. If the tumor is limited, chemotherapy can be continued after re-reduction surgery. If no chemotherapy interval is within 6 months, then it is drug-resistant ovarian cancer, the chemotherapy effect is poor, the original chemotherapy regimen is ineffective, and the chemotherapy drugs need to be replaced, such as Topotecan, Jianzhi, platinum oxalate, VP16, isocyclophosphamide, liposomal adriamycin, etc. If an effective chemotherapy regimen is found and the tumor is confined, the tumor can also be reduced again and chemotherapy can be continued after surgery. If effective chemotherapy is not found, it is not advisable to operate again in a hurry, as surgery is difficult, complications are many, tumor removal is difficult, and even if all of them are removed, the tumor will grow out again soon. If economic conditions permit, biological targeted therapy can be combined, but its effect is not particularly good at present. If patients have obvious symptoms such as intestinal obstruction, they can undergo symptom reduction surgery. Other treatments can be combined with herbal medicine. However, it should be noted that such patients have poor treatment results and short survival time, and should focus on improving their quality of life, while combining their respective economic conditions, and that being poor in person and in poverty due to illness is not the best choice.