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. I. Measures after elevation of simple CA125 level If elevated simple CA125 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 CA125 is found to be elevated, 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. II. Selection of the timing of treatment for simple CA125 elevation As mentioned earlier, the purpose of treatment for patients with recurrent ovarian cancer is to improve patients’ symptoms, improve survival quality and prolong survival time. Patients with simple CA125 elevation do not have any clinical symptoms, so it is very important to select the timing of treatment. Many studies have found that advancement of treatment does not prolong 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 initial treatment. If recurrence occurs within 6 months and treatment is required, it is called platinum-resistant ovarian cancer, and the efficiency of re-treatment is low and the treatment effect is poor; chemotherapy-free interval more than 12 months is good for re-treatment. Therefore, whether or not to treat CA125 after it is found to be elevated in the follow-up consultation needs to be combined with the following: 1. whether a comprehensive examination and assessment has been performed, including physical examination, CT or PET or PET-CT, and whether there is clinical evidence of tumor recurrence. 2.Whether the patient has symptoms, such as abdominal distension, lower limb edema, pain, etc. 3, Time interval from initial treatment (length of chemotherapy-free interval). 4. The degree of CA125 elevation. Progressive management measures should be decided according to the following: 1.If there are symptoms and clinical evidence of tumor recurrence such as ascites and tumor found, immediate treatment should be carried out. 2.If CA125 is mildly elevated and the patient is asymptomatic, chemotherapy can be withheld and triamcinolone, megestrol or drugs to improve immunity can be given, especially for patients within 6 months after initial treatment, but CA125 level should be closely monitored. If it is 12 months after the initial treatment, then an appropriate aggressive attitude can be adopted. 3. An exponentially elevated CA125 level or a single CA125 level of 150-200u/ml or more should be started even if the tumor is not clinically detected. III. Treatment of recurrent ovarian cancer 1. If the interval without chemotherapy is more than 6 months, the original chemotherapy regimen, i.e. paclitaxel combined with platinum-based chemotherapy, can be chosen. If the tumor is limited, you can choose to continue chemotherapy after tumor reduction again. 2. If no chemotherapy interval time is within 6 months, then it is drug-resistant ovarian cancer, with poor chemotherapy effect and original chemotherapy regimen is ineffective, need to replace chemotherapy drugs, can choose Topotecan, Jianzhi, platinum oxalate, VP16, isocyclophosphamide, liposomal adriamycin, etc. If effective chemotherapy regimen is found and the tumor is limited, can also reduce the tumor again and continue chemotherapy 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 financially weak and impoverished by the disease is not the best choice.