Saving...
MerryMarkhamMD
(Physician
- OBGYN - Gynecologic Oncology
(Verified)
)
| Communities: Ovarian Cancer , Cervical Cancer , Uterine and Endometrial Cancer , Non-Hodgkin Lymphoma | Thank You's: 1 |
| Member Since: Jan. 2012 | Questions: 0 |
| Answers: 8 |
Ask MerryMarkhamMD a question:
0
Cc:
Twitter
Facebook
Professional Statement
Dr. Markham is an Assistant Professor and Program Leader of the Gynecologic Oncology Program at the University of Florida. She is a clinical investigator and educator with a focus on lymphoproliferative disorders and gynecologic malignancies.
Dr. Markham is board certified in Medical Oncology, Hematology, and Internal Medicine. She is a member of the American Society of Clinical Oncology (ASCO), the American Society of Hematology (ASH), and the American College of Physicians (ACP), and numerous clinical trial cooperative groups.
Dr. Markham is board certified in Medical Oncology, Hematology, and Internal Medicine. She is a member of the American Society of Clinical Oncology (ASCO), the American Society of Hematology (ASH), and the American College of Physicians (ACP), and numerous clinical trial cooperative groups.
Professional Info
Credential:
MD
Primary specialty:
OBGYN - Gynecologic Oncology
Medical school:
University of Miami
Residency:
University of Florida
Fellowship:
University of Florida
Areas of expertise:
Diagnosis and Treatment of Lymphomas, including Hodgkin’s and non-Hodgkin’s Lymphomas.
Diagnosis and Treatment of Gynecologic Malignancies.
Diagnosis and Treatment of Gynecologic Malignancies.
Research interests:
Experimental therapeutics and prognostic factors for non-Hodgkin’s lymphoma and Hodgkin’s lymphoma.
Experimental therapeutics and prognostic factors for gynecological malignancies.
Experimental therapeutics and prognostic factors for gynecological malignancies.
Hospital affiliation:
University of Florida Department of Medicine
Practice address:
Gainesville, FL
32610-0278
Practice phone number:
352.273.7832
Twitter
https://twitter.com/DrMarkham
Personal Bio (My story)
Highly involved in medical education, Dr. Markham is a medical school course director and frequent lecturer in the College of Medicine. She serves as a mentor and teacher of medical students, residents, and hematology-oncology fellows in the Department of Medicine, and she has received numerous awards for her teaching activities.
MerryMarkhamMD Activities
A lymphoproliferative disorder is an abnormality of a component of the immune system, the lymphocyte, in which lymphocytes are produced by the body in excess quantity. Some of the most common lymphoproliferative disorders include these cancers: non-Hodgkin lymphoma, Hodgkin’s lymphoma, chronic lymphocytic leukemia, and Waldenstrom’smacroglobulinemia.
Lymphedema is the swelling of an extremity – an arm or a leg – due to an injury or damage to the lymphatic system. For example, some women who have had pelvic surgery which involved removing (or damage to) pelvic lymph nodes might have lymphedema of their legs. Also, women who have had breast cancer surgery, and had axillary (underarm) lymph nodes removed as part of that surgery, might have lymphedema of that arm.
Lymphoproliferative disorders are not related to lymphedema.
A lymphoproliferative disorder is an abnormality of a component of the immune system, the lymphocyte, in which lymphocytes are produced by the body in excess quantity. Some of the most common lymphoproliferative disorders include these cancers: non-Hodgkin lymphoma, Hodgkin’s lymphoma, chronic lymphocytic leukemia, and Waldenstrom’smacroglobulinemia.
Lymphedema is the swelling of an extremity – an arm or a leg – due to an injury or damage to the lymphatic system. For example, some women who have had pelvic surgery which involved removing (or damage to) pelvic lymph nodes might have lymphedema of their legs. Also, women who have had breast cancer surgery, and had axillary (underarm) lymph nodes removed as part of that surgery, might have lymphedema of that arm.
Lymphoproliferative disorders are not related to lymphedema.
Lymphedema is the swelling of an extremity – an arm or a leg – due to an injury or damage to the lymphatic system. For example, some women who have had pelvic surgery which involved removing (or damage to) pelvic lymph nodes might have lymphedema of their legs. Also, women who have had breast cancer surgery, and had axillary (underarm) lymph nodes removed as part of that surgery, might have lymphedema of that arm.
