My ca 125 has been 10 for 2 yrs. I had a mix of clear cell and endometrial cancer

Important Update: Your CA-125 and Histology Changes Everything

Thank you for this critical additional information. This significantly changes the surveillance picture for you. Let me explain why.

Why Your CA-125 Level Matters

A CA-125 of 10 for 2 years is excellent — this is a normal/low level and suggests you're in sustained remission. This is genuinely good news and actually reduces the urgency for routine imaging.

However, your histology (clear cell AND endometrial components) requires special attention because these are less common ovarian cancers (LCOC) with different behavior patterns than high-grade serous cancers.

Clear Cell and Endometrial Ovarian Cancers: What You Need to Know

According to NCCN Guidelines for Ovarian Cancer, clear cell and endometrial carcinomas have important differences:

Clear Cell Carcinoma:

• Often associated with endometriosis
• Can be more chemotherapy-resistant than serous cancers
• May have different recurrence patterns
• Typically high-grade tumors

Endometrial-Type Ovarian Cancer:

• Often associated with endometriosis
• May be lower-grade
• Can have different treatment responses
• Hormone receptor status may be relevant

Key Point: These histologies sometimes behave differently than typical high-grade serous ovarian cancer, which is why your surveillance approach may need to be tailored.

What This Means for Your Surveillance

Given your normal CA-125 + 2-year remission + LCOC histology, here's what to discuss with your oncologist:

Questions Specific to Your Situation:

1. "Given my clear cell/endometrial histology, do you recommend any different surveillance approach than standard Stage 1C patients?"

2. "My CA-125 has been stable at 10 — at what level would you be concerned and order imaging?"

3. "Are there other tumor markers specific to clear cell or endometrial ovarian cancers that you monitor?"

4. "What is the typical recurrence pattern for my histology, and how does that inform surveillance?"

5. "Should I have any imaging now at the 2-year mark, or do you plan to continue clinical monitoring only?"

6. "If I remain asymptomatic with normal CA-125, what's the long-term surveillance plan (years 3-5)?"

Red Flags Specific to Your Histology

Beyond general ovarian cancer symptoms, watch for:

• Pelvic or abdominal pain (clear cell can recur in peritoneum)
• Persistent bloating or distension
• Changes in bowel habits
• Unexplained weight loss
• Any vaginal bleeding (given endometrial component)

The Bottom Line

Your normal CA-125 + 2-year remission is reassuring, but your specific histology (clear cell + endometrial) deserves specialized attention from an oncologist experienced with less common ovarian cancers.

NCCN Guidelines note that LCOC may have limited approved therapeutic options and different natural histories, so surveillance should be individualized based on your specific pathology.

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Important Questions to Bring to Your Next Visit

Since you have a mixed histology, ask your oncologist:

• Do they have specific expertise with clear cell and endometrial ovarian cancers?
• Should you be followed by a gynecologic oncologist with LCOC experience?
• Are there any clinical trials for LCOC surveillance or recurrence prevention?

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.

Sources: NCCN Guidelines Version 3.2025 — Ovarian Cancer/Fallopian Tube Cancer/Primary Peritoneal Cancer (Principles of Pathology section on Less Common Ovarian Cancers)