Friday, September 5, 2014

Going to NET conference 9/18-22 in Charlotte

National NET Cancer Patient Conference info and survey!
 
 
        
 
Agenda
THURSDAY
3:00 - 3:30         Affordable Healthcare Reform:  William Maples, MD
3:30 - 3:45   Q & A with Dr. William Maples.
3:45 - 4:15 Emotional implication of NETS treatment:          Ronda Ayala RN    
4:15 - 4:45 Be your own advocate and how to be an advocate for NETS       Judy Goltz, RN
4:45- 5:00 Q & A                                                                                                                 
 
6-9PM               Welcome Reception
 
FRIDAY AM                                              Moderator: Eugene A. Woltering, MD
7:00-7:45 Breakfast
7:45-8:00   Introduction :Bob and Maryann Wahmann from CCAN
8:00-8:40 NETS-Introduction to the basics:                     Richard Warner, MD
8:40-9:20 NETS pathology: What's important and what's not?:               Chanjuan Shi, MD
9:20-9:30Break
9:30-10:00 Midgut NETs surgery. The technical aspects:                               Yi-Zarn Wang. MD
10:00-10:30 Pancreatic NETs surgery. The technical aspects:                    Michael Choiti  MD
10:30-11:00 Does serial cytoreduction of midgut NETS increase survival?:  ugene A. Woltering MD
11:00-11:30 How NETS affects your heart: Current recommendations for on going scanning,
prevention and current therapy of NETS-induced heart disease: HeidiConnollyMD
11:30-12:15 Q & A with panel and moderator
12:15-1:15 Lunch
 
FRIDAY PM                             Moderator: Thomas M. O'Dorisio, MD
1:15-2:00 Clinical trials for chemotherapy/biologic response modifier therapy of gut-based NETS:Edward Wolin,MD
2:00-2:45 Clinical trials for chemotherapy/biologic response modifier therapy of pancreatic NETS.:Emily Bergsland MD
2:45-3:00 Break
3:00-3:30 New approaches to the treatment of NETS induced diarrhea:                                 Sajeve Thomas MD
3:30-4:00   Somatostatin analogs control symptoms and slow tumor growth: Summary of recent trials:   Alexandria Phan MD
4:00-4:30 Update on NETs markers:What, how many and cross-laboratory validation studies: MiaTepper MBA
4:30-5:15 Q & A with panel and moderator
 
  
SATURDAY AM                                                                           Moderator: J.Phillip Boudreaux MD
7:00-8:00 Breakfast
8:00-8:45 The Benefit of Multidisciplinary Teams Treating NETs:           Eric Liu, MD
8:45-9:15 The role of the gastroenterologist in the diagnosis & treatment of NETS: David MetzMD
9:15-9:45Summary of therapy with 177 Lu vs. high dose LAR: The AAA trial:         Richard Campeau MD
9:45-10:00 Break
10:00-10:30   An update on Multi Visceral Organ Transplants (MVOT):                    Rodrigo Vianna M.D
10:30-11:00 My personal experience with MVOT:                                                  Paul Johnson MD
11:00-12:00 Q &A with panel and moderator
12:00-1:00   Lunch
 
SATURDAYPM                                                                                                                                                                                                                                                                                                                Moderator: Richard Warner MD
1:00-1:30 Investigator-initiated trials of 68 Gallium somatostatin analogs:Where are we going?:Thomas M. O'Dorisio MD
1:30-2:00 Update on studies in the risk of familial NETS:                        Steve Wank MD
2:00-2:30 How to scan for NETs: Primary's and their metastasis:                                            DavidBushnellMD
2:30-2:45 Break
2:45-3:15 Vitamin supplements & alternative therapies:How to assess safety & efficacy: Mary Hardy, MD
3:15-3:45 Spheres vs. Chemoembolization vs. Bland embolization- Which is best? :Charles Nutting MD
3:45-4:15 RFA, microwave,c ryotherapy, nanoknife and other invasive therapies for liver metastasis: David Iannitti MD
4:15-4:45 Q & A with panel and moderator
4:45-5:00 Announcement of next National Patient NET conferencein September2016:Eugene A. Woltering MD and CCAN
 
 

Thursday, August 28, 2014

Considering new scan instead of going to conference

The summer continues t be very busy with lots of little trips on the boat and around the region that have been fun and lots of babysitting of grandchildren. all good!

I may go to UCLA in a few months for a Galium 68 scan and skip the September conference on NET's. This scan has previously only been available in Europe but is now being offered in a clinical trial basis for about $2500 not counting travel and lodging. I'll post more details later. in the mean time some symptoms have increased causing me a bit of concern even though CT showed no growth. I may be doing a bit too much and not getting enough sleep and down time. Cutting back to 2 days per week babysitting instead of 3 starting late September. Going to SLC, Utah with 3 girlfriends to visit a fourth friend from my old Evergreen State College Days. The 4 of us will hike and camp in some of the national parks in Utah. I'll be among the arches and beautiful scenery.
Peter and I enjoyed our anniversary in Friday Harbor on the boat and stayed at the Friday Harbor House with a wonderful view and great food. We just got back from a few days in Victoria again on the boat with friends. This week end off to Blain on the boat to visit with my brother and see and stay at his new beach house. We'll be at Semiahmoo Marina a nice place we've visited before.