Lymphoproliferative disorders are not related to lymphedema.
A lymphoproliferative disorder is an abnormality of a component of the immune system, the lymphocyte, in which lymphocytes are produced by the body in excess quantity. Some of the most common lymphoproliferative disorders include these cancers: non-Hodgkin lymphoma, Hodgkin’s lymphoma, chronic lymphocytic leukemia, and Waldenstrom’smacroglobulinemia.
Lymphedema is the swelling of an extremity – an arm or a leg – due to an injury or damage to the lymphatic system. For example, some women who have had pelvic surgery which involved removing (or damage to) pelvic lymph nodes might have lymphedema of their legs. Also, women who have had breast cancer surgery, and had axillary (underarm) lymph nodes removed as part of that surgery, might have lymphedema of that arm.
Lymphoproliferative disorders are not related to lymphedema.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
1
Answer |
3 months ago
The reason chemotherapy has a role in the treatment of ovarian cancer is that, in most instances, the gynecologist oncologist is not technically able to remove microscopic cancer cells that may remain after the initial surgery. Post-operative chemotherapy for advanced ovarian cancer can improve survival in women, and this is the reason it is often recommended over surgery alone.
One way to measure whether chemotherapy is working appropriately in ovarian cancer patients is to follow the tumor marker for ovarian cancer, the CA-125. If this marker, which is obtained in a simple blood test, is elevated prior to beginning chemotherapy, and if it falls to the normal range while on chemotherapy, the chemotherapy is likely working. The CA 125 is not perfect, however, and it can be elevated for other reasons. If it is not clear to the oncologist what is happening with the status of the ovarian cancer, a scan of some type – either a CT scan or a PET scan – may be recommended.
The reason chemotherapy has a role in the treatment of ovarian cancer is that, in most instances, the gynecologist oncologist is not technically able to remove microscopic cancer cells that may remain after the initial surgery. Post-operative chemotherapy for advanced ovarian cancer can improve survival in women, and this is the reason it is often recommended over surgery alone.
One way to measure whether chemotherapy is working appropriately in ovarian cancer patients is to follow the tumor marker for ovarian cancer, the CA-125. If this marker, which is obtained in a simple blood test, is elevated prior to beginning chemotherapy, and if it falls to the normal range while on chemotherapy, the chemotherapy is likely working. The CA 125 is not perfect, however, and it can be elevated for other reasons. If it is not clear to the oncologist what is happening with the status of the ovarian cancer, a scan of some type – either a CT scan or a PET scan – may be recommended.
One way to measure whether chemotherapy is working appropriately in ovarian cancer patients is to follow the tumor marker for ovarian cancer, the CA-125. If this marker, which is obtained in a simple blood test, is elevated prior to beginning chemotherapy, and if it falls to the normal range while on chemotherapy, the chemotherapy is likely working. The CA 125 is not perfect, however, and it can be elevated for other reasons. If it is not clear to the oncologist what is happening with the status of the ovarian cancer, a scan of some type – either a CT scan or a PET scan – may be recommended.
The reason chemotherapy has a role in the treatment of ovarian cancer is that, in most instances, the gynecologist oncologist is not technically able to remove microscopic cancer cells that may remain after the initial surgery. Post-operative chemotherapy for advanced ovarian cancer can improve survival in women, and this is the reason it is often recommended over surgery alone.
One way to measure whether chemotherapy is working appropriately in ovarian cancer patients is to follow the tumor marker for ovarian cancer, the CA-125. If this marker, which is obtained in a simple blood test, is elevated prior to beginning chemotherapy, and if it falls to the normal range while on chemotherapy, the chemotherapy is likely working. The CA 125 is not perfect, however, and it can be elevated for other reasons. If it is not clear to the oncologist what is happening with the status of the ovarian cancer, a scan of some type – either a CT scan or a PET scan – may be recommended.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
1
Answer |
3 months ago
This is a very good question. Palliative care – treatment aimed at the relief of suffering – should begin from the time of diagnosis. This involves treating symptoms caused by the cancer and by the cancer treatment. Chemotherapy can often be considered palliative if the goal of chemotherapy is to relieve symptoms and not cure the cancer.
