Ronny Allan - Ronny Allan - Living with Neuroendocrine Cancer

03Oct 2023 by Ronny Allan No Comments

Who needs a gallbladder anyway?

We can survive without a gallbladder, but clearly it is a useful, functioning organ, and we are better off to keep it if we can. There are times when things can go wrong such as gallstones, sludge and blocked ducts, and then it may need to be removed. However……even though there wasn’t really anything wrong with my gallbladder in 2010/2011, I was convinced it had to go. For info, gallstones incidence in the general population makes it considerably more common than NETs so it follows that some NET patients will have a gallstone issue totally unrelated to their NET. Gallstones are thought to be caused by an imbalance in the chemical make-up of bile inside the gallbladder. Bile is a liquid produced by the liver to help digestion. For some,…

02Oct 2023 by Ronny Allan 3 Comments

Neuroendocrine Cancer Clinical Trial – Lutetium-177Lu (Satoreotide)

Clinical Trials and Research

What is Satoreotide? It's an agonist treatment. i.e. a 'next generation' radiologand for Peptide receptor radionuclide therapy (PRRT) or more specifically the radiopharmaceutical that binds to both activated and unactivated somatostatin receptors which are upregulated on these tumours. There is far higher binding via this mechanism than standard octreotate. The technical name of the radiopharmaceutical is Satoreotide tetraxetan lutetium-177 (author's note, I'm guessing but it could be a variant of Lanreotide). Somatostatin type 2 (SST2) receptor is overexpressed in many around 80% of NETs, some NEC and in certain hard-to-treat cancers such as small cell lung cancer (SCLC) and neuroblastoma, an aggressive, rare type of cancer that occurs mainly in young children. It was once named JR11 when owned by Ipsen (see history below). The term 'antagonist' is important and…

30Sep 2023 by Ronny Allan No Comments

A review of September 2023 on RonnyAllan.NET – Living with Neuroendocrine Cancer

Newsletters

On my website RonnyAllan.NET, September was an interesting month because I had pushed out some blogs before I went on a planned overseas holiday from 6th - 25th Sep and then pushed out some more on return. This had the effect of producing higher figures than August. Normally holidays mean lower figures. I'm thankful to those who supported these posts, some of which will no doubt appear below. I continue to interleave personal life via short motorhome breaks and maintenance of my blog and other social media sites. It's tough to keep up sometimes but I'm thankful to the loyal supporters who are on my blog site and the other sites day and night. I am very grateful. Below, I'll list the top 10 performing blog posts in September, I…

29Sep 2023 by Ronny Allan 3 Comments

Never mind the Bollocks – here’s the cancer

Awareness, Living with Neuroendocrine Cancer, Patient Advocacy, Treatment

I don't tend to share some very personal stuff, but this is on the boundary of that rule and there are some important messages to be teased out. For those who follow my blog in detail, you may remember the post entitled "Neuroendocrine Cancer - Signs, Suspicions, Symptoms, Syndromes, Side-Effects, Secondary Illnesses, Comorbidities, and Coincidences" (now named "a difficult jigsaw) As you can see from the title above, I got hooked on a bunch of 'synonyms' that represent the difficulty in sorting out what can be attributed to Neuroendocrine Tumours (NETs) and what might be something else. You'll note they all begin with the letter 'S' except 'Comorbidities' and 'Coincidences'. However, these 2 were actually retrospective add-ons to the blog title and there is a potential overlap between both. Life…

28Sep 2023 by Ronny Allan No Comments

First and only FDA-cleared, fully automated chromogranin A assay

A Spotlight on NENs - Testing Series, Clinical Trials and Research, Patient Advocacy

There has been controversy about the utility of Chromogranin A for many years now. Specialists have been critical about its use but to be fair even those less critical still confirm that alone it would not be trusted to formally diagnose Neuroendocrine Cancer. That said, it was still controversial when certain US guidelines were updated to recommend it is not regularly tested. It's well known for being a sensitive but non-specific marker for most tumours of Neuroendocrine type, the non-specificity is mostly due to the other conditions, some of which are highly prevalent in many countries, including but not limited to the use of proton pump inhibitors, heart disease and kidney disease. Another criticism has been the lack of faith in using it to assess reaction to treatment.I have to say,…

27Sep 2023 by Ronny Allan No Comments

Neuroendocrine Cancer: Question, Clarify, Confirm

Patient Advocacy

One of the many observations I make in my private Neuroendocrine Cancer Facebook group is the misunderstandings caused by the use of non-standard terminology combined with a lack of understanding of what is up to date or not. And I don't always mean a misunderstanding by patients. If I am to believe doctors uttered some of the often-quoted words and phrases provided by patients from anecdotal conversations or from a letter or report, then it is clear that some doctors are out of date. I attempted to pin this down in my much read "10 questions to ask your specialist" but perhaps this post will supplement this list extending it to any doctor at any type of appointment, not just diagnosis. If your doctor or pathology report says you have…