The grandchildren continue to be great joys! Kimani begins his pre-kindergarten readiness program for 4 year olds on Wednesday 9/3. Ayana is not only walking but running at 14 months and Paityn has begun pulling herself up to standing and walking around or pushing items in front of her - not quite walking yet at 10 months.

Life is very good and I'm enjoying every minute of it. Be well!

Wednesday, August 6, 2014

New CT Scan looks good

CT SCAN chest, abdomen and pelvis - Details

 

Narrative

[HST]: Carcinoid

[SAS]: f/u of lung and liver metastases

CT of the chest abdomen and pelvis

Hx: Carcinoid

IV contrast material was given, 125 cc of optiray 320(low osmolar IV
contrast material).

Neutral density oral contrast was also given.

iso Voxel reconstructed images in three planes

In the lungs it is difficult to demonstrate the few previously
described tiny noncalcified lung nodules. Lymph node anterior to the
left axillary vessels described previously again demonstrated
appearing most similar to exam from 10/2013, about 7 mm in transverse
diameter. AP diameter varies from exam to exam based on this calipers.

Hyperenhancing liver masses are much more conspicuous now than on
several previous exams probably due to more optimal timing of the
bolus for demonstrating these. They measure on the order of up to 3
cm in diameter. Difficult to assess for changes because of the very
faint appearance previously compared to today's exam.

Postsurgical changes in the upper abdomen are again demonstrated.

A a mass in the posterior lateral superior left gluteal soft tissues
is less prominent than on 2/2014 exam. There is another in the
posterior superior right gluteal subcutaneous tissues that is now
larger and contains some gas. Is the patient getting injections? It
measures about 2.5 cm in diameter.
This is from my monthly injections.
Very similar appearance to the osteoblastic bone lesions described
previously.

Impression

IMPRESSION:
1.Very little change in appearance of the CT scan since 2/2014.
Hypervascular liver lesions are much more conspicuous now but
primarily due to more optimal timing of the injection bolus.


______________________________________
This is very good news!!!


Electronically signed by:JOSEPH G DUFFY, MD
Date: 08/06/2014
Time:09:41

Component Results

There is no component information for this result.

General Information

Collected:08/06/2014 9:00 AM
Resulted:08/06/2014 9:41 AM
Ordered By:Eric Martin Feldman, MD
Result Status:Final result

Wednesday, July 16, 2014

Resilient

From my July: A Fearless Woman calendar:

She weaves a web of resilience

Resilient - from the Latin resile: to bounce back

From countless tests and tumbles
she crafts a net of tenacity and fortitude.
With a glowing confidence she bounces back
to take the risks and rise again.

Week 3 of my very disciplined diet of no sugar or refined carbs is moving along. This whole foods diet using dairy only as a condiment and eating almost no sugar or carbs is the "rest of my life" diet. Organic vegetables, fruit, beans, quinoa, lean organic meat and wild fresh Alaskan fish. I've had a little steel cut oats with raisins and cinnamon and some smoothies made with full fat Greek yogurt and berries.  I am drinking lots of green tea and have a cup of coffee every morning with coconut milk and stevia in it. What a treat! I've lost 8 pounds and would like to loose about 20 more. I think it will happen slowly and surely as I'm walking the loop (2.5 miles) and swimming 30-50 lengths of the pool (one or the other daily and sometimes both in one day) and I'm doing Pilates 2 times per week (I would do more but it is so expensive). I start Aqua Zumba this Saturday. My blood sugar numbers are down some with this diet, activity and having started the diabetes medication. I've been feeling better!!!

I'm looking forward to going to see Henry Kapono this evening at the Triple door with my sister in law Jackie, seeing my parents here in Seattle tomorrow, helping my son prepare for an art show he is doing and Sunday taking my grandson to Snohomish for a train ride on Thomas the train. Peter leaves on Monday for a big fishing trip in Canada with 2 of his buddies. I gave him the trip as a gift on our 10th anniversary last year. Life is good!

Monday, July 7, 2014

The Good the Bad and the Ugly

The good news is I'm still here and realize more and more that I can make the choice to feel good. Sometimes it is mind over matter or recognizing that this might be my new normal and I can choose to be happy when I don't feel as good as I used to. Sometimes I feel like complaining and describing repeatedly in great detail exactly what is ailing me at that moment and through out the day but in reality that doesn't really make me feel better. Not that I'm being a Pollyanna all the time or in denial about my discomfort but just as with children, distraction and changing the subject can work well.