Another meaning for palliative care, and the one that I think is meant by this question, is when to stop active treatments (i.e., chemotherapy) and move towards end-of-life care or Hospice care. There is no one right time to discuss end-of-life care and wishes. If your physician is not bringing it up for discussion, then by all means, ask your doctor about it directly. Dying on our own terms should be important to all of us, so my personal opinion is that the sooner we talk about preparing to stop treatments, preparing for death, the more prepared we can all be. This is a very good question. Palliative care – treatment aimed at the relief of suffering – should begin from the time of diagnosis. This involves treating symptoms caused by the cancer and by the cancer treatment. Chemotherapy can often be considered palliative if the goal of chemotherapy is to relieve symptoms and not cure the cancer.
Another meaning for palliative care, and the one that I think is meant by this question, is when to stop active treatments (i.e., chemotherapy) and move towards end-of-life care or Hospice care. There is no one right time to discuss end-of-life care and wishes. If your physician is not bringing it up for discussion, then by all means, ask your doctor about it directly. Dying on our own terms should be important to all of us, so my personal opinion is that the sooner we talk about preparing to stop treatments, preparing for death, the more prepared we can all be.
Another meaning for palliative care, and the one that I think is meant by this question, is when to stop active treatments (i.e., chemotherapy) and move towards end-of-life care or Hospice care. There is no one right time to discuss end-of-life care and wishes. If your physician is not bringing it up for discussion, then by all means, ask your doctor about it directly. Dying on our own terms should be important to all of us, so my personal opinion is that the sooner we talk about preparing to stop treatments, preparing for death, the more prepared we can all be. This is a very good question. Palliative care – treatment aimed at the relief of suffering – should begin from the time of diagnosis. This involves treating symptoms caused by the cancer and by the cancer treatment. Chemotherapy can often be considered palliative if the goal of chemotherapy is to relieve symptoms and not cure the cancer.
Another meaning for palliative care, and the one that I think is meant by this question, is when to stop active treatments (i.e., chemotherapy) and move towards end-of-life care or Hospice care. There is no one right time to discuss end-of-life care and wishes. If your physician is not bringing it up for discussion, then by all means, ask your doctor about it directly. Dying on our own terms should be important to all of us, so my personal opinion is that the sooner we talk about preparing to stop treatments, preparing for death, the more prepared we can all be.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
1
Answer |
3 months ago
Targeted therapies for gynecologic cancers have not been as successful as we would hope, but they are still under investigation. The most frequently used targeted therapy under study for the treatment of ovarian cancer is bevacizumab (Avastin®), a monoclonal antibody that targets a molecule called vascular endothelial growth factor (VEGF) and interferes in the process of tumor blood vessel growth. Bevacizumab is not yet FDA approved for ovarian cancer and studies are ongoing.
Targeted therapies for gynecologic cancers have not been as successful as we would hope, but they are still under investigation. The most frequently used targeted therapy under study for the treatment of ovarian cancer is bevacizumab (Avastin®), a monoclonal antibody that targets a molecule called vascular endothelial growth factor (VEGF) and interferes in the process of tumor blood vessel growth. Bevacizumab is not yet FDA approved for ovarian cancer and studies are ongoing.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
1
Answer |
3 months ago
Clinical trials (research studies) have been performed over the years to determine the most effective chemotherapy regimens for ovarian cancer. In the United States, the most common regimen prescribed includes two drugs -- a platinum-based drug (most often carboplatin) plus a chemotherapy from the class of chemotherapy drugs known as taxanes (such as paclitaxel or docetaxel). This regimen is standard in the US, however, research studies are ongoing to determine if other regimens might give better results. Also, individual patients might be offered slightly different chemotherapy drugs depending on other factors, such as whether the patient has kidney or liver abnormalities.