25Sep 2023 by Ronny Allan No Comments

Clinical Trial – Lutathera NETTER-2 Important Update

Clinical Trials and Research, Treatment

UPDATE - Sep 25th, 2023 - Novartis radioligand therapy Lutathera® demonstrated statistically significant and clinically meaningful progression-free survival in first line advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs)Phase III NETTER-2 trial met primary endpoint of improvement in progression-free survival (PFS) and key secondary endpoint of objective response rate (ORR) in patients with Grade 2 and 3 advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) who received first line treatment with Lutathera® in combination with long-acting octreotide, versus high-dose long-acting octreotide alone. Lutathera is the first radioligand therapy (RLT) to demonstrate clinically meaningful benefit in a first line setting. Findings to be presented at an upcoming medical meeting and discussed with regulatory authorities, with submissions to follow What this great news means for NET patients is not yet clear, but the implications suggest a first line…

10Sep 2023 by Ronny Allan No Comments

Lanreotide: Ipsen injection devices vs generic injection devices

Treatment

Whenever I get a chance to talk to a pharma involved in somatostatin analogue injection devices, I tell them one very important thing ...... "To the patient, the injection delivery is almost as important as the drug". I also add that my opinion is based on thousands of comments about the patient experience in my patient online group. My own experience is based on the use of Sandostatin Acetate (Octreotide) daily shots (the ones where you break an ampule open and suck the drug into the syringe etc). I was pleased to see some later developments in this area such as the BYNFEZIA PEN. However, the use of octreotide daily shots was a short-term solution to prepare me for surgery and this was followed by monthly somatuline autogel (Lanreortide) which I…

06Sep 2023 by Ronny Allan 17 Comments

Cancer doesn’t take holidays (but I do)

Inspiration, Living with Neuroendocrine Cancer

Glen Etive Scotland in 2018 [caption id="attachment_2911" align="alignleft" width="300"] Mt Jacinto near Palm Springs[/caption] After diagnosis in July 2010, with the exception of a planned holiday to Turkey prior to my 'big surgery', holidays were put on the back burner, there were too many problems and too many risks - not least of which was the lack of overseas insurance cover for my condition. After 2 years of treatment including several surgeries, I was feeling more confident and my body had become stronger, holidays were put back on the agenda, but nothing too strenuous, nothing too far away. We stuck to Europe over the period 2012-2014. However, in 2015, I was getting more confident and managed to get back to one of my all-time favourite places - California. A total…

05Sep 2023 by Ronny Allan 10 Comments

Update from Ronny Allan: No evidence of progressive disease at any site

Diet and Nutrition, Living with Neuroendocrine Cancer, Patient Advocacy, Survivorship

Update August 2023. Latest CT surveillance scan reports “No evidence of progressive disease at any site".Very pleased!With incurable but treatable cancers such as metastatic Neuroendocrine Cancer, 'Stable' is normally not the end of the matter, for many there is still a long road ahead and that road may not be straight or flat. The long road may be considered an advantage by some given that with very aggressive cancers, incurable can frequently mean terminal. The surveillance must continue in case of a recurrence.It's important to understand that 'Stable' simply means the disease is "under control" with tests and scans showing the cancer hasn't changed over time. One of the disadvantages of 'incurable but treatable' is that Quality of Life (QoL) can in many cases be compromised due to the consequences…

04Sep 2023 by Ronny Allan 12 Comments

Exercise is Medicine

Inspiration, Survivorship, Travel with Ronny

Exercise is medicine. Clearly I need to be careful with that statement given my aversion for cancer myths. However, those who know me will totally get where I'm coming from, they will know that there is no way I am saying it cures cancer. What I am saying is that the vast majority of doctors will tell you exercise is good for us but like me they must realise that it sometimes takes quite a bit of effort to get out there and do some! Apparently the older you get, the harder it becomes (I can confirm this is true!). I did write about this in 2014 when I was doing an A to Z of terms way back then - notice the difference in quality of blog template!!! (Exercise…

03Sep 2023 by Ronny Allan No Comments

Jimmy Buffett 1946-2023 – Neuroendocrine Carcinoma (Merkel Cell Carcinoma)

Awareness

US singer-songwriter Jimmy Buffett, best known for his 1970's hit Margaritaville, has died aged 76. "Jimmy passed away peacefully on the night of September 1 surrounded by his family, friends, music and dogs," said a statement on his website. The cause of death has been given as Merkel Cell Carcinoma, a type of Neuroendocrine Carcinoma of the skin. Read more about Merkel Cell Carcinoma on Dana Farber - click here Many people in US and elsewhere will have heard of Jimmy and love his music. I vividly remember going into the Jimmy Buffett's Margaritaville in Universal Orlando Resort CityWalk and found his music very pleasant to listen to. RIP Jimmy, your name and music lives on! https://youtu.be/ohDqjRGqpIU Disclaimer I am not a doctor or any form of medical professional, practitioner…

03Sep 2023 by Ronny Allan 4 Comments

Passive patient or active advocate?

