
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 […]

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 […]

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” […]

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 […]

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 […]
Dear Ronny, I’m going to begin exploring your website for more information but I wanted to introduce myself and thank you for being someone who lends so much support to this community. For starters I haven’t been diagnosed yet. I have lost about 15-17 lbs since Dec. Flushing. First incident I remember was in December when I had a few drinks with friends but I didn’t think much of it at the time. Then I had a single drink in Feb and again flushing. I’m not a big drinker so just decided to not drink anymore. I assumed that my body was changing as I got older and I couldn’t metabolize the alcohol as well. Then recently I noticed I would flush randomly and I had a more pronounced flushing episode after I ate a big fatty steak. Combined with some black specks in my stool and bloating after eating and this sent me online to do some research. I came across this condition called carcinoid syndrome and I felt this sinking feeling as I read about the symptoms… I didn’t think my GI tract could be a problem as I’d just had an endoscopy and colonoscopy in Jan 2020 but what I didn’t realize at the time is that the small bowels are not included in the standard exam.
I went for blood and urine testing. My CgA just came back elevated at 121 ng/mL. The gastrin level was normal. I’m still waiting to find out the results of the 5HIAA test. I was on PPIs for about a week before discontinuing three days before the blood test and I’ve read that that can affect the results so I’m still holding out hope. I’m only 42 years old and this all seems unreal to me. I moved from NYC to Taipei in Sep of last year. I will be qualified for the Taiwanese health insurance on 5/10/2020. If I do have this condition I’m not sure I should stay here or head back to the US. I know there is special enrollment period in the US because of covid so I may be able to qualify for health insurance there. I suspect if I need to have a surgery for this that the US would be a better option since in Taiwan this condition is seems fairly rare and I’d want a surgical team with experience to handle this.
I feel overwhelmed… I’m not sure what my next move is. So far I’ve been battling to get testing done for myself. I’m assuming if all these test results all come back bad then the doctors will treat me as more of priority. What types of tests should I bet trying to receive next? Ga-68 scan? Other biomarkers for hormone imbalances? A biopsy to determine the grade of the cancer? If I have carcinoid syndrome would that rule out grade 3 (I haven’t been able to find out if grade 3 can cause the syndrome and obvious I’m terrified by the possibility of having grade 3 versus grade 1 or 2). How would they determine if surgery is appropriate for me? I’ve read that a big part of it is how badly it’s spread to the liver and that there is curative, debulking or no surgery if it’s really bad. How does one sign up for a surgery? How does one research who the best surgeons are for the procedure? Is there a long waiting list? Would I be expedited if they felt there was a chance for a curative surgery?I’m guessing I’d also need to have my heart examined to see if it’s been damaged before they’d operate on me. Could I first have another treatment option to perhaps knock back the cancer and then they do the surgery after it was shrunken a bit? Is that even possible? Is anyone ever cured of this if it’s spread to the liver by getting the surgery or is this then something which will always be with me? I know I’m just going on and on with questions. My mind is spinning at this point and I’m trying to make sense of this all. On top of that I haven’t told my wife yet so there are personal issues added on top of this. I really have no idea how to have a conversation like this with her (hey babe we need to talk, I have stage 4 cancer uggg) and on top of it her green card process will take over a year for approval since we left the US in a hurry and didn’t complete the process while we were still there. This means that if I need to go back to the US for a surgery I’d be saying good bye to my wife, potential for the last time. And then if I had the surgery and it was successful and I still had this, I’d hope to come back to Taiwan to be with my wife but I’m not sure if they have the medical technology and experience to optimally treat this condition. Anyway, I’m rambling now. Thank you for taking the time to read my rather long message. Any insights or advice are greatly appreciated.
Sincerely,
Don Spanton
You need a scan, CT to start with
“Neuroendocrine Cancer: Diagnosing the Undiagnosed – Ronny Allan – Living with Neuroendocrine Cancer” https://ronnyallan.net/2018/09/07/diagnosising-the-undiagnosed/
You need a scan, CT to start with. PPIs affect Chromogranin A rather than 5HIAA
“Neuroendocrine Cancer: Diagnosing the Undiagnosed – Ronny Allan – Living with Neuroendocrine Cancer” https://ronnyallan.net/2018/09/07/diagnosising-the-undiagnosed/
I am interested in joining your NET group. I was diagnosed with NET last February (2020), had surgery in May 2020 and am currently on lanreotide injections (6 months). However, I am not facebook user and do not want to sign up to facebook. Can I still sign up for your group?
Unfortunately it’s a Facebook group, sorry!