Clinical trials (research studies) have been performed over the years to determine the most effective chemotherapy regimens for ovarian cancer. In the United States, the most common regimen prescribed includes two drugs -- a platinum-based drug (most often carboplatin) plus a chemotherapy from the class of chemotherapy drugs known as taxanes (such as paclitaxel or docetaxel). This regimen is standard in the US, however, research studies are ongoing to determine if other regimens might give better results. Also, individual patients might be offered slightly different chemotherapy drugs depending on other factors, such as whether the patient has kidney or liver abnormalities.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
1
Answer |
3 months ago
A gynecologic oncologist is a physician who has trained in obstetrics and gynecology, and then completed specialized training in gynecologic cancer surgery. The gynecologic oncologist should be involved from the very beginning, from the time when ovarian cancer or other gynecologic cancer (such as uterine cancer or cervical cancer) is suspected. In addition to performing surgery, gynecologic oncologists are trained to administer chemotherapy for gynecologic cancers, however some work closely with a medical oncologist who provides the chemotherapy.
A gynecologic oncologist is a physician who has trained in obstetrics and gynecology, and then completed specialized training in gynecologic cancer surgery. The gynecologic oncologist should be involved from the very beginning, from the time when ovarian cancer or other gynecologic cancer (such as uterine cancer or cervical cancer) is suspected. In addition to performing surgery, gynecologic oncologists are trained to administer chemotherapy for gynecologic cancers, however some work closely with a medical oncologist who provides the chemotherapy.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
1
Answer |
3 months ago
A gynecologist oncologist should be involved at the very beginning, once ovarian cancer is suspected. The main surgery to make the diagnosis and to remove the cancer should be done by a gynecologist oncologist, not a general surgeon.
A gynecologist oncologist should be involved at the very beginning, once ovarian cancer is suspected. The main surgery to make the diagnosis and to remove the cancer should be done by a gynecologist oncologist, not a general surgeon.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified))
2
Answers |
3 months ago
The majority of cases of ovarian cancer (approximately 75%) are diagnosed at stage III or IV (spread of cancer outside the ovaries and into the abdominal cavity or beyond). The primary difference is in prognosis. The percent of women with stage I ovarian cancer who are alive 5 years after diagnosis is around 83-89%. For women with stage II ovarian cancer, that number drops to 65-70%. For women with stage III, it drops to 32-45%; and for stage IV cancers, the number of women alive 5 years after their diagnosis is less than 20%.
The primary treatment for all stages of ovarian cancer is surgery. After surgery, chemotherapy is recommended for most women, regardless of stage. The majority of cases of ovarian cancer (approximately 75%) are diagnosed at stage III or IV (spread of cancer outside the ovaries and into the abdominal cavity or beyond). The primary difference is in prognosis. The percent of women with stage I ovarian cancer who are alive 5 years after diagnosis is around 83-89%. For women with stage II ovarian cancer, that number drops to 65-70%. For women with stage III, it drops to 32-45%; and for stage IV cancers, the number of women alive 5 years after their diagnosis is less than 20%.
The primary treatment for all stages of ovarian cancer is surgery. After surgery, chemotherapy is recommended for most women, regardless of stage.
The primary treatment for all stages of ovarian cancer is surgery. After surgery, chemotherapy is recommended for most women, regardless of stage. The majority of cases of ovarian cancer (approximately 75%) are diagnosed at stage III or IV (spread of cancer outside the ovaries and into the abdominal cavity or beyond). The primary difference is in prognosis. The percent of women with stage I ovarian cancer who are alive 5 years after diagnosis is around 83-89%. For women with stage II ovarian cancer, that number drops to 65-70%. For women with stage III, it drops to 32-45%; and for stage IV cancers, the number of women alive 5 years after their diagnosis is less than 20%.
The primary treatment for all stages of ovarian cancer is surgery. After surgery, chemotherapy is recommended for most women, regardless of stage.
New answer by MerryMarkhamMD (Physician - OBGYN - Gynecologic Oncology (Verified)) in topic(s) Ovarian Cancer Chemotherapy, Ovarian Cancer Treatment, Ovarian Cancer, Cancer Treatment, Chemotherapy
1
Answer |
3 months ago
MerryMarkhamMD's Profile
Cancer questions and answers.
Personalized, helpful, and accurate health information.
TalkAboutHealth Rewards
Please join TalkAboutHealth and you will be able to ask questions.
Your question to MerryMarkhamMD:
Optional: What context or background information is relevant to this request?
Notes:
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
Find us on Facebook and Twitter
Newsletter |
Blog |
Faq |
Contact Us |
About Us |
Privacy Policy |
Terms of Service
© 2010, 2012
