Re: Tumor Necrosis
Tumor Necrosis
Dear N.Ruehl,
With all due respect, taking a diagnosis like this and asking on the web is very similar to taking one's medical records to each passerby on the street. That is to say, your doctors should have explained all of this to you, and not left you at the mercy of the kindness of strangers.
That said, none of us have any real idea about your outcome and prognosis. How could we? Even with all the pathology reports, all your labs and all clinically relevant medical history it is very difficult to make any sort of accurate prediction about medical outcomes.
I took a few moments to check medline for outcome studies, which I am attaching and which may or may not be relevant to you. That you are here on the web is proof to me that you would benefit from a second opinion, and your use of alternatives means you might benefit from an integrated opinion from N.D.s and M.D.s, perhaps from someplace like Cancer Treatment Centers of America (no, I don't get money for mentioning them. They just happen to have N.D.s on staff).
Oh, from an armchair, I would say that you need ongoing surveillance of the tumor, checking to see if the necrosis is resulting in the death of the tumor, or an ever expanding area of regular cell death. Only that would give you the answers about progression and future risk of bleeding. All things are possible, but you are badly in need of some clear guidance by someone who can go over your complete medical history and give you some definitive answers.
I hope this is helpful.
Christopher Maloney, Naturopathic Doctor
Augusta, Maine www.maloneymedical.com.
Informational only, I cannot treat or diagnose via the web.
I can give you research, and research is available on my site.
I have no affiliation with Naturopathic Medicine Network, I just post because someone needs to.
Zentralbl Gynakol. 1985;107(17):1050-6. Related Articles, Links
[Therapeutic vascular embolization in life-threatening gynecologic hemorrhages]
[Article in German]
Banaschak A, Stosslein F, Kielbach O, Bilek K, Elling D.
Report on 12 women with acute massive or chronic tumor hemorrhage, treated with embolisation. There were 7 women with cervical cancer T3/T4, 3 women with adenocarcinoma (2mal primary progressive, one with metastases in lymph-nodes), one woman with progressive malignant mesenchymale tumor in vagina and one with local persistent ovarian cancer. In 10/12 cases hemorrhage stopped immediately after embolisation. In 3 cases, after one-sided embolization, repeated procedure of the contralateral vessel was necessary. In 2/12 cases side-effects like fever and subileus, and, in one case, complications like skin necrosis and bladder-vagina-fistula were seen. In all patients temporary improvement of life-quality were found. Low risk and good tolerance of this palliative therapy are emphasized.
PMID: 2414947 [PubMed - indexed for MEDLINE]
Gynecol Oncol. 1993 Jan;48(1):80-7.
Squamous cell carcinoma of the vagina: a review of 70 cases.
Dixit S, Singhal S, Baboo HA.
Department of Radiotherapy, Gujarat Cancer & Research Institute, Ahmedabad, India.
Seventy cases of squamous cell carcinoma of the vagina registered between 1985 and 1989 were analyzed. The overall 2-year disease-free survival was 33%. Stagewise 2-year survivals were as follows: stage I, 100% (8/8); stage II, 70% (7/10); stage III, 19% (8/42); and stage IV, 0% (0/10). Incidentally, 60% of the cases presented below 50 years of age, and the majority of these were in advanced stage (p < 0.02). Due to the relatively greater number of cases of advanced disease in the elderly age group treated with external radiotherapy alone, a significant survival difference between the two age groups was not apparent (P > 0.10). External radiotherapy alone yielded poor results. External radiotherapy in combination with brachytherapy in the form of either vaginal cylinders or uterine tandems with vaginal cylinders resulted in 42 and 50% 2-year disease-free survivals, respectively. Advanced stage, more than two-thirds to full vaginal length involvement, and multiple vaginal wall involvement were found to be poor prognostic factors. The majority of cases had tumor grades 2 and 3. No association between tumor grade and survival was observed. To improve survival, downstaging of the disease through routine gynecological checkup, even in premenopausal women, and delivery of high doses through a judicious combination of external radiotherapy and brachytherapy are needed.
PMID: 8423026 [PubMed - indexed for MEDLINE]
Gynecol Oncol. 1992 Jan;44(1):24-7. Related Articles, Links
Long-term survival and sequelae after surgical management of invasive cervical carcinoma diagnosed at the time of simple hysterectomy.
Kinney WK, Egorshin EV, Ballard DJ, Podratz KC.
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905.
From 1956 to 1988, 27 women (median age, 60 years) found to have occult invasive carcinoma of the cervix at total hysterectomy underwent radical reoperation consisting of radical parametriectomy, upper vaginectomy, and pelvic lymphadenectomy. Residual disease was present at reexploration in 4 (15%) of the 27 patients: in the pelvic lymph nodes in 2, in the parametrium in 1, and in the vagina and a para-aortic node in 1. All patients were followed a minimum of 18 months; there were no deaths within 3 months of operation. However, 2 (7%) of the 27 patients developed ureterovaginal fistulas. Recurrent disease was observed in 6 (22%) of the patients: 2 had successful salvage procedures, and 4 died of disease, all within 4 years of reoperation. Recurrence correlated with the presence of residual disease at reoperation and with nonsquamous histologic findings. At a median follow-up of 8.4 years, 23 of the 27 patients were alive and disease-free. The 5-year absolute survival estimate (Kaplan-Meier) was 82%. Radical reoperation can be performed safely in selected patients who have early-stage invasive carcinoma of the cervix at the time of total hysterectomy with the expectation of an acceptable rate of long-term disease-free survival.
PMID: 1730422 [PubMed - indexed for MEDLINE]