Hi Ronny, my 10 year old son tested with High serotonin in the blood due to tests performed by your allergist.
We got quite worried and traveled to the Arnold Children’s Hospital in Orlando where he was seen by an Oncologist-Hematologist. They performed a Pet Scan Galliun 68 and it came out without evidence of Nets, only with some enlarged lymphatic nodules in the pelvic area, Serotonin in urine normal and normal Chromogranin A (CgA) as well.
The doctor could not tell us the reason for his high blood Serotonin levels.
Any idea what we should do?
He did not indicate any medication for him. He said it was a rare and complicate case. We are looking for a Pediatrics NETs Specialist . Could you recommend us someone?
Thanks
Kelvin
the only one I know about is Dr Sue O’Dorisio (her husband is also a NET specialist) https://medicine.uiowa.edu/pediatrics/profile/m-sue-odorisio
Urine 5HIAA (metabolite of serotonin) is more accurate as serotonin fluctuates throughout the day. I hope this can be cleared up and you have my best wishes
Thanks Ronny. I appreciate your info.
April 21 2020
Hi Ronnie I have just diagnose with Neuroendocrine neoplasm. Did a ct scan it has not gone to any other organs yet. Now am awaiting a second endoscopy for them to try and take out the tumor. But because of covid 19 it’s put on hold. Hoping and praying that it can be done sooner than later.
best wishes, hope you don’t have to wait too long
Best wishes for a quick resolution
Hi Ronny – Newly diagnosed with low grade metastatic NET and awaiting additional results (dotatate PET and possible biopsy) for more information. We have a long way to go and it has been difficult to find clear information out there about. It’s been a strange journey so far for this “you look fine and I feel fine guy”. Your site and social groups are immensely helpful. Thank you.
Thank you, Ronny for everything you do, and I’ve only scratched the surface, and know it’s a lot. I’m recently diagnosed and my journey started on the internet like a lot of folks. When I finally learned the scary, actual search terms, your site was the second one on my google results. I felt like I got a hug, from a friend who just been waiting for me to show up. All ❤️❤️ From West Virgina.
Cheri
What a nice comment! Can I use it in my marketing? Just out of curiosity, who was the first site in your searching?
Thanks Ronny. I an Shlomo from Israel. I participatein MENETS, the local group, led ny Michael Rosenberg.
Your work is big help for our group.
Rhank you very much
Thank you, say hello to Michael!
Dear Ronny,
First I want to use this opportunity to thank you for so wonderfully serving the needs of NET/NEC patients. Being a silent reader I have already received numerous extremely helpful pieces of information from you, and I am very grateful to you for that.
I am writing to you today because being a NEC patient I was recently ready to prepare myself for the final stage of my life as there had not been any promising therapy option left in my case. Things, however, changed from one day to the other thanks to the research by a Japanese team of scientists. These days I am living an almost normal life again.
Previously I received Cisplatin and Etoposide until it was stopped because of too much toxicity, Irinotecan (did not work), Opdivo for 2 months (did not work) and Amrubicin for about 6 months. Thereafter, there were a few treatment options but with limited promise that they would work.
As it happened, however, a Japanese team of researchers found a new therapy by combining Paclitaxel and Ramucirumab. I am receiving this therapy now with very positive results. While I spent most of my time at home until recently because I was getting weaker as a result of my progressing disease I now have hardly any complication in my daily life, and I am slowly but surely regaining the 65 pounds which I had lost before.
A comprehensive summary of the Japanese research results, which are the basis of my current treatment, can be found in “Efficacy and safety of ramucirumab-containing chemotherapy in patients with pretreated metastatic gastric neuroendocrine carcinoma”
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212678/). If you google “paclitaxel ramucirumab nec” you can find a lot more on this.
I can imagine that this therapy may not have the same positive effect in the case of all patients with similar symptoms, but I hope that my case can serve as an addition to the discussions between patients in similar situations and their doctors about the best subsequent therapy.
Kind regards,
Alex
tanks for the info, I will study the drug/trial. Best wishes to you.
Hi Ronny, thank you for all of your amazing info and helping folks! My children’s father was diagnosed with PNET with dual lobe liver mets in Sept 2016. He was seen at Dana Farber and they advised his liver mets were inoperable. He started with Sandostatin inj for about a yr and half. Liver mets got worse so he was started on Captem, did that for 6 months or so but wasn’t working. He also got spinal cord spread (tumor) which was treated in end of 2018. He then was put on FOLFOX for about 3-4 months but that didn’t work. He went to Roswell Park in Buffalo, they did a gallium scan and he did have some lymph node involvement. He now has had a Lutathera treatment June 27, 2019, being the last line of treatment left, having exhausted every other treatment. No one has really told him his “stage”. Thoughts on what to expect? It’s frustrating not even having a clue! Thanks again, Beth
if he has liver and bone mets then he is stage 4. Don’t be too concerned by stage 4 as its not normally the red flag it is with more aggressive cancers. NETs is one cancer where grade is more important than stage. Do you know is Ki67 score or grade?