Awareness, Inspiration, Survivorship

I've been researching Neuroendocrine Cancer for some time now. Why do I do this? Whilst I have a great medical team, I'd also like to be my own advocate and this means understanding what medical people tell me! Moreover, I don't want to be a passive patient, I want to be an active advocate for my own health. I found this infographic on the internet which sums up my own views nicely (special thanks to Know your Own Health Ltd). [caption id="attachment_1938" align="aligncenter" width="500"] Passive vs Activated Patient[/caption] I actually enjoy researching neuroendocrine disease and I'd like to think it was all in one book somewhere - this simply isn't the case! From what I've read since diagnosis, I suspect the 'all encompassing' book would need to be about 10…

02Sep 2023 by Ronny Allan 5 Comments

Childhood Cancer Awareness Month – Neuroendocrine Cancer (featuring Elizabeth)

General

September is Childhood Cancer Awareness Month! The newspapers and social media will no doubt be featuring many childhood cancer articles. You may not see one about NET though. I personally cannot begin to imagine what it must be like to be a parent who has a child with cancer. I would just hope my child would be placed into the care and safe custody of experienced medical teams and would be able to get access to the best treatments available. I don't know that much about Childhood cancers, but I do know that over half of childhood cancers are either Acute Leukaemias or Brain Cancer, both of which are frequently in the news. It always breaks my heart when I read stories of children with cancer. I do know a…

31Aug 2023 by Ronny Allan No Comments

A review of August 2023 on RonnyAllan.NET – Living with Neuroendocrine Cancer

Newsletters

On my website RonnyAllan.NET, August was as quiet as July but in the second half, I accelerated publication of some posts. The month was also helped by the publication of a solid tumour clinical trial and the breaking news of the CABOZANITINIB trial for NETs (if you missed those see below). I continue to interleave personal life via short motorhome breaks and maintenance of my blog and other social media sites. It's tough to keep up sometimes but I'm thankful to the loyal supporters who are on my blog site and the other sites day and night. I am very grateful.Below, I'll list the top 10 performing blog posts in August, I can assure you there is some great information in there, and you may have missed some of my newest…

30Aug 2023 by Ronny Allan 16 Comments

Is your glass half empty or half full?

Inspiration, Living with Neuroendocrine Cancer

Most people have probably heard of the saying "is your glass half empty or half full". If you said 'half empty', you have more of a pessimistic view on life; if you said 'half full', you tend to have more of an optimistic or positive outlook. I don't think a positive outlook actually means you permanently wear 'rose tinted glasses' and act like everything is fine. I think it just means you approach potentially negative situations in a more positive and productive way. I agree that sometimes it’s hard not to veer into negative thoughts or actions from time to time. I'm only human and I've been in some dark places since diagnosis. However, I believe to continuously be in 'half empty mode' can have a detrimental effect on your…

28Aug 2023 by Ronny Allan 1 Comment

Neuroendocrine Cancer – normally slow but don’t be fooled!

Awareness

An awareness post from Ronny Allan. There are a lot of scary diseases in this world but some of them are particularly sneaky. One such sneaky disease is the lesser-known type of cancer that infiltrated my body - Neuroendocrine Cancer. Not only is it scary and sneaky, but it's also cunning, devious, misleading, and double-crossing. It likes nothing better than to play tricks on you. Don't be fooled, it's the great pretender. It will grow in your body without you knowing. It finds places to hide, mainly the small intestine, appendix, lungs, stomach, pancreas, rectum, and a host of other places. It can be fiendishly small to avoid being seen. Once it's established in the primary location (....or locations), it will try to break out via your blood and lymphatic…

27Aug 2023 by Ronny Allan 15 Comments

Diagnosis – I’m no longer in control

Awareness, Survivorship

The clouds are gathering. Diagnosis. The dreaded moment when you're looking at an Oncologist and waiting to be given some news. I'd been to a routine annual Asthma clinic, referred to my General Practitioner (GP), referred to a specialist, had a bunch of tests, and now referred to an Oncologist. There were many hints along the way, but it did not reduce the out of body experience I was having that day. This happens to other people but not me. I felt in control. Rewind 2 months to May 2010...... I was happily working, getting stuff done, making things work. I had sufficient autonomy and freedom of manoeuvre. I felt in control. I'm happy as a pig in the proverbial! My annual Asthma clinic comes along and it's an opportunity to work…

26Aug 2023 by Ronny Allan 1 Comment

Phase 3 CABINET Clinical Trial – Cabozantinib for Advanced Neuroendocrine Tumours

Clinical Trials and Research

BREAKING NEWS - 24TH AUG 2023 Exelixis Announces Remarkable Efficacy in CABINET Trial for Advanced Neuroendocrine Tumors On August 24, 2023, Exelixis made an exciting announcement regarding the Phase 3 CABINET pivotal trial. This trial focused on evaluating the effectiveness of cabozantinib in treating advanced pancreatic and extra-pancreatic neuroendocrine tumors. The CABINET trial was a significant undertaking, involving multiple centers and enrolling a total of 290 patients who were divided into two groups. The trial progressed smoothly, but to everyone’s surprise, it was stopped early. The reason for this premature conclusion was the remarkable improvement in efficacy observed. The Alliance for Clinical Trials in Oncology independent Data and Safety Monitoring Board unanimously recommended ending the trial due to these unprecedented results. "CABINET trial will be unblinded and stopped early due…

26Aug 2023 by Ronny Allan 16 Comments

Living with an incurable cancer – does mind over matter help?

