OPINION. When you’re diagnosed, you go through a whole host of emotions. It’s not just the initial shock, the disbelief, the anxiety and morbid worry produced by the words “you have cancer”, it’s other stuff such as anger and denial. With the latter, the denial normally wears off as you finally accept the predicament.
In hindsight, the anger is interesting because there can be a mixture of thoughts including “why me“, “what could I have done to head this off“; and would you believe I was even angry that my diagnosis was going to affect my performance at work and even my personal credibility. We all react differently but in general terms our experiences can be categorised into 3 main areas: initial reaction, distress and then adjustment.
Initially, I was frustrated I didn’t know what had caused my cancer, perhaps my thinking was that I could warn others. Those feelings soon wore off as I discovered that no-one really knows why people succumb to certain cancers.
If you don’t know what caused your NET, you’re not alone. According to several studies in the past 10 years, around 40% of cancers are preventable indicating that up to 60% might just be plain bad luck. Clearly this figure varies between cancer types with the biggest culprits being Lung and Skin cancer with too much exposure to tobacco and ultraviolet light respectively. However, the reports also pointed out that people can and will still get these cancers without significant exposure to the commonly preventable causes. The latest study is interesting because it raises the issue that some cancers may be totally unavoidable as they are caused by random errors associated with DNA replication. This study remains controversial because it undermines government prevention strategies. There’s a balanced article from Cancer Research UK which is a useful read (interesting quote … “Even if, as this study suggests, most individual cancer mutations are due to random chance, the researchers admit that the cancers they cause may still be preventable”).
Risk Factors for NETs
Not a lot is known about what causes neuroendocrine tumors, so there aren’t many strategies to prevent them. People with certain risk factors are at a higher risk of developing neuroendocrine tumors than others, these risk factors include:
- A family history of multiple endocrine neoplasia (MEN) syndromes and other familial related syndromes.
- Hereditary paraganglioma/pheochromocytoma.
- Von Hippel-Lindau syndrome
- Neurofibromatosis Type 1
- Tuberous sclerosis complex.
- Certain conditions that affect the stomach’s ability to produce stomach acid, such as atrophic gastritis or pernicious anemia (e.g. Type 1 Gastric NETs), or Zollinger-Ellison syndrome (e.g. Type 2 Gastric NETs).
- Smoking tobacco (e.g. Small Cell Lung Cancer (SCLC)).
Risk factors are just risk factors and they do not mean these risks will always materialise into a NET. As for the remainder, will we ever know? Perhaps one day but in my opinion, not anytime soon. Many people claim environment and diet is a risk factor for NETs but there just isnt any evidence to support that. However, one interesting find is a study funded by NET Research Foundation which is designed to discover the molecular causes of a Small Intestine NET (SiNET). In addition, they will investigate potential environmental causes, including epigenomic and infectious causes.
I often think about what actually caused my NET but I no longer worry about what the answer might be. I’m the first to admit I could have led a healthier life (like many others) but even that may not have had any impact or involvement in my cancer diagnosis. There doesn’t seem to be any point worrying because the clock cannot be turned back …..even if I knew, I would still have metastatic NETs. However, if the cause of my cancer was connected to a heredity condition, clearly this would be important to know. That’s only my own opinion though.
Thanks for reading
PLEASE SHARE THIS POST