Ovarian Cancer

Respected sir, i am valsala of age 57yr old lady having to kidas elder gril and younger boy ............ here with i am giving my case summery .a case of ca overy underwent TAH with BSO and Infracolic omentectomy in 2007 (for post menopausal bleeding) found to have left overy granulosa cell tumour.took 4 cycles of chemotherapy with Carboplatin and Etoside followed by this operation.after that on november 2008 recurent ovarian cancer occured and debulking of the ovarian tumer done.Findings: no peritoneal fluid. small intestinal loop were adherent to the anterior parieties. 7*5*4cm size tumor deposits present over the antimesentric border of sigmoidcolon which is also adherent to the ileoaecal region and to appendix tumor has cystic and hard areas. tumer deposits were adherent to anterior wall of urinary bladder. multiple small serosal nodule present over the small intestinal mesentry and pouch of douglos. on september 2009 due to pain on abdomen a USG of abdomen and pelvis done and impression are :heptomegaly with fatty change, well defined hypoechoeic lesin with cystic areas one in Lt lumbar region,2 in Rt lower abdomen. possibilities of recurrence cannot be ruled out suggested biopsy correlation. another lesion similar to overy seen posterior tp urinary bladder in midline. AND MY DOCTER RECOMMENDED HORMONAL THERAPY AND PRESCRIBED TAMOXIFEN. SIR SHALL I CONTINUE THIS DRUG AND WHY THIS RECURRENCE OCCUR FREQUENTLY. WHAT TYPE OF TREATMENT SHOULD I FOLLOW