Inspiration, Living with Neuroendocrine Cancer, Patient Advocacy, Survivorship

When I started blogging in 2014, it was relatively easy - all I needed to do was to talk about my own experience to help raise awareness of Neuroendocrine Cancer; then talk about my hike along Hadrian's Wall for a local Charity. This blog you are reading now was only ever intended to be a temporary supporting tool for that hike and its build up; but I was persuaded by good reviews and viewing numbers to keep it going. That suddenly made it more difficult!In my early blogs, there were several 'no go areas' which were either too complex or potentially controversial. I didn't really have much time to think them through properly at that point in time. However, over time, I started to realise the important of some of these…

21Aug 2023 by Ronny Allan 2 Comments

Piss off cancer, you’ve been annoying me for 13 years but I’m still here!

Awareness, Inspiration, Patient Advocacy, Survivorship

Actually it has been bothering me for more than 13 years, I just didn't know what was bothering me in the lead up. On 26 July 2010, had you said I'd be writing this 13 years later, I would have said no. I was diagnosed on 26th July 2010. However, as things progressed, as treatment was administered, and as I got used to living with Neuroendocrine Cancer, I eventually became more confident about living longer than I initially thought. 10 years was a bit of a stretch target, I guess it can be more elasticated than you initially think. Think great doctors, better treatments, better guidelines and sprinkle some luck on top. Some might say attitude helps but clearly scientific proof might be lacking there. One thing though, everyone is…

18Aug 2023 by Ronny Allan No Comments

Blood pressure – The NET Effect

The NET Effect Series

Blood pressure (BP) is a commonly discussed subject in my 8600 strong group. But when you look at the prevalence of elevated BP beyond nationally stated thresholds (hypertension), it's patently obvious that many people with a NET will have elevated BP issues regardless (see figures below). Nonetheless, patients often attempt to link it to NET, even when a diagnosis of NET comes after their hypertension diagnosis, although this is possible sequence in certain scenarios covered in this blog post. I also noted there were several causal sources of hypertension but with many other contributory factors. The aim of this blog post is to look at known linkages to elevated BP and NETs. Prevalence of Hypertension Clearly differences will emerge from country to country and region to region, but I found they…

12Aug 2023 by Ronny Allan 2 Comments

Lung cancer diagnosed early because of new tool

Clinical Trials and Research, Patient Advocacy

I'm a believer in science overtaking mortality figures and there is evidence of that already happening when you read the latest survival figures. But too many are still succumbing to this killer disease. I also believe that artificial intelligence (AI) has the potential to help. Even with cancers of the lung, where known causes are heavily linked to death rates, are decreasing but that is mainly due to preventative measures such as stopping smoking. However, not all cancers of the lung are caused by smoking. Most low-grade Lung NETs is a good example, there are others. I've had a flurry of initiatives appear in my inbox in the last month or two and wanted to document those here. These may not have an impact on you currently but a sign…

05Aug 2023 by Ronny Allan 2 Comments

The Cancer Legacy of Steve Jobs?

Awareness, Clinical Trials and Research

Just about everyone knows who Steve Jobs is but not many people have heard of Reed Jobs. Clearly a relative and is actually his son. Now aged 31, he wants to get into the cancer business via a venture capitalist initiative. The headline below looks great but it means cancer, not just Neuroendocrine Cancer (note the use of Steve Jobs' actual diagnosis). I first heard about this and switched off after the news article stated that Steve Jobs had Pancreatic Cancer. Don't get me wrong, I strongly believe that Pancreatic Cancer needs lots of attention and lots of funding and research. But so does Neuroendocrine Cancer including the actual cancer that Steve had, a Neuroendocrine Tumor of pancreatic origin. The article which brought back my attention to the usual Steve…

05Aug 2023 by Ronny Allan 3 Comments

Still here, just reshaped

Inspiration

The tallest tree in Wales had been damaged by a storm and was supposed to be cut down, but chainsaw artist Simon O'Rourke - Tree Carving found a better solution to symbolize the tree's last attempt to reach the sky. I suspect you could also call Simon a tree surgeon. I was reshaped too! In one of my diagnostic stories, I said that my body was slowly dying and that was just how it felt having been diagnosed with something that had not made some grand announcement. It slowly just crept into my life, occasionally giving small clues that it was there but nothing that pointed to a stage IV cancer that could not be cured. I guess that is what happens to many people and without screening for just…

02Aug 2023 by Ronny Allan No Comments

Phase 1 Clinical Trial AOH1996 for the Treatment of Refractory Solid Tumors

Clinical Trials and Research

Facebook Twitter Pinterest WhatsApp Email The City of Hope-developed small molecule AOH1996 targets a cancerous variant of the protein PCNA. In its mutated form, PCNA is critical in DNA replication and repair of all expanding tumors. Here we see untreated cancer cells (left) and cancer cells treated with AOH1996 (right) undergoing programmed cell death (violet). (Photo credit: City of Hope) This particular clinical trial for solid tumours has been widely reported in the news this week (July/august 2023). It is touted as a "cancer-killing pill" has appeared to "annihilate" solid tumours in early research - leaving healthy cells unaffected. Whether these are the words of the sponsor or the media is not clear. Some of the media wording may have been based on preclinical data on animal testing. The new…