Hi Ronny,
I wrote once before about my husband and I both having Nets/Carcinoid. I was trying to find out in all your studies have you heard of this before. We even have same locations and same surgeries last year. Any help would be appreciated. Thank you for your articles , they are very informative.
Amazing story. On the basis cancer doesn’t pass from one person to another other than via hereditary, I would say it’s a complete coincidence
I have GI Nets & Carcinoid Syndrome.
I go to Alabama Oncologist in Alabaster, Al.
I take a shot lanreotide injection once a month.
I have been taking shots for this for a year & they are watching me closely. I would appreciate any help you could give me about this.
We spoke elsewhere Evelyn
Can you give me names of carcinoid specialists in N J
https://polldaddy.com/js/rating/rating.js
Links are in here https://ronnyallan.net/2017/04/25/diagnosed-with-neuroendocrine-cancer-10-questions-to-ask-your-doctor/
Hello Ronny, I was diagnosed with NETs in 2015 having had problems dating back to 1990. I had a small bowel resection in 2015 which was discovered by chance. Previously, a tumour was found in my right lung in 2008, which I was not told about till four months later! My problem now, is that I have a negligence case and need to know how I can find out if the one in my lung was the primary and cause of the ones on the bowel. Apart from the Royal Free caring for me now, I don’t know who else or where else to go to get this information. Can you help please. Thank you Anne A.
The only real way to find out for sure is to have your case reviewed by an independent Neuroendocrine Specialist. Therein lies the problem. I cannot think of any other way to categorically prove this. If you wanted a personal view, you could message me on my facebook site.
God Bless you Ronny. My wife is a NET patient (6 mo’s from first surgery), and gets a tremendous amount of encouragement and strength from your blog, and she amazes me with her attitude. Keep up the good work.
thanks John and best wishes to your wife.
Very inspirational, best of luck to you Ronny!
Thank you Linda!
Today while watching the Pasadena Rose parade l texted Dr Woltering stating that it would be very nice to see Him and Dr Boudreaux waving their hands on top of one of those floats celebrating life , and He was very happy with the idea
I think it can be done
What do you think?
great team, hope you get to see them!
[…] NET cancer patient and blogger, Ronny Allen, published a post awhile back entitled, “I’m only as good as my last scan.” That sentiment definitely resonated with me as I never know what to say when people ask me […]
Thanks for the mention ☺
Thank you, I might use this quote in my personal marketing if you don’t mind?
I absolutely love your information. It gives me and my doctor help when needed!
Hi Ronny, why does it always pick on the good guys? Be strong mate and your work in facing up to this and your support for other people going through similar heartache is inspirational. It must ne the RTG training mate!!!! Continue being so positive mate!! Thinking of you, Best Wishes, Paul “Scouse” Downey
Thanks Scouse, a blast from the past! Hope you’re doing OK?
The spirit really makes me impressed!
Hi Ronnie
My husband was diagnosed with oespheagal cancer in Feb this year. This then was diagnosed as Neuroendocrine cancer. We live in the UK and can’t find out anything about this disease. He had had Chemotherapy and Radiation treatment but no sooner has the treatment finished it starts growing back. Do you know of any helpful sites which would give us some more insight into what we’re dealing with. Please. I have tried to contact you via Facebook but I’m not that clued up with computers,
Sorry to hear that Angela. However, in addition to giving you hope, my site can signpost you to the correct areas. My site can also provide you with useful patient centric advice. Firstly, please ‘Like’ this page https://m.facebook.com/NETCancerBlog/
Can you confirm where the Neuroendocrine Tumours are? If I’ve read this correctly, it was oesophagus but then also Neuroendocrine. Or do you mean mis diagnosed with oesophagus instead of neuroendocrine or he has both? Speaking on Facebook messenger is easier, so when you like the page above, please make contact thanks
Hi Ronny, I come from the Czech Republic, I found the link to your blog. I taught English at the school of the German language 🙂 But what I can handle PC, I throw it into the compiler and hopefully it translates correctly. I’m 34 years old and I was diagnosed with a malignant carcinoid tumor 13.8.2015 in the intestine, so far I have hemikolektomii and I’m waiting on further examination, I’m afraid. But your site is a great pity that something like this is not for us. Big thumbs up and greet you from the Czech Republic.Hanka
Big welcome to you Hanka. I hope your treatment is successful. Keep me informed please 🙂
Hanka – google translate now embedded in each article
Thank you so very much for the quick turnaround! Unfortunately I don’t use facebook, but will google “loveablelungnoids” and see what comes up. Feel good!!!!!!!!!
