One of the key milestones in my awareness campaigns occurred when I featured as a guest blogger for one of the biggest cancer ‘support’ organisations in the world – Macmillan.

The aim of the blog ‘Sorry I’m not in service’ was actually to highlight the consequences of cancer and its treatment (a Macmillan Campaign message), and to a certain extent to highlight the conflict that can often exist between work and cancer. However, it was also a fantastic opportunity for me to grab the interest of the general population with the word ‘Neuroendocrine’.  The response was amazing and on twitter it was one of Macmillan’s most retweeted posts over that period.  The Macmillan Facebook post was also very popular and still rising with around 500 likes and around 40 shares so far.

There are some great comments on the post and the one which stuck out most is now the title of this blog article. I’ve always thought the ‘anatomy’ factor was a strong awareness message for Neuroendocrine Cancer and I outlined this in an article I wrote last year entitled ‘The Human Anatomy of Neuroendocrine Cancer’.  There are not many cancers that have the anatomical reach of Neuroendocrine Cancer –  the ‘suckers’ can indeed get everywhere!

Although there are common areas for Neuroendocrine Cancer to pop up, there are also many rare locations.  I was, therefore, both astonished and delighted when the Macmillan Facebook post brought together two people from UK diagnosed with a NET of the nasal cavity, an extremely rare location for any cancer.

Why is the potential distribution of NETs so wide?  Neuroendocrine Cancer is nearly always formed in the diffuse neuroendocrine system, which is made up of neuroendocrine cells found in the respiratory and digestive tracts. The respiratory tract includes the bronchial tubes and lungs. The digestive tract starts at the mouth and ends at the rectum. Neuroendocrine cells are also found in the endocrine glands, such as the adrenal glands, pancreas, thyroid, parathyroid, and pituitary. These cells are also found in the ovaries and the testes.  However, these ‘little suckers’ have a propensity to spread (metastasize) and can end up in even more obscure sites throughout the body.  When you carry out a bit of light research in reputable areas plus taking into account their metastatic tendencies, you end up with a list like this:

Small intestine (small bowel)

Lung (including the pulmonary pleura)

Pancreas

Appendix

Stomach

Large intestine (large bowel or colon)

Rectum

Adrenal Glands

Liver

Gallbladder

Bile Ducts

Kidneys

Spleen

Ovaries

Uterus

Testicles

Prostate

Seminal Vesicle

Parathyroid

Thyroid

Tongue

Cheek

Larynx

Thorax

Bronchus

Oesophagus

Thymus

Pituitary

Pineal

Brain

Breast

Epicardial

Eye – including Retro-orbital (situated or occurring behind the orbit) and the choroid (vascular structure supplying the outer) 

Mesentery (keeps the small intestine in place against the abdominal wall)

Abdominal wall

Peritoneum (lining of the abdominal cavity)

Retroperitoneum (behind the Peritoneum)

Nasal Cavity

Skin (Merkel cell)

Bones in general

Sacrum – the large, triangular bone at the base of the spine

Lymph Nodes – mainly in the area of the Mesentery, Peritoneum, Retroperitoneum, Chest Wall; but also in distant locations such as axillary (armpit) and supraclavicular (collar-bone area)

Bladder wall

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Did I miss any?  Feel free to add!