31Jul 2023 by Ronny Allan No Comments

A review of July 2023 on RonnyAllan.NET

Newsletters

On my website RonnyAllan.NET, July was a bit quieter mainly due to my holiday and other commitments. However, there was still significant support within and without the community. Below, I'll list the top performing blog posts in July, I can assure you there is some great information in there, and you may have missed some of my newest blogs which made it to the top 10. Number 1 is the story of US Representative Joaquin Castro, great diagnostic story and showing signs of being vocal about NET and the US healthcare system to a much wider audience - this is great awareness too! Bonus photos of our walk in Dartmoor at the end. Best wishes to Joaquin Castro Do not miss this story [caption id="attachment_44523" align="aligncenter" width="640"] Click on the…

26Jul 2023 by Ronny Allan 4 Comments

13 years – I’m still here!

Awareness, Inspiration, Patient Advocacy, Survivorship

I finally made 13 years since I was diagnosed on 26th July 2010. A milestone I was not certain at the time I would reach. However, as things progressed, as treatment was administered, and as I got used to living with Neuroendocrine Cancer, I eventually became more confident this was a possibility with the help of Chris my wife of 48 years. I was fortunate that my cancer was not that aggressive although it was aggressive enough over an unknown period of time (probably years) to have grown inside my small intestine and mesentery, reached an army of lymph nodes, and settled in my liver and beyond including, strangely, in my left armpit. It was incurable, and unique to serotonin secreting midgut Neuroendocrine Tumours, it had caused a dense fibrotic…

24Jul 2023 by Ronny Allan 2 Comments

Sometimes you gotta climb that hill, even if you get wet!

Inspiration, Patient Advocacy, Survivorship

Sometimes you gotta climb that hill, even if you get wet is another metaphor post. Earlier this month in July 2023, Chris and I set off to climb a hill on Dartmoor. The weather was unpredictable, and we anticipated getting wet alongside the physical effort needed to climb Cox Tor. We spent an hour steadily climbing up an approach path just to get to the base of Cox Tor and it had already rained twice at this point. The clouds were moving fast over our heads, dropping their rain each time. We still had to climb to the top and it was steeper than the first hour of the walk. I won't lie and say it never crossed my mind to cut this bit of our walk out and head south on…

23Jul 2023 by Ronny Allan No Comments

A tumour-finding probe improves the ‘effectiveness of surgery in Gastrointestinal neuroendocrine tumours

Clinical Trials and Research, Patient Advocacy, Treatment

A major challenge that cancer surgeons face currently is that there are no reliable methods to identify the tissue type during surgery (other than fast tracking tissue sampling). The surgical procedures, therefore, rely extensively on the experience and judgment of the surgeon to decide on how much tissue to remove around the tumor margins. Sometimes this can result in the removal of excessive healthy tissue. On the other hand, not removing some tumour cells can often need a follow-up surgery to remove residual cancer tissue. This just adds to patient morbidity and long-term detrimental effects on the patient’s outcome. The use of tumour finding probes is not new and scientists have been looking at this for a number of years. Some healthcare commentators described some of these tools as working in…

19Jul 2023 by Ronny Allan No Comments

Biopsies – tissue is the issue!

Patient Advocacy

Biopsies for suspected cancer 13 years ago on 19th July 2010, I had a liver biopsy. Following some low hemoglobin and some weight loss reported to my GP surgery in May, I met with a specialist on 8th July and after sending me straight for a CT scan on the same day, I eventually had to have a liver biopsy done to confirm the cancer. I won't lie and say it was an enjoyable experience. I vividly remember a lot of discomfort including pain. At the time no-one knew I had metastatic Neuroendocrine Tumours; no-one knew I had associated carcinoid syndrome. I suspect that may have played a part in the discomfort of that important procedure. The doctor carrying out the biopsy had several assistants in the room and sent for…

18Jul 2023 by Ronny Allan 1 Comment

A person with Cancer fell into a hole and couldn’t get out……….

