The Colon Club

Hello ,
" Mostly necrotic tumor consistent with recurrent adenocarcinoma " that was the biopsy results which at first I thought could be a little good news I mean dead cells in a tumor has to be good right ? Oncologist says no that it's common to see necrotic tumors with cancer which sucks big time and then old Dr Google is really scary today saying that it means the tumor is outgrowing it's blood supply and that means it's aggressive with poor prognosis . Which the oncologist didn't say none of and since we got to wait until the middle and end of the month for more appointments with radiation oncologist I am freaking out . If it's so aggressive why are they waiting so long to start treatment ? It really makes no sense to me .
So looking for someone who knows about or has had a necrotic tumor to try to get more information about what it really means as far as my dad's cancer . Should I be pushing to speed things up ? Is it common to see necrotic tumors with rectal cancer ? Any help really at this point I will take I got to stop googling stuff online feel like I am losing it .

Partially necrotic tumors are common because a lot of them outgrow their blood supply. Also the new blood vessels they grow are usually leaky and don't deliver blood very well. That's one thing Avastin (bevacizumab) does--it reduces the leakage and normalizes the blood flow, which is actually a good thing since it means the other chemo (it is not used alone) can access the tumor better.

I don't recall when this tumor was found on your father but it was fairly large, correct? My husband has a tumor in a very similar location, against the sacrum. I am going to try to talk them into using radiation on the remnant. His surgeon said that there are a lot of blood vessels there so surgery isn't an option, but radiation works. However, it puts the small intestine at risk. His tumor has shrunk dramatically on folfiri/bev which should make radiation safer. Have they discussed trying to shrink his tumor before radiation?

catstaff wrote:Partially necrotic tumors are common because a lot of them outgrow their blood supply. Also the new blood vessels they grow are usually leaky and don't deliver blood very well. That's one thing Avastin (bevacizumab) does--it reduces the leakage and normalizes the blood flow, which is actually a good thing since it means the other chemo (it is not used alone) can access the tumor better.

I don't recall when this tumor was found on your father but it was fairly large, correct? My husband has a tumor in a very similar location, against the sacrum. I am going to try to talk them into using radiation on the remnant. His surgeon said that there are a lot of blood vessels there so surgery isn't an option, but radiation works. However, it puts the small intestine at risk. His tumor has shrunk dramatically on folfiri/bev which should make radiation safer. Have they discussed trying to shrink his tumor before radiation?

My dad's tumor was microscopic left over from surgery however in watching and waiting after for five months to be sure there was some left it has grown to 6 cm . Is a necrotic tumor more aggressive then since it is outgrowing it's out blood supply ? Also leaky that seems bad to have leaky blood vessels does that cause complications ? They have discussed doing chemo and radiation together for my dad they also say the small bowel is at risk . But that's a good idea I may bring up doing chemo first to try and shrink it .

How did they know there was a microscopic leftover? Margins weren't clear? Margins were supposedly clear on my husband but he still got a similar recurrence, though his may be a lymph node. I am not sure whether it automatically means it's aggressive if it outgrows its blood supply. I suppose it does indicate it's growing rapidly; but nearly all large tumors will have some necrotic areas.

Leaky vessels may be bad but it's what you get; the vessels a tumor induces to grow are abnormal.

There was no particular plan to shrink my husband's mets for radiation because I don't think there was a plan to use radiation on them. I am just going to try to argue to get rid of the largest ones entirely. The others were very small lymph-node mets, too small to biopsy or to be obvious on CT. I am hoping they can be managed with chemo.

catstaff wrote:How did they know there was a microscopic leftover? Margins weren't clear? Margins were supposedly clear on my husband but he still got a similar recurrence, though his may be a lymph node. I am not sure whether it automatically means it's aggressive if it outgrows its blood supply. I suppose it does indicate it's growing rapidly; but nearly all large tumors will have some necrotic areas.

Leaky vessels may be bad but it's what you get; the vessels a tumor induces to grow are abnormal.

There was no particular plan to shrink my husband's mets for radiation because I don't think there was a plan to use radiation on them. I am just going to try to argue to get rid of the largest ones entirely. The others were very small lymph-node mets, too small to biopsy or to be obvious on CT. I am hoping they can be managed with chemo.

Surgeon said she left some in cause it was up against the tailbone so she was sure there was some left on the tailbone but this spot isn't on the tailbone exactly but she says it was the spot she left alot of questions still . Margins showed it was right up to the margin so yeah I guess they where not clear . My dad's is still one tumor no mets yet but his liver numbers are out of whack so I suppose that could mean he does have a met not sure about that yet . Another question is your husband's considered stage 4 then ? There not sure what to make of my dad's cause it's still the original spot but it's up towards the abdominal lining . Oncologist actually told me there not sure if it's considered stage 4 or not it's hard to say .

My husband is Stage IV due to the lymph-node spread. The source of the tumor near the sacrum is unclear; it could be a lymph node. He had clear margins for the surgical specimen.

As far as I know local recurrences are not considered Stage IV but they have their own problems, and anything left behind can seed further spread. But it may not spread beyond that.

Thanks for the replies catstaff just wish there was more info about there about necrotic tumors alot of info says it is a sign of aggressive cancer that usually spreads . But all the info I can find doesn't say anything about rectal cancer it says other kinds . And my dad's cancer hasn't spread and oncologist says it seems to be relatively slow growing . Since his next appointments to set up treatment aren't until 16th and 25th then I assume treatment will start after that I am worried about the waiting cause his liver numbers are already up hoping that's from his steatosis .

worriedson, if you would do a signature it would really help the rest of us follow what is going on with your father.

boxhill wrote:worriedson, if you would do a signature it would really help the rest of us follow what is going on with your father.

No idea how to do that lol can you explain how please ?

Go to your use control panel, under Profile, there's an "Edit signature" tab

I don't think there's a tumor classification for necrotic, so I'm not sure that it's a super important distinction from a clinical standpoint.

My colon cancer tumor was necrotic, but I only know that because I read the full surgeon's report; it was buried in the body of the report. It hasn't been mentioned anywhere else.

Jannine, thank you for mentioning the surgery report. It slips my mind every time when appt comes around. I wrote it down this time to get it.