Thursday, October 14, 2021

Pancreatic cancer is one of the most lethal malignancies in the world, Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells.



Pancreatic cancer is one of the most lethal malignancies in the world, with mortality rates being close to the incidence rates. The incidence rates of pancreatic cancer is 3%.1,2 Most patients with pancreatic cancer are diagnosed at the advanced stage due to the deficiency of a standard program for screening patients at a high risk of pancreatic cancer,leading to a poor prognosis with a 5-year survival rate of <7%. Therefore, it is very important to clarify the mechanisms of pancreatic cancer progression and develop novel therapeutic strategies to improve the overall survival of affected patients.

VHL in pancreatic cancer has remained elusive.


Not only Irrfan Khan and Steve Jobs fought neuroendocrine cancer I am fighting it too


Neuroendocrine tumors (NET) are tumors arising from neuroendocrine cells in the body and are found in the gastrointestinal tract, and less commonly pancreas, lungs,thymus and thyroid C-cells. There has been a recent increase in the prevalence of the NETs, which is attributed to better diagnostic procedures. NETs were thought to be slow growing benign tumors in the past but almost all NETs are now considered to have malignant potential.


KEY POINTS


The plan for cancer treatment depends on where the NET is found in the pancreas and whether it has spread.


There are three ways that cancer spreads in the body.


Cancer may spread from where it began to other parts of the body.




Treatment of pancreatic NETs is based on the following:




Whether the cancer is found in one place in the pancreas.


Whether the cancer is found in several places in the pancreas.


Whether the cancer has spread to lymph nodes near the pancreas or to other parts of the body such as the liver, lung, peritoneum, or bone.




Cancer may spread from where it began to other parts of the body.


When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.


Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.


Pancreatic neuroendocrine tumors, known as PNET, are also called islet cell tumors. They are a type of neuroendocrine cancer that starts in the pancreas. There are different kinds of PNET. Some PNET make and release different hormones. They also vary in size and how fast they grow.



PNET are different from other types of pancreatic cancer, because they form from neuroendocrine cells in your pancreas. Neuroendocrine cells are part of your body’s normal “control system.” When your brain and nervous system send messages, neuroendocrine cells release hormones and other chemical messengers to control bodily functions, like digestion, reproduction, airflow to the lungs, and responses to stress or injury.   



There are many subtypes of PNET; most are slow growing, but some may be aggressive.



The most common type of pancreatic cancer, adenocarcinoma of the pancreas, starts when exocrine cells in the pancreas start to grow out of control. Most of the pancreas is made up of exocrine cells which form the exocrine glands and ducts. The exocrine glands make pancreatic enzymes that are released into the intestines to help you digest foods (especially fats). The enzymes are released into tiny tubes called ducts which eventually empty into the pancreatic duct. The pancreatic duct merges with the common bile duct (the duct that carries bile from the liver), and empties into the duodenum (the first part of the small intestine) at the ampulla of Vater.



Endocrine cells make up a smaller percentage of the cells in the pancreas. These cells make important hormones like insulin and glucagon (which help control blood sugar levels), and release them directly into the blood. Pancreatic neuroendocrine tumors start in the endocrine cells. See Pancreatic Neuroendocrine Tumor for more about this type.


A neuroendocrine tumor (NET) begins in the specialized cells of the body’s neuroendocrine system. These cells have traits of both hormone-producing endocrine cells and nerve cells. They are found throughout the body’s organs and help control many of the body’s functions. Hormones are chemical substances that are carried through the bloodstream to have a specific effect on the activity of other organs or cells in the body. Most NETs take years to develop and grow slowly. However, some NETs can be fast-growing. See the Grades section to learn more.



NETs can begin in any part of the body, including:



Gastrointestinal (GI) tract. NETs develop most commonly in the GI tract, specifically in the large intestine (20%), small intestine (19%), and appendix (4%). The GI tract plays a central role in digesting foods and liquid and in processing waste. GI tract NETs used to be called carcinoid tumors. Learn more about NET of the GI tract.



Lung. The lung is the second most common location of NETs. About 30% of NETs occur in the bronchial system, which carries air to the lungs. Lung NETs also used to be called carcinoid tumors. Learn more about NET of the lung.



Pancreas. Approximately 7% of NETs can develop in the pancreas, a pear-shaped gland located in the abdomen between the stomach and the spine. Pancreas NETs used to be called islet cell tumors. Learn more about NET of the pancreas.


A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body if it is not found early and treated. A benign tumor means the tumor can grow but will not spread. A benign tumor usually can be removed without it causing much harm.



It is difficult to tell if pheochromocytoma and paraganglioma are benign or malignant, even after surgically removing the tumor and examining it under a microscope. The only sure way to know if a pheochromocytoma or paraganglioma is malignant is if it has spread, called metastasis, or if it comes back, called a recurrence.



Pheochromocytomas and paragangliomas are considered a subset of a group of tumors called neuroendocrine tumors (NETs). A NET begins in the specialized cells of the body’s neuroendocrine system. These cells have traits of both hormone-producing endocrine cells and nerve cells. They are found throughout the body’s organs and help control many of the body’s functions. Hormones are chemical substances that are carried through the bloodstream to have a specific effect on the activity of other organs or cells in the body. All NETs have the potential to become metastatic. Most NETs take years to develop and grow slowly. However, some NETs can be fast-growing. 