Awareness, Patient Advocacy, Survivorship

A person with Cancer fell into a hole and couldn’t get out. As a colleague walked by, the person called out for help, but the colleague yelled back, "Suck it up, dig deep and get on with it" then threw the person a shovel. The person accepted that advice and dug that hole deeper.A manager went by, and the person called out for help again. The manager shouted down "Use the tools your colleague has given you", but then threw down a bucket adding to the tools available. The person used the tools to dig the hole deeper still and filled the bucket.A healthcare professional walked by. The person called, “Help! I can’t get out!” so the healthcare professional gave the person some drugs and said, "Take this it will…

17Jul 2023 by Ronny Allan 2 Comments

NET Specialists, Multidisciplinary Teams (MDT) and Centres of Excellence

Awareness, Living with Neuroendocrine Cancer, Patient Advocacy, Treatment

NET Specialists, Multidisciplinary Teams (MDT) and Centres of Excellence - a summary from Ronny AllanWhat is a NET Specialist?"What is a NET Specialist" is a frequently asked question but there's no official definition of what constitutes a "NET Specialist", and it may differ from country to country/from region to region. Similarly, many people ask what makes a doctor an expert and that is a difficult question but let's just say specialist and expert are the same thing given there is no exam or special qualification to become one. In the broadest sense, a NET Specialist is a doctor who is not only knowledgeable about NETs but is also experienced in treating and managing this type of cancer. It is someone who sees a lot of NET patients in their clinics and…

04Jul 2023 by Ronny Allan 2 Comments

Best wishes to Joaquin Castro

Awareness

Who is Joaquin Castro? I have an international following so many people outside of USA may not know much about Joaquin Castro. He is an American lawyer and Democratic politician who has represented Texas's 20th congressional district in the United States House of Representatives since 2013. The district includes just over half of his native San Antonio. He was diagnosed with a Small Intestine NET in July 2022 after an incidental finding while he was working in Spain. His car hit a boar on a highway the night before he was due to fly home to the US. He was taken to hospital for a check up. The hospital spotted some abnormalities in his scan and advised him to visit his doctor on return to US. One year later, he…

01Jul 2023 by Ronny Allan No Comments

Summary of June 2023 on RonnyAllan.NET

Newsletters

Summary - June was a relatively quiet month on my website RonnyAllan.NET - mainly due to me being on holiday for much of it! However, a respectable 18,000 blog views are not to be sniffed at! The top 10 for June are now listed. Take a look please, open them up, read them, share them. 1 Sometimes, you gotta climb that hill, even if it hurts (ronnyallan.net) This must have struck a chord. It's not a story about physical fitness, it's a metaphor about the mental challenges of living with cancer. [caption id="attachment_43915" align="aligncenter" width="640"] Click on the picture to read[/caption] 2 Currently trending on RonnyAllan.NET - Ronny Allan - Living with Neuroendocrine Cancer My post for busy people to catch up. [caption id="attachment_43009" align="aligncenter" width="640"] Click picture to read…

10Jun 2023 by Ronny Allan 6 Comments

Sometimes, you gotta climb that hill, even if it hurts

Inspiration, Patient Advocacy, Survivorship

I started my "sometimes you gotta climb that hill" series/campaign some years so. I used it as a metaphor based on my own experience of actually climbing up hills. In the first couple of years after diagnosis, there was no way I could have done some of the physical stuff I can do now - having 3 surgeries and recovering from all 3 put paid to that. But in hindsight, I don't believe I could have done some of these hills before I was diagnosed! To be bluntly honest with myself and you guys, I was too busy at work to keep myself in shape. The "climbing hills" metaphor can also be applied to living with a diagnosis of cancer - there are many metaphorical hills to climbOne of the first…

07Jun 2023 by Ronny Allan No Comments

A spotlight on duodenal Neuroendocrine Neoplasms (dNENs)

A spotlight on NENs - Types

What are Duodenal Neuroendocrine Neoplasms (dNEN)?The duodenum is technically part of the small intestine, and you can find that in most anatomy-based descriptions. One of the research references I used was titled "Somewhere between the pancreas and the small intestine" and in the case of Duodenal NENs (dNENs), I can understand why they adopted that unconventional anatomy description. I suspect they contextually meant that they are not like either of these organs, but they share some similarities. They are not normally treated like small intestine NETs (SI NETs) or pancreatic NETs (pNETs) but they share some relationships, particularly wth the latter. They are also closely aligned to the stomach (Gastric NENs) in terms of symptoms and syndromes that they sometimes present. Although they are a type of NEN (i.e. dNENs), they can…

06Jun 2023 by Ronny Allan No Comments

Neuroendocrine Cancer: Awareness is key, but it must be the right message

Awareness, Patient Advocacy

Let me start by saying that Neuroendocrine Cancer awareness is in a better place than it was when I was diagnosed in 2010. But it should be further forward, much further forward. In some areas, we appear to be going backwards.It's not where it should be because some people, some organisations (including some so-called advocacy organisations) and even some healthcare professionals, insist on hanging on to old ideas which are sending the wrong message. One example is a recent ASCO publication where the authors suggested the perceived rarity of NETs is holding back clinical research (the same publication also stated that NETs are uncommon but definitely not rare).It's no secret that I have been fairly 'pushy' in this area for some years now, and I will continue to push and…