Hi. I was wondering if you are aware of or can direct me to any studies done regarding lung carcinoid tumors. I am particularly interested in where they come from; whether anyone has discovered genetic markers for them; who gets them; recurrence numbers; nutritional and/or homeopathic remedies or suggestions to help stave off recurrence; whether there is a resource specifically for lung carcinoid tumor patients; comparative pathology reports; studies or trials in this arena, etc. Thanks so much in advance for your help!!!!
that’s a wide spectrum of requirements …. however, check out this document. http://www.cnetscanada.org/pdf/Pulminary_nets_Gridelli.pdf
I also suggest you join a specialist lung carcinoid support group who will be able to find other things faster than me! https://www.facebook.com/groups/lovablelungnoids/?ref=ts&fref=ts
Great to see you’re doing well 5 years after your diagnosis! My mom was diagnosed with neuroendocrine cancer in May 2010 and died in July 2010.
Ashley, I’m so sorry to hear about your Mom, particularly as she was only diagnosed a very short time before she passed and as I was myself being diagnosed. Sometimes this type of cancer can be as cruel as more aggressive types and your comment is a timely reminder of that. Feel free to keep in touch. Ronny
Hi Ronny,
I hope you can help me. On Thursday I have been asked to be apart of an ITV piece on cancer. They are interviewing me and I need a clip/ sound bite to describe what I have. Short but sweet. Suggestions please. I hope to do my bit to spread awareness…Thank you. Susan
what type please?
Dr. Wolin, Markey Cancer Center at U.K. (top specialist with Pancreatic Neuroendrocrine Tumors) said if you lined up one million cancer patients, only three would have a PNET.
thanks Sue, he’s not far off. The study which I referred to has a breakdown by type and pNETs are measured approx 0.4 per 100,000 which turns out to be 4 per million as at 2004 (so is likely to be higher today). Clearly pNET is only one type of Neuroendocrine Tumour and the figures quoted are for all types. Yes, as a standalone condition, pNETs are rare. As I said in the blog, the rise in incidence is mainly due to lung, small intestine and rectal NETs increases. I personally think the numbers are potentially underestimated as pNETs are more difficult to detect and diagnoise and some will have been recorded incorrectly as Pancreatic Cancer, however, perhaps less of a problem in USA where recording is much better. Thanks for taking the time to comment!
Husband diagnosed with P NET – at first said it was stage 4 adenocarcinoma (size of a large grapefruit) – no symptoms! On biopsy, said it was good news – P NET with metastases to liver but no where else. We are fortunate to live 100 miles from Un. of Ky. where one of the foremost NET specialists treats patients at the Markey Cancer Center, Dr. Edward M. Wolin. Suggested: First an Octreotide Scan for three days to see if the radioisotope material adheres to the receptors; then if ;yes; Lanreotide monthly and CAPTEM oral chemotherapy, which, he said, has had remarkable success in shrinking NET tumors…and possibly pancreatectomy and splenectomy down the road. I guess this is the “new normal” for us, but a blessing that it wasn’t the adenocarcinoma they thought at first when they said to get our house in order and our bucket list made!
thank you for taking the time to comment. Yes, there is a lot of stories about the diagnostic confusion between pancreatic adenocarcinoma (not a nice cancer to have). Check out “The Anatomy of NET Cancer”.
Sounds like you are in good hands, I’ve heard great things about Dr Wolin. I’m a 4 year Lanreotide veteran and happy to hear husband is on that. I have also heard good things about CAPTEM – in fact I included that in a blog last week – “A deadly cloud……” – check it out. I do hope you will get time to read some of my blogs and also subscribe (Like) to my Facebook page here: https://www.facebook.com/pages/NET-Cancer-Blog/476922399112723
Keep in touch and best wishes to your husband.
Ronny
Ronnie
Great to find your website. Decided to comment for first time ever since diagnosis…..small intestine carcinoid found on routine colonoscopy. No symptoms so this was primary…very lucky for me to have a great gastro guy. Anyway have a great day and keep on blogging!