A pheochromocytoma is a rare NET of the adrenal glands. The body has 2 of these small, yellowish glands. One is on top of each kidney. Adrenal glands have 2 main parts that function separately: the outer adrenal cortex and the inner adrenal medulla. Each part produces a different set of hormones.



A pheochromocytoma begins in the chromaffin cells of the adrenal medulla. The cells release hormones called catecholamines during times of stress. Adrenaline and noradrenaline, which increase blood pressure and heart rate, are 2 of those catecholamines. A pheochromocytoma can cause uncontrolled surges of extra adrenaline and noradrenaline into the blood. Even though an estimated 90% of pheochromocytomas remain localized to the area they began, these hormone surges can still lead to life-threatening health problems, such as a stroke, heart attack, hemorrhage, or sudden death.



Most people develop a pheochromocytoma in one adrenal gland. Some people develop a tumor in both glands. There can also be multiple tumors in a gland. Pheochromocytomas usually grow slowly.



A pheochromocytoma is called a primary adrenal gland tumor because it starts inside an adrenal gland.



A paraganglioma is a rare NET that develops from the same type of cells that pheochromocytomas do. However, paragangliomas form outside the adrenal glands. These tumors are also called extra-adrenal paragangliomas. The majority of paragangliomas form in the abdomen. They can also form in other parts of the body, including near the carotid artery, along nerve pathways in the head and neck, and in the chest, heart, abdomen, pelvis, and bladder. Paragangliomas are less common than pheochromocytomas. An estimated 60% remain localized and 40% may spread, though that cannot be determined at the time of diagnosis or from the pathology evaluation.


NETs can start in different parts of the body. Like all cancers, NETs are named after the place they start growing. For example, a NET that starts in the lung is called a lung NET. This is the primary cancer. If the cancer spreads to another part of the body, it’s called secondary cancer. 


Around 5 out of every 10 NETs (50%) start in the digestive system. This is also called the gastrointestinal (GI) system. It includes the:


  • stomach

  • small and large bowel

  • pancreas

  • back passage (rectum)

  • Around 2 out of every 10 NETs (20%) start in the lung. NETs can also start in other places such as the:


  • food pipe (oesophagus)

  • appendix

  • skin

  • prostate

  • womb

  • adrenal, parathyroid and pituitary glands


All NETs are malignant (a cancer) by definition. Some NETs are diagnosed early and you might be able to have treatment to cure it.


Money under most circumstances can't buy peace and happiness for you. Your Creator will provide just as much as you need for your own personal sustenance because that is what you deserve, asking for more is being greedy and is a punishable offense. We find everyone running after fame, prosperity, wealth and power which results in daily indigestion and therefore they have built gyms in their premises to work out, not just to build eight-pack abs by shedding out the extra fat but to get rid of menacing indigestion and get a peaceful night's sleep which seems to elude them always.



Our scriptures say


  • Do your duty, but do not concern yourself with the results.


  • The fruits of your actions are not for your enjoyment.


  • Even while working, give up the pride of doership.


  • Do not be attached to inaction.



But people are different these days before doing their duty they are concerned and whining about the effort they have to put in, they desire to bask in the glory of their deeds which makes them choosy... which duty to do… which will fetch them the attention of the world and they take substantial pride in doing something which gives birth to dignity and significance. Sometimes doing hard work which wouldn't fetch money and fame leads to inaction.

Itching and scratching diseases get full attention

My cancer is beyond comprehension

On anti- itching drug shall I focus my attention

Repeatedly scratching is hideous to behold

Mind adopted  with ventues manifold.

Multiple dural based DOTANOC avid enhancing nodular and plaque-like lesions noted bilaterally, largest along right frontal bone measuring approximately 2.1 x 1.0 cm SUVmax 5.23 with adjacent erosion along the inner table of right frontal bone. Other small nodular enhancing lesions noted along left frontal lobe measuring 6 mm SUVmax 

3.78, left temporal lobe 7 mm SUVmax 8.06, right temporal lobe measuring 8 mm SUVmax 

1.73, left parasellar region adjacent to superior orbital fissure measuring approximately 7 mm 

SUVmax 3.97. Few specks of calcification noted in splenic parenchyma.


In a known case of VHL syndrome; PET/CT scan findings reveal multiple DOTANOC avid 

(somatostatin receptor expressing) dural based nodular and plaque-like lesions as 

described.



A protein on the surface of cells that binds to a hormone called somatostatin, which helps control other hormones in the body. Somatostatin receptors are found on many different types of cells, and they may also be found in higher than normal amounts on some types of cancer cells. Knowing the amount of somatostatin receptor in tumor tissue may help diagnose cancer and plan treatment.


Carcinoid is slow growing cancer was Somatostatin analogs: Most neuroendocrine tumors have receptors for the hormone somatostatin. A number of synthetic somatostatin analogs, including octreotide and lanreotide, are available that mimic the action of somatostatin and can be used to treat these tumors. These drugs are usually highly effective in decreasing hormone production and can also help slow tumor growth.

Chemotherapy: Chemotherapy has been used for many years as a treatment for neuroendocrine tumors, and in some cases can be highly effective, particularly for pancreatic neuroendocrine tumors. Drugs that are used include streptozocin and temozolomide.

I am on octreotide

Taking Cyclophosphamide as chemotherapy for metastatic neuroendocrine cancer at BL Kapoor memorial hospital 








https://www.ketto.org/fundraiser/i-need-your-urgent-support-for-my-neuroendocrine-tumors-nets-treatment-516332









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