04Jun 2023 by Ronny Allan 2 Comments

Summary of May 2023 on RonnyAllan.NET

Newsletters, Patient Advocacy

Summary May produced the best statistics in 2023, mainly due to your support for my blog post on Maria Menounos whose announcement headlined as "Pancreatic Cancer" caused a storm within the Neuroendocrine Cancer community. Below, I'll list the top performing blog posts in May and no secret which one is listed first. Repeat after me: Maria Menounos has Neuroendocrine Cancer (ronnyallan.net) [caption id="attachment_42595" align="aligncenter" width="640"] Click picture or heading to read more[/caption] Clinical Trial: Novel Somatostatin Receptor Subtype 2 Antagonist Labelled With Terbium-161 (161Tb-DOTA-LM3) (Beta plus) - (ronnyallan.net) [caption id="attachment_42803" align="aligncenter" width="640"] Read more by clicking on the picture or the heading above[/caption] The Human Anatomy of Neuroendocrine Cancer - Ronny Allan - Living with Neuroendocrine Cancer [caption id="attachment_42728" align="aligncenter" width="640"] Click to read more on the picture or the…

03Jun 2023 by Ronny Allan 1 Comment

Getting back in the saddle

Inspiration, Living with Neuroendocrine Cancer, Patient Advocacy, Survivorship, Travel with Ronny

The "getting back in the saddle" metaphorI thought back about a few periods since my diagnosis on 26th July 2010 about how I would 'get back in the saddle'. I suspect many cancer patients experience similar junction points in their own journeys. After I was told about my metastatic Neuroendocrine Cancer, work was my anchor, something that I felt comfortable and in control, so in effect that was my metaphoric saddle in the early days. But as my treatment came into view, particularly major surgery, clearly new thoughts about how quickly I could get 'back into the saddle' were on my mind. In fact, one of the first questions I asked my surgeon was "how much time off do I need before I can drive and also go to work". …

01Jun 2023 by Ronny Allan 2 Comments

Clinical Trial: Phase 1/2a Study of 23ME-00610 in Patients With Advanced Solid Malignancies (incl Neuroendocrine Neoplasms)

Clinical Trials and Research

Who are 23andMe?I personally had not heard of 23andMe but many people in North America might have. When you first look at what they do, you can be excused for thinking they are just another 'Ancestry' company, but they are more than that. They also get involved in genetics and health. To quote their marketing "we’re all of these things". Read more here: About us - 23andMe But what I found most interesting is that they have a clinical trial involving Neuroendocrine Tumors using their product 23ME-00610. However, an analysis of the documentation available indicates it is aimed at Grade 3 both well and poorly differentiated. Also includes small cell lung cancer (SCLC) and Merkel Cell Carcinoma. The results from this clinical trial were presented at a recent conference and I will…

24May 2023 by Ronny Allan No Comments

A spotlight on Chromogranin A

A Spotlight on NENs - Testing Series, Patient Advocacy

What is Chromogranin A? Chromogranin A (CgA) is an acidic protein released along with catecholamines from chromaffin cells and nerve terminals. This statement alone might explain why it's a good marker to use with Neuroendocrine Neoplasms. It is said to be a measure of tumour bulk. Depending on the test kit being used, you may also see test results for Chromogranin B (CgB) alongside CgA. CgB is said to be less affected by false positives and forms a useful adjunct to the more established chromogranin A measurement. The brand of test kit which includes CgB tends to be confined to Europe. Immunohistochemical Testing. CgA is one the most commonly used immunohistochemical (IHC) markers for neuroendocrine cells and their tumours. You may find the mention of CgA in your biopsy reports…

18May 2023 by Ronny Allan No Comments

Neuroendocrine Cancer: Catch them early, not late!

Awareness, Patient Advocacy

Diagnosing Neuroendocrine Neoplasms (NENs). It's no secret that Neuroendocrine Neoplasms (NENs) can be difficult to diagnose, particularly well differentiated slow growing types (NETs) which can sometimes be difficult to see. Plus, many patients present with relatively routine day to day symptoms suggesting a myriad of day-to-day illnesses seen daily in every GP/PCP practice. But conversely, many are found incidentally while checking for something else, or in reaction to a visit to the ER/A&E or as a referral by primary care physicians for further checks at secondary facilities. A few examples: 1. Most appendiceal NETs are found when patients present with pain in the right lower quadrant i.e. symptoms of appendicitis. The resulting appendectomy will find the tumour. However, it's true to say that most appendectomies will be connected to appendicitis…

12May 2023 by Ronny Allan No Comments

A spotlight on Rectal Neuroendocrine Neoplasms

A spotlight on NENs - Types, Awareness, Patient Advocacy

What are Rectal NENsRectal Neuroendocrine Neoplasms (NENs) (rNENs) account for approximately 1-2% of all primary cancers in the rectum. The other main cancer types found in the rectum are regular adenocarcinomas (the vast majority) and some other rare types including Gastrointestinal stromal tumors (GIST) and Lymphoma. The vast majority of rNENs will be well differentiated, i.e. rectal Neuroendocrine Tumours (rNETs) and are mostly indolent tumours treated effectively with surgical procedures if less than 1cm in size. Above that size there are different scenarios. Most will be found incidentally upon presentation of classic rectal symptoms or via colonoscopy screenings and faecal tests which lead to colonoscopy follow ups. They are typically diagnosed in older patients but the incidence in younger patients is on the increase, see author's note below in epidemiology section. Poorly differentiated…