I can begin the day by reminding myself that Life supports me and wants me to be fulfilled and happy. Eating right and exercising are good choices I can make that help me feel better. Basically Love is all there is and all I really need to focus on; so a smile from one of my 3 beautiful grandchildren can go a long way toward feeling good if I let it. I try to let in and remember all the love and good I have in my life. Sometimes when I'm working in my garden I bask in the glow of Life's love, which shines on me like the summer sun. It feels as though the whole world and everyone in it loves me. It may have taken me a long while to understand this, but now I feel it in every fiber of my being at times. All my relationships are at peace and I truly have all that I really need. This is a good time to think about how I want to be remembered. I hope to be remembered as kind and smiling much of the time among other things.

The bad news is that the canoe journey that I did for almost 20 years is currently underway without me. This is my second year to miss it due to the cancer management. Last year I had been in surgery a week before it started and this year with some of the new challenges I'm facing with type 2 diabetes,  high blood pressure and intestinal discomfort I decided not to go. I believe I will be able to go next year and that it was best for me to still take care of myself now with a steady schedule of taking medications (2 new ones), eating right, sleeping well and moving my body in a way that gets me back in shape. All this isn't always possible when paddling 30-40 miles in the open ocean and then camping along the way for at least a week to 10 days. I was almost ready to go and it was a hard decision to remain here and not help my Raven Canoe family members on this years journey to Bella Bella on the BC coast. I trust I made the right decision for myself and the others in the canoe who might not have been able to get me to shore in time to go to the bathroom. :-) Limitations are merely opportunities to grow. I use them as stepping stones to success what ever that might be now in my life. Rather than bemoan my loss of the canoe journey experience this year I remember that my happy thoughts help create my healthy body and that there are endless possibilities to focus on when something I think I wanted doesn't appear or develop. I am safe in this world and make safe choices for my health. I am comfortable with change and growth.

The ugly is that I'm now taking more different medications and supplements.  I've gone to one of those daily organizational pill holders because there were too many bottles on the bathroom counter (ugly). :-) I just started metformin for the diabetes that developed because my pancreas is compromised. I also started a small half a pill to keep water weight down and for the edema in my feet. I take a small dose of high blood pressure medication, a thyroid pill, iron, a pro-biotic and vitamin C, D3, magnesium, calcium and Turkey tail mushroom capsules for immune support.

My recent labs resulted and I have some questions for Dr, Chad, Naturopathic Doctor (ND) and oncologist when I see him 7/17. I'm not sure why my Hemoglobin A1C is in the high range, ALK Phos is high and CRP Cardiac (the most concerning) is high sensitive at 5.3 (normal is 0-3). My next appointment with Group Health Oncologist Dr. Feldman is August 7th. This will be to evaluate the results of the August 4th labs and August 6th CT scan.

Dr. Chad  recommended a new oncologist,  Dr. Pillarisetty at SCCA. He is a specialist on the pancreas (various cancer and illnesses) and liver metastases. I am in the process of getting a referral from Group Health to have a second opinion consult with him. My SCCA oncologist Dr. Back also thought it was a good idea for me to discuss my case with him to see what else we might be able to do moving forward. We want to prolong life of course and also keep working on quality of life, meaning how I'm feeling.

I found a new book, ordered it in the mail and read most it this week end on management of diabetes with diet instead of drugs. Even though I began the medication I am hopeful that I will get my blood sugars down to the point where I will not longer need to take it. In the book is a proven (lots of data) step by step plan to reverse type 2 diabetes naturally. As with so much else that I've read and implemented in addition to diet and exercise stress reduction is key. I continue to work on having a "good attitude" and a sense of humor.  :-)

I'll end with more quotes related to my health journey that appear in the new book.

"Denial ain't just a river in Egypt". Mark Twain

"Perhaps everything terrible is in its being something that needs our love". Rainer Maria Rilke

"I've learned that nothing is impossible; and almost nothing is easy". Anonymous

"Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending". Carl Bard

"looking back, we see with great clarity, and what once appeared as difficulties, now reveal themselves as blessings". Dan Millman

"The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease". Thomas Edison 1847-1931

Happy Summer!!!!

Friday, June 27, 2014

2014 National NET Patient Conference

                                                      CCAN Logo

Contact

Maryann Wahmann 
CCAN                      2014netconf@optonline.net                     or call 866 850 9555
 

When

Thursday September 18, 2014 - 3:00 PM
-to-
Saturday September 20, 2014-  5:30 PM
A Special Lungnoid Session
 Sunday Sept 21, 2014 - 8 AM to 12PM 
Add to Calendar 

Where

Charlotte Marriott City Center, Charlotte, NC 
100 West Trade Street
Charlotte, NC 28202
 

 Hotel rooms $139 a night.  
Reservations for the Event will be made by individual attendees directly with Marriott reservations at (800) 228-9290 or (704) 333-9000 or click link
This is in addition to your conference registration fee. Do not forget to register for the conference!


Driving Directions 

A Special Thanks to our Sponsors!