Dx. May 10, 2014
Ottawa, Ontario , Canada
Thanks Cheryl!
sounds like they caught you early and I hope you continue without problems. I had a colonscopy 20 months before dx but nothing was found, not sure if they did one of those special ones which can check the first part of the small intestine just past the cecum, perhaps not. If you get a chance, please like my Facebook site too…. https://www.facebook.com/pages/NET-Cancer-Blog/476922399112723?ref=aymt_homepage_panel
Ronny
Very happy to read your blog on Facebook today. My 25 year old son Robert, was recently diagnosed the day after Christmas, with stage 4 Carcinoid cancer after being misdiagnosed numerous times. His also started in his small intestine, and spread to his lymph nodes and liver. Best wishes and thank you for sharing.
thank you and I wish your son all the best with his treatment. Look out for future blogs which may be of relevance. Thanks also for liking my new facebook page, this is helping spread the word. Kind regards
Hi Ronny. I believe that collective awareness continues to rise because people have the courage to speak honestly about their experiences. I feel that if by blogging you, me or any of the others out there affected by cancer, can help someone else in making informed decisions or normalizing their experience then we have done a good thing. My personal mantra is all about an alkaline diet and blending traditional and non traditional methodologies in treatment. All the best and I am now a happy follower.
Absolutely Jenny, this is precisely why I do this blog and my mission is to break out of the NET bubble (where everybody knows about it) into the wider community. More likes/ratings/comments/shares and follows will help. Also, I’m starting to see more external hits on my Facebook site http://www.facebook.com/NET-Cancer-Blog-476922399112723 I need to increase my ‘Likes’ so I can break out to the wider community on that media too. Help sharing these links is much appreciated
thank you Jenny!
Hi Ronny, Ed here from http://www.carcinoid-cancer.com. Thank you for the follow. I didn’t know you were a neuroendocrine cancer patient as well. It’s great to find you. Maybe we can compare notes. I’m going to follow you too. 🙂
Thanks Ed, I also setup a Facebook page rhis week https://m.facebook.com/profile.php?id=476922399112723
Good blog Ronny, I hope your blog and mine and the others are successful in raising awareness and helping others with our disease.
Cy
DX May 2011, mid-gut carcinoid with mets in liver. Half of liver removed May 2013. Primary still not located.
Very inspirational Ronny, diagnosed a year last May with Carcinoid that has metastasised in my liver. Still trying to find a treatment that will work for me, lanreotide not helping. My biggest worry is my lack of fitness and how quickly I lost it. So in the short term I am going to try Force Cancer re-hab and try to enjoy what is now a very limited lifestyle.
thank you. I think it’s helpful to consider all aspects of your treatment to date against the efficacy of Lanreotide. For example, if you’ve had abdominal surgery then there are side effects which Lanreotide may not fully counter (in fact the malabsorption issue may be exacerbated) but there are other ways of tackling that. I hope you have a NET centre looking after you? I’ve woken up to my lack of fitness only this year (4 years post diagnosis) and hopefully my latest drive will improve overall quality of life. Get in touch with me via private facebook message or email ronny.allan@sky.com Keep reading my blogs though!
Diagnosed PNET 2013 – partial pancreatectomy, splenectomy and partial stomach resection- metastasized to liver and bowel and abdomen – 2x Y90 to liver – partial success and now monthly Lanreotide – biggest issue is fatigue – working full time but need to exercise- how to get started? I find your blog very helpful – thank you
Tony
Hi Tony – thanks for the comment. Pleased you like my blog, sounds like you’ve been through the mill. Working full time vs exercise vs fatigue is tough. Particularly if your job involves long commutes. I managed it for 4 years until I’d had enough but fortunately I was in a good position to move on. I’m quite interested in the metastasis to the bowel for a pNET – is that the upper part of the duodenum or further away?
I’m glad you’re enjoying my blog and I post even more on my associated Facebook page here: https://www.facebook.com/NETCancerBlog
Hello Ronny! I have a 15 year old daughter that was just diagnosed this summer with Metastatic Carcinoid Tumor Cancer!!! Any feedback will be beneficial to us in learning about this.
Hi Miranda, really sorry to hear that. Can I ask where you are from please?
Hi Miranda – if you want to message me on Facebook, I can make sure you are in the right contact with support groups for your country/area?
Great blog Ronny!
Sharon
Dx 2012, net cancer, small intestines w/liver mets. Stage IV
thank you for the support Sharon, looks like we have similar dx! I got some distant lymph nodes still work in progress but not causing me issues
thanks Terry!
Good luck Ronny!
Good luck Ronnie!