10May 2023 by Ronny Allan No Comments

Clinical Trial: Novel Somatostatin Receptor Subtype 2 Antagonist Labelled With Terbium-161 (161Tb-DOTA-LM3) (Beta plus)

Clinical Trials and Research, Treatment

A new clinical trial post.What is Terbium-161 (161Tb-DOTA-LM3) (Beta plus).Terbium-161 is a radioactive substance. DOTA-LM3 is a novel somatostatin antagonist targeted using somatostatin receptor number 2 (SSTR2). Combined they form a radioligand for use in Pepetide Receptor Radionuclide Therapy (PRRT). It's a beta emitter but labelled 'plus' on the basis it offers more than the currently approved Luthera product (lutetium 177 or 177Lu Dotaxxx series). There is evidence that terbium-161 (161Tb) is more powerful than 177Lu, not only in combination with SST2 agonists but particularly with SST2 antagonists.Agonist vs Antagonist in the context of PRRTThe currently approved Luthera product (lutetium 177 or 177Lu Dotaxxx series) are SST2 agonists. SST2 antagonists are more efficient because they can access more binding sites on the cell surface, resulting in higher tumour uptake and…

03May 2023 by Ronny Allan 3 Comments

Repeat after me: Maria Menounos has Neuroendocrine Cancer

Awareness

Like many people from outside USA, I don't really know anything about Maria Menounos. For those in the same boat, let me confirm she is a very well-known personality in USA. A journalist, television presenter and actress. She has hosted Extra and E! News; she was a TV correspondent for Today, Access Hollywood, and co-hosted the Eurovision Song Contest 2006 in Athens, Greece. She also co-created and is currently CEO of online podcast series network AfterBuzz TV. She is currently signed to WWE where she has served as an ambassador since 2013. She hosts the podcast 'Conversations with Maria Menounos'. She also has an impressive website here. All in all, she looks like an impressive and inspiring person. News broke today that she survived "Pancreatic Cancer" and that headline is currently…

01May 2023 by Ronny Allan 1 Comment

Summary of April 2023 on RonnyAllan.NET

Living with Neuroendocrine Cancer, Newsletters

Summary of RonnyAllan.NET website activity in April 2023 The top 10 most read posts in April are included below as the main product of this summary of my website RonnyAllan.NET in April 2023. A challenging month given other commitments and a rib injury sustained on holiday but pleased with my output. I hope there is something you missed and can catch up here. As usual, share this with anyone you think may benefit. Many thanks for reading. Oh yes, it's the great pretender - a new entry A new RonnyAllan.NET awareness campaign and it deserves to be shared to the world (oh yes!) as it may lead to a diagnosis. If this floats your boat - Click here or on the picture. [caption id="attachment_41518" align="aligncenter" width="640"] Click picture to read more[/caption]…

28Apr 2023 by Ronny Allan 2 Comments

A spotlight on 5-HIAA

A Spotlight on NENs - Testing Series, Patient Advocacy

Background. It's important to note that not every type of Neuroendocrine Neoplasm will get the same tests due to the heterogenous nature of this cancer type. Some are more specific than others. A wide range of tests may be necessary at diagnosis if the type of NET is not clear. This post will cover one of the main tests to check for a common type of Neuroendocrine Tumour (NET) that is known to secrete excess amounts of the hormone Serotonin leading to symptoms indicative of Carcinoid Syndrome. These tumours are often labelled using the antiquated and misnomer term ‘Carcinoid Tumour’ but more and more healthcare organisations and specialists are avoiding use of this term for several reasons. Mainly because the word has been 99% removed from the widely accepted World Health Organisation…

24Apr 2023 by Ronny Allan 5 Comments

The NET Detectives

Awareness, Patient Advocacy

The NET Detectives is an awareness post.Detecting NETsIn general, it's probably true to say that Neuroendocrine Tumours (NETs) are difficult to diagnose. Some are more complex than others and their heterogeneity is legendary. In many cases, they can be quiet, and imaging is key in finding them if they are big enough to be seen. As most primary care facilities (e.g. General Practitioner (GP) offices) don't have a range of imaging devices on site, referrals are often necessary to investigate more. I don't believe it's right to say this referral is a misdiagnosis, it's just another stage in the investigation, another hunt for clues.The number of cases where incidental diagnoses occur is fairly significant in certain types. I have no numbers but appendiceal NETs are a good analogy. Symptoms are…

23Apr 2023 by Ronny Allan No Comments

Low FODMAPs – The NET Effect

Diet and Nutrition, Patient Advocacy, The NET Effect Series

Background Many people with NET have had issues prior to diagnosis and then continue to have similar issues after. For some it will be either one, i.e. no issues before but issues after or vice versa. However, it's even possible that some people have will have different issues after diagnosis than they had before, e.g. the side effects of the treatment will produce new problems for those people. In the early days, I once said to my Oncologist "I was never misdiagnosed with irritable bowel syndrome (IBS) but I sometimes feel like I have it now". IBS is said to affect up to 1 in 7 of the 'western' population in varying degrees of severity with the symptoms of abdominal pain and abnormal bowel habits (constipation, diarrhea or a mixture…

Author: Ronny Allan