Platinum Sponsors
Inter Science Insititute
Gold Sponsors
Novartis Oncology
Ipsen Pharmaceutical
Lexicon Pharmaceuticals
Pfizer Oncology
Sliver Sponsors
Ochsner Medical  Center-  Kenner
LSU
Mallinckrodt
Enhanced Exhibitor
University of Kentucky
NET Alliance
 
Contact us if you need a special dietary restrictions. There will be Vegetarian meals available. Please call the office!                    866 850 9555



2014 National NET Patient Conference
The 2014 National Carcinoid/NET Patient Conference is right around the corner! Mid-gut noids, Lungnoids, P-Net patients, Whipple patients and OTHER NET PATIENTS- get ready for another fantastic lineup featuring 20 or so WORLD CLASS NET EXPERTS presenting the information you need!
Some of the topics are brand-new and just published, sprinkled in with advice from the EXPERTS on the top issues faced by NET patients. Topics that will be covered welcome an audience of all levels, including patients, family members and caretakers of patients, as well as physicians and other health professionals.
Plus, you'll get to network with hundreds of other patients who understand what you are going through and share your concerns.
This is a perfect opportunity to build your knowledge and become a better advocate for your health!
$125 per person from 5/1 through 8/31.
$150 pp for late registration- 9/1 and later.
Please note there will be a cancellation fee of $25 pp!
Tentative agenda: Times and titles are subject to change.                              The physicians listed have committed to making presentations.
2014 NETS PATIENT CONFERENCE CHARLOTTE, NORTH CAROLINA
 Thursday, September 18th –  Saturday 20th 
THURSDAY AFTERNOON
3-5 PM       Emotional implication of NETS treatment: Ronda Ayala, RN
THURSDAY EVENING
6-9 PM                  Reception 
FRIDAY AM     Moderator: Eugene A. Woltering, MD       
7:00-7:45              Breakfast
7:45-8:00              Introduction: Bob and Maryann Wahmann - CCAN
8:00-8:45              NETS— Introduction to the basics: Richard Warner, MD -                          Mount Sinai Hospital NY,NY
8:45-9:30              NETS pathology: What’s important and what’s not? : Chanjuan Shi, MD Vanderbilt University Medical Center , Nashville, TN
9:30-9:45              Break
9:45-10:15            Midgut NETs surgery. The technical aspects: Yi-Zarn Wang MD -          LSUHSC  New Orleans,LA
10:15-10:40         Pancreatic NETs surgery. The technical aspects: Michael Choiti MD -               UT Southwestern Dallas,TX
10:40-11:00         Does serial cytoreduction of midgut NETS increase survival? : Eugene A. Woltering MD -  LSUHSC  New Orleans,LA - Oschner Medical Kenner
11:00-11:20         How NETS affects your heart: Current recommendations for ongoing scanning, prevention and current therapy of NETS-induced heart disease: Heidi Connolly MD Mayo Clinic Rochester, MN 
11:20-12:00         Q & A with panel and moderator
12:15-1:15            Lunch
FRIDAY PM      Moderator: Thomas M. O’Dorisio MD
1:15-2:00              Clinical trials for chemotherapy/biologic response modifier therapy of gut- based NETS: Edward Wolin, MD -  Cedars -Sinai Medical Center, LosAngeles, CA
2:00-2:45              Clinical trials for chemotherapy/biologic response modifier therapy of pancreatic NETS.: Emily Bergsland MD -  University of California , San Fransico , CA
2:45-3:00              Break
3:00-3:45              New approaches to the treatment of NETS induced diarrhea:                  Sajeve Thomas MD - MD Anderson Cancer Center Orlando, FL   
3:45-4:15           Somatostatin analogs control symptoms and slow
tumor growth:  Summary of recent trials: Alexandria Phan MD
 
