StageIV adenocarcinoma lung cancer lymph node question - 1256351

wantvictory
Posts:16

I have been staged as above and was just told the 4RL lymph node is 3CM and necrotic in the center.
It was the one biopsied for diagnosis.
What cause the necrosis and is it good or bad. I've heard both yes and no.

I understand ( I think) necrosis is good for tumor because it's dying, but not sure about lymph node.

Please clarify.

Thanks so much,
1st time user on your site,
want victory

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JimC
Posts: 2753

Hi want victory,

As Dr. West has said, in the context of lymph nodes:

"Necrosis means that it is likely a node that was involved by cancer, but the cancer has been killed there by the treatment (radiation and chemotherapy). I don’t know what can specifically be said about it — I believe it’s fair to presume that this is an area that was involved by the cancer initially, but the hope is that it was eradicated by the treatment." - http://cancergrace.org/topic/necrosis-in-the-neck#post-1250932

Hoping that is what has happened in your case.

JimC
Forum moderator

wantvictory
Posts: 16

Thank you Jim,
I searched for necrotic nodes and could not find any thing!

This helps except for the fact that I had not yet started treatement at the time of that scan.
This was the node that made the diagnosis. Could dead tissue make a diagnosis? Maybe the biopsy damaged the node and caused necrosis?
Could it mean my own immune system could have caused it to become necrotic in the center?
If necrosis is only in the center is the entire node dead/dying? So many questions about 1 node!

Dr West
Posts: 4735

To my knowledge, there aren't any major implications of a necrotic node. Necrosis in the center of a cancer, whether it's the primary tumor, involved lymph node, or a metastasis, just signifies that the cancer was growing fast enough to outgrow its blood supply, so it dies in the center, where blood flow tends to be lowest. Therefore, it suggests a relatively faster growing cancer, but that doesn't mean people can't do well -- sometimes the faster growing cancers are more responsive to chemotherapy and radiation. The overall stage and other factors are still the more dominant prognostic variables, and of course a huge one is response to treatment, which remains to be seen.

Good luck.

-Dr. West