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Cavity in middle of tumor


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My father had his first pet after avastin taxo/carbo combo had started. Avastin every other week. Had 20 radiation treatment ranging from july to end of august. CT scan beginning of sept showed some shrinkage.

The latest CT scan showed that there was a hollow cavity in the middle of the original tumor. Anyone else have any experience with this? the tumor remained the same size but there was a strange cavity in the middle that the onc. could not really explain, anyone have any info?

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Ask Dr.West:


I think it may be that the avastin is killing the tumor from the inside. It goes after the blood vessels to the tumor and so the tumor may be starved for blood and so is dying from the inside out. Also, I think avastin goes to the center of the tumor to do its work.

Sometimes a big tumor, in excess of 5 cm, will cavitate because the blood supply can no longer support a huge tumor. I had a cavitating 7 cm by 5 cm by 4 cm at my last PET/ct scan 8-31-07. The docs think it is just too big to keep the center alive. I am not on and have not used avastin.

Don M

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  • 3 weeks later...

That type of response with a cavity in the middle of the tumor is classic for what you often see with avastin. There is some debate about whether having a cavitary lesion increases the risk of developing a bleeding complication on avastin, but right now it's not standard practice to discontinue avastin if cavitation develops. It may be that cavitation before treatment starts is really associated with squamous cancer, or in some way that cavitation before chemo/avastin is more worrisome than cavication after treatment starts. We don't really know all of the details yet.

-Dr. West

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