4:45- 5:30             Q & A with above panel and moderator
SATURDAY AM Moderator:  Dr. J. Philip Broudreaux
7:00-8:00              Breakfast
8:00-8:35              The Benefit of Multidisciplinary Teams Treating NETs:  Eric Liu MD-  Vanderbilt University Medical Center , Nashville, TN
8:35-9:10              The role of the gastroenterologist in the diagnosis and treatment of NETS:               David Metz MD - Perelman Center for Advanced Medicine Philadelphia, PA
9:10-9:45          Summary of therapy with 177 Lu vs. high dose LAR: The AAA trial: Richard Campeau- MDLSUHSC  New Orleans,LA           
9:45-10:00            Break
10:00-10:35         An update on Multi Visceral Organ Transplants (MVOT): Rodrigo Vianna M.D-  University of Miami , FL
10:35-11:00          My personal experience with MVOT:  Paul Johnson MD
11:00-12:00         Q & A with all panel members and moderator
12:15-1:15           Lunch
SATURDAY PM Moderator: Richard Warner MD
1:15-2:00              Investigator-initiated trials of   68 Gallium somatostatin analogs: Where are we going?: Thomas M. O’Dorisio MD -  University of Iowa
2:00-2:45              Update on studies in MEN I and the risk of familial NETS: Steve Wank MD -  NIH
2:45-3:00              Break
3:00-3:20              How to scan for NETs: Primary’s and their metastasi: David Bushnell MD-     University of Iowa
3:20-3:40              Vitamin supplements & alternativetherapies: How to assess safety & efficacy:  Mary Hardy, MD
3:40-4:25              Spheres vs. Chemoembolization vs. Bland embolization- Which is best? : Charles Nutting MD -  Radiology Imaging Associates Englewood, CO
4:25-5:15              Q & A with all panel members and moderator
5:15                        Announcement of next National Patient NET conference in September 2016:     Eugene A. Woltering MD and CCAN
SPECIAL CONFERENCE ON LUNGNOIDS AND DIPNECH
Sunday September 21st, 2014
SUNDAY AM       Eric Liu MD Moderator
8:00-8:30              How we find lung NETS and their metastasis: Eric Liu MD - Vanderbilt University Medical Center , Nashville, TN
8:30-9:00              Bronchoscopy, percutaneous and trans-bronchial biopsies for lung lesions: Susan Gunn, MD - Oschner Medical Center, Kenner, LA
9:00-9:30              Surgical approaches to DIPNECH, primary NETS and their metastasis: Rodney Landreneau MD-   Oschner Medical Center, Kenner, LA
9:30-9:45                Break
9:45-10:30            Role of chemotherapy, biologic response modifiers and PRRT in the therapy of lung NETS: Dan Granberg MD. PhD - Uppsala University Hospital Sweden
10:30-11:30         Questions and Answers:  All speakers and moderator
   

Wednesday, June 25, 2014

Bastyr trained Naturopath appointment

My busy, full and blessed life continues to include fun adventures, family, grandchildren and the management of my health. I've written frequently about the challenges regarding my diet now that I am missing my spleen and gall bladder, my pancreas is still on the mend and my liver has grown back. The list of symptoms I'm reporting is lengthy and complicated. They are: frequent thirst and urination, high blood sugar levels, edema in feet and ankles, bloating and weight gain, fatigue, abdominal pain and diarrhea, head aches and burning, itching, watery eyes. My eye sight has also declined substantially. Prior to the pancreas surgery I was advised that I would probably develop diabetes at some point due to the pancreas damage. I will be seeing Dr. Shaul my primary care physician about diagnosing and getting medication for diabetes if I do indeed have it. My joint pain could be normal ageing and I could have developed allergies causing some cold like symptoms and eye disturbance. It is unnerving not to know when something is related to the cancer as opposed to normal aging or other medical conditions or concerns. My mom had hip pain by my age and went on to have 3 hip replacements. It is likely I need glasses beyond the readers I now use and may have eye strain.

All in all I am managing well. I try to eat mostly organic lean protein and fruits and vegies. I try to drink water all day. I seriously limit my sugar and carbs. I have been walking and swimming daily (thus the concern about weight gain). I should be loosing weight and Peter can attest to the fact that I eat very small portions and have been extremely disciplined.

Two recent trips one a boat trip to Princess Louisa in BC on our 22 foot power boat with friends and one a family reunion in CA for Peter's mom's side of the family were fun. Both took there toll however and because they were back to back I ended up really exhausted by the time we returned. I'm still having grandchildren over to watch Mon-Wed so it took me a few days to catch up on sleep. I'm feeling pretty good today and did a couple hours of yard work and will now go swim laps while my wonderful friend Louise watches Paityn for me. Her assistance again makes it possible for me to help my children out with childcare in this way. I truly adore and love my 3 little darlings. They bring me a great deal of joy and laughter. It is well worth the tiredness at the end of the day.

Due to my intestinal challenges and tiredness I have had to decide not to participate in the annual Native American canoe journey that I love so much. This will be my second year to miss going. I hope to be able to rejoin next summer. We'll see how things go. It has been one year since the liver surgery and only 7 months since the pancreas surgery. I've been told it takes over a year to fully recover.  I'm thrilled that the cancerous tumors seem to be staying tiny and not causing any problems with my health. As I fully recover and learn more about how to take care of my digestion and balance exercise with fatigue I expect to feel even better.

I've got lots of fun things coming up over the rest of the summer. A trip to the ocean with my parents, to Vancouver by boat with Peter, to Utah to visit a girl friend with old Evergreen college friends, to the ocean again for our wedding anniversary, to Mason Lake near Shelton to visit my cousins and in September a conference on Neuroendocrine Tumors for patients in North Carolina.


Tomorrow is my monthly Octreotide shot at Group Health which appears to be keeping the symptoms of the tumors at bay as well as keeping them from growing. Also tomorrow I'll see,
 Dr. Chad Aschtgen ND (Naturopathic Doctor), American Board of Naturopathic Oncology (FABNO) at the Institute of Complementary Medicine (IC Medicine.com) Integrative Health Clinic located near me in Seattle. I'm excited to see him for the first time and see what ideas he might have for diet and supplements to help me. I feel like I'm doing so much and taking so many supplements all ready but I may not be doing the best thing given my circumstances.

