### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Gynacologist has identified my disease as Uterus cancer before the Surgery and the Oncologist has confirmed as Ovarian cancer on the 2nd of October 2009. It was stage IV and grade III. I underwent Laparotomy surgery (both uterus & ovarian removed) and then followed by chemotheraphy. I have completed all 6 chemos on the 10 of Feb 2010.My CA 125 report before the Surgery is 2750 U/ml, 3 weeks after the surgery is 385 U/ml(ie,before chemo), before the fourth chemo is 32.9 U/ml and after the 5th chemo is 15.4 u/ml.(it should be less than 21 according to the Lab.After that my CA 125, ultra sound scan and blood reports were normal up to Jan 11. CA 125 reading is 76.90 as on 02/04/11. went for CT scan (chest, abdomen and pelvis) on 18/04/11 and the impression is as follows:Enlarged fatty liverLarge incisional hernia of bowelno features of a recurrent or residual tumour.CA 125 is 112 as on 04/05/11. do I need to go for chemo or PET scan? it is not available in Sri Lanka. how can I do it at Adaiyar cancer hospital. pl guide.

### output:

Hi, Thanks for writing in. You have a large incision hernia of the bowel probably through the laparotomy area. This is important to be repaired surgically and if required with the insertion of a wire mesh to contain the bowel and prevent hernia. Your CA 125 is constantly increasing as seen in the last two reports. Doing a PET scan is important to know if there is any hidden suspicious cancer activity that is not visible on the CT scan. PET scan shows areas with high glucose metabolism and this usually refers to areas where there is increase cell multiplication like a cancer. Chemotherapy can be started after PET scan confirms any cancer activity. Please do not worry.