As I said above on Monday 6/30 I'll see Dr. Shaul about the diabetes question too. I've been getting massages, using my sauna and remaining relatively stress free. I'm having a birthday party for my son at our house this Saturday.  I enjoy being with his family and friends. I love being grandma to his wonderful children. We've got lots of other family birthdays in July and August with my dads 80th - a big one. We recently updated our deck for BBQ's and look forward to showing it off along with our colorful yard that I've been working in.  Life is good!

I am thankful for every day and every relationship. I see love and good things everywhere I look. Thank you for reading my blog and for all the prayers always coming my way. You know they are helping me stay healthy.

Monday, June 2, 2014

What is Carciniod Cancer

WHAT IS CARCINOID CANCER? Carcinoid is part of a group of tumors called neuroendocrine tumors that grow in the hormone producing cells, is listed with the National Organization of Rare Disorders.

Because neuroendocrine (NET) cancer is considered rare and due to a lack of public awareness the disease has had a low priority for medical research. Current studies suggest that Carcinoid and Neuroendocrine tumors are not as rare once thought.

Over 11,000 new patients are diagnosed each year and as many as 125,000 patients are living in the US today- AND the number of diagnoses is increasing by more than 5% annually.

Carcinoid/NETs are also regularly overlooked during the diagnostic process. Many patients go untreated for years and have been told the have another disease. However, due to the generosity and selfless effort of many people, progress IS being made!

If the tumors are found early and you get proper treatment, you can live a long life. There are many 20 year survivors living in the USA. Failure to diagnose the disease and provide proper treatment, however, has the most serious consequence.

Thursday, May 15, 2014

New Clinical Trial for neuroendocrine tumors sounds promising

From The Caring for Carcinoid Foundation web site

 

 

Theragnostics of Neuroendocrine Tumors with Somatostatin Antagonists

Peptide Receptor Radionuclide Therapy (PRRT) is a technique widely used in Europe for the management of patients with metastatic neuroendocrine tumors.  There are currently clinical trials in the United States for PRRT with somatostatin agonists as described below.
PRRT delivers targeted radiation therapy by exploiting the physiology of neuroendocrine tumors. Most neuroendocrine tumors, including carcinoid, have specialized cellular receptors that bind to somatostatin, a hormone that exists naturally in the human body. Scientists have developed artificial “analogs” of somatostatin to attach to these receptors.  These are called somatostatin agonists and they include agents like octreotide. Somatostatin agonists are able to target neuroendocrine tumors by binding to the somatostatin receptors present on tumor cells.
The PRRT currently in use typically combines a somatostatin agonist with a radioactive substance called a radionuclide to form highly specialized molecules called radiopeptides. These radiopeptides can bind receptors on tumor cells where they emit radiation that can either 1) be read for diagnostic imaging or 2) kill tumor cells.
Studies have suggested that PRRT with somatostatin agonists can lead to a decrease in tumor size and alleviation of symptoms in some patients.  However, not all patients respond and there can be serious side effects including kidney failure.   To date, randomized prospective clinical trials, of the nature typically required by the FDA for regulatory approval have not yet been completed.  However, there is currently a prospective randomized clinical trial of PRRT with somatostatin agonists in the United States enrolling patients at multiple centers.
The Memorial Sloan-Kettering Clinical Trial 
To improve effectiveness while reducing side effects, Dr. Weber and his collaborators have developed a technique for “next generation” PRRT.   Instead of somatostatin agonists, this next generation PRRT will employ somatostatin antagonists. Based on preclinical data, Dr. Weber believes that somatostatin receptor antagonists can be more effective and generate fewer side effects than the substances that are currently being used to treat patients.
Specifically, this trial will assess the potential viability of 68 Ga-DOTA-JR11 and 177 Lu-DOTA-JR11 as a pair of diagnostic and therapeutic radiopeptides for neuroendocrine tumor patients. Gallium 68 is a radionuclide that can be used in diagnostic PET scans. Lutetium 177 is a radionuclide often used with somatostatin analogs to form therapeutic radiopeptides. This study will assess the sensitivity of gallium 68 and the safety of lutetium 177 when combined with the somatostatin antagonist, DOTA-JR11 developed by the researchers. Eight patients with progressive, metastatic and inoperable tumors will participate in a clinical trial of peptide receptor radionuclide therapy with the somatostatin antagonist DOTA-JR11.  Thanks to funding from another large Foundation these eight patients will enroll alongside an additional 12 patients for a total of 20 patients enrolled.
This trial may provide proof of concept data to assess the potential for peptide receptor radionuclide therapy with somatostatin antagonists as a new treatment for patients in the United States. Furthermore, strong data from this trial could enhance the commercial potential of these specific compounds. This could pave the way for development of a new treatment and diagnostic imaging strategy for patients with neuroendocrine tumors in the United States.
Institution: 
Memorial Sloan - Kettering Cancer Center
Investigator: 
Wolfgang Weber, M.D. Ph.D.
Diane Reidy-Lagunes, M.D. 
Amount: 
$250,000
Duration: 
2 years
Research Objectives: 
1. Assess biodistribution and tumor uptake of 68Ga-DOTA-JR11 and compare the sensitivity of 68Ga-DOTA-JR11 PET with conventional imaging
2. Determine tumor and normal organ doses after administration of 177Lu-DOTA-JR11; and
3. Obtain preliminary data on tumor response to 177LU-DOTA-JR11.
Abstract: 
Peptide-receptor radionuclide therapy (PRRT) with radiolabeled somatostatin analogs has been developed in the 1990s, and is now frequently used in Europe for treatment of metastatic neuroendocrine tumors. However, not all patients respond well to PRRT; there are serious side effects, most notably chronic renal failure due to the renal excretion of the radiopeptides.  Thus, there is a clear need to develop new ligands with higher tumor uptake and a more favorable tumor-to-kidney dose ratio.
To address this need, members of our group have developed radiolabeled somatostatin receptor type 2 antagonists. These are the first radiolabeled somatostain receptor antagonists.  In this project we will study the second generation somatostatin receptor antagonists, 68Ga-DOTA-JR11 and 177Lu-DOTA-JR11, as a pair of diagnostic/therapeutic radiopharmaceuticals (theragnostics) in patients with neuroendocrine tumors. Specifically, we will (i) assess biodistribution and tumor uptake of 68Ga-DOTA-JR11 and to compare the sensitivity of 68Ga-DOTA-JR11 PET with conventional staging procedures; (ii) determine tumor and normal organ doses after administration of 177Lu-DOTA-JR11; and (iii) obtain preliminary data on tumor response to 177Lu-DOTA-JR11.
We will conduct a clinical trial including 8 patients with well to moderately differentiated, progressive and inoperable midgut carcinoids. Patients will first undergo a PET/CT with 68Ga-DOTA-JR11. Patients with sufficient tumor uptake of 68Ga-DOTA-JR11 will be offered therapy with 177Lu-DOTA-JR11. Therapy will be preceded by a dosimetric study to determine the amount of radioactivity that can be safely administered.

Wednesday, May 14, 2014

May flowers and good health

Being in Hawaii for the month of April was glorious.  I really did swim and snorkel everyday. Peter came with me for the first 10 days and my girlfriend from Hood River came for a week after that. The last week I was on my own. My "other" son Leo and his wife Genevie and 2 boys live on the Big Island and I spent good family time with them. Leo came to live with Thaddeus, Jessica and I when he and Thaddeus were best friends in the 5th grade. We were blessed to have him be a part of our family for many years after. Not long after he turned 18 he moved to the Big Island and met his future wife.
When the kids were little our main vacation spot was the Big Island and we had many exciting 2 and 3 week vacations there. I always seemed to have one friend or relative that lived there and welcomed us to stay making it an affordable vacation with 3 kids. I'm glad that my introduction of Leo to the Big Island led to him relocating and starting his family there. We enjoyed going out to lunch, dinner and evening music during this trip. We reminisced also that I introduced he and Thaddeus to African Drumming around the same time we took that first trip to the Big Island. Both boys ended up having a love of African Dance and Drumming that has continued into their adulthood. When parenting teen agers it is always beneficial if you have a hobby or 2 that you do together. One that is challenging enough and that the youth involved can excel at and even pass the adult up in their skill level. I enjoyed a drumming class with Thaddeus and Leo every Thursday night for years. We had a great time together. They surpassed me and went on to incorporate music into their lives in various ways. For Jessica and I it was walking, running, going to the gym, taking abs buster classes and of course shopping. She definitely surpassed me in these areas as well. :-)

It's funny how being retired I think about the past now in a different way than I did. I'm fond of the activities I carried out and those who played staring roles in my various life trends and era's. Also how I start out on one story (Hawaii) and end up talking about something entirely different (kids raised).

I did miss my kids, grandkids, mom, family and friends being gone almost a month. I enjoyed the sunsets and the swimming with the dolphins and turtles so much that I continually thought about how nice it would be share the experience with my whole family. Maybe someday we can all go together. Upon return I started back up with the babysitting routine. I watch Jessica's daughter, Paityn (Pai Pai) on Monday and Wednesday and Thaddeus's kids, Kimani and Ayana on Tuesday's. Thursday and Friday are free days and my friend Louise still helps me on Monday and Wednesday's and took over while I was gone. Imagine arranging my own substitute.

I'm very pleased to announce that I did well on the health front during my trip. For the last 10 days I did need to give myself 3 shots a day of Octreotide in the tummy since they don't give the every 28 day, long acting shot of it on the Big Island. The sub Q shots I gave went into the area on my stomach where I have no sensitivity from the surgeries, so I didn't feel it.  I did feel a little worse with the shots than I do with the long acting version though, a little more hormonal fluctuation and intestinal upset.

My return to regular life here in Seattle was a bit bumpy too. I had a red eye flight with a lay over in LA. I did not sleep on the flight. I arrived home to wonderful 85 degree weather but couldn't sleep that night (it was hot) after getting a call that the mammogram I had before leaving did result that a biopsy was needed of the left breast and lymph node area. So arriving home Thursday morning I had the biopsy Friday morning at 7 am. I also gave blood for my every 3 month labs and got my long acting Octreotide shot that morning. The short acting and long acting merged together weirdly and it felt very different. The combination of all this and the time (3 hours difference) and weather change (it then started raining and was in the 50's) caused a day or 2 of rest to be needed. Peter, my mom and Jessica helped remind me to take care of myself. Also hanging over my head was a bone scan scheduled for the following week. The great news is that the biopsy was benign and the bone scan showed no growth of the metastasis in the hip and back.. In my last entry I mentioned that the last CT scan also showed no growth and that there was no longer any cancer in the thyroid.  From all indications I have a 4-6 month period now where all looks good and I can enjoy the summer and eating healthy and exercising. We want to continue in this direction indefinitely.

Helping me to feel good the Lake Ridge outdoor pool opened Mothers Day and I hope to start swimming laps one of these days soon. Mothers Day was really special this year since my mom is recovering well from back and neck surgery, my health is stable and we have 2 new baby girls in the family who were not here last year. It was Jessica's first Mothers Day! We all gathered at my house and shared a healthy meal. Lots of good pictures taken.

I had my first Pilates lesson the other day and think I'm ready to start back in with an abdominal core body strength work out. I know it is good that I have gained - not lost weight but the weight gain is a bit too much now. :-) I'm hoping to drop 20 pounds over the summer by reintroducing exercise into my routines. I'm walking about 2.5 miles per day now. A great mental health plus is that I've developed a friendship from the NET support group with a guy who has NET's with a very similar medical history to mine. It is good to compare notes and to laugh about the diarrhea and other uncomfortable side effects of either the cancer or the medication. Both of us know every day is a blessing.

Another blessing about being in Hawaii for a month was the amount of reading and listening to CD's I was able to do.  I love affirmations. May I be safe, may I be healthy, may I be at peace and may I live with ease - love this. I like saying these for myself, for others and for all of us. I also have a daily calendar by Louise Hay and published by Hay House. There are so many great affirmations that I'm reading them every morning over and over again. Here are some of my favorites.

I am grateful to be alive today. It is my joy and pleasure to live another wonderful day.

I let go of fear and doubt, and life becomes simple and easy for me.

Good health comes from love and appreciation.

I am able to make correct decisions. I recognize my own intuitive ability.

I trust my inner wisdom.

I easily let go of everything I know longer need. (like tumors :-)) Another similar one: Today I easily release all that my body no longer needs. (With healthy eating and living the tumors are shrinking and going away-I'm certain of it)

I give myself the green light  to go ahead, and I joyously embrace the new.

I expect good experiences to come to me. All is truly well in my world.

Today I trust that my future is in good hands.

I move beyond past limitations into the freedom of the now.

I am centered and focused, I feel more secure each day.

I use my mind and thoughts to enhance my life.

A smiling face and joyful, loving words are the best presents I can share with all those I know.

It is only a thought, and a thought can be changed.

Wherever I am, I always have an enjoyable time.

It feels good to know that I am safe and I am loved. ( I feel so good about all my relationships)

Today I take a moment to count my blessings. (and there are many)

I have a harmonious relationship with my family. (yes)

I express who I am in joyous, positive ways.

I express love and create harmony wherever I go.

As I go through my day I am aware that the Universe (God, my family) loves me.

Today I look for the good in my life and that is what I find.

I am always safe no matter what doorway I pass through.

Today I enjoy every minute of what ever I'm doing.

For every problem that I may create I am confident that I can find a solution.

Patience is being at peace with the process and pace of life.

My body is always doing its best to create perfect health.

I choose only thoughts that create a wonderful future, and I move into it now.

Positive affirmations create my future while making me feel good in the moment.


Believe it or not these are only a few of my favorites but you get the idea. My wonderful future includes family reunions, playing with grandchildren, spending time with my mom; boating, travel, home projects and movies with Peter, the annual Native canoe journey, swimming, sauna's, walking, farmers market's, organic whole foods, lemon water and lots of restful sleep.

In closing I wanted to mention once again that Peter has been a constant in this cancer journey. Most recently he went with me for the biopsy and bone scan and even came home from work quickly one day when I was babysitting and didn't feel well.  His band the Peter Jamero Project played recently and sounded great as usual. He sang a song, which was new and sounded great. His children, sisters and dad are also a joy to know.
My mom and I are enjoying each others company more than ever. Is it possible to love her even more than I always have? :-) She is supportive and understanding and such a great - great grandma! My son and daughter continue to inspire me to be a better and better person. These 3 grandchildren are the cutest, sweetest and most well behaved kids I think I've ever experienced. No really!

Life is just so good and all my May flowers are blooming!