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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Neuroendocrine Carcinoma. PET Shows Liver Metastasis. Starting Chemotherapy. Want Second Opinion

Hello
My name is Sofía Castillo from Concepción, Chile.
My mother was diagnosed with Pancreatic Cancer about 9 months ago, she had a Neuroendocrine Carcinoma in the tail of the Pancreas, it was very located so the doctor was able to resect it and about tree other lynph nodes where the cancer had spread. In December of 2012 she had routine exams where she had a PET CT and it revealed that everything was all right and she was cancer free. About two weeks ago she had another routine PET CT and this one revealed that she has meths in her liver, and not just one tumor, so this time is inoperable. Is a really agressive Neuroendocrine Carcinoma type KY67. She is starting Chemotherapy (etoposide and cisplatin chemotherapy) this week so she is able to prolong her life. The thing is I would like to have a second opinion and we are not able to travel to the USA... My questions are...
- How long does she have.
- What are her chances of living

Thu, 2 May 2013
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General Surgeon 's  Response
Hi and welcome to HCM.
It would be better if you posted PET CT images. First, this should have been prevented and discovered at the time tumour was operabile. She should have had more frequent CT checks up. Secondly, neuroendocrine liver metastasis have more favorable prognosis then colorectal and lung metastasis and surgeon should always try to operate it except when there is major vessels infiltration. It is impossible to predict survival. It depends how will she react on chemo and how fast would tumour grow but I consider that it should be several years.YOu should show PET CT to expert surgeons and see is there possibility of surgical procedure. Wish you good luck.
I find this answer helpful
General Surgeon Dr. Dr. Ivan Romich's  Response
Hi and welcome to HCM.
It would be better if you posted PET CT images. First, this should have been prevented and discovered at the time tumour was operabile. She should have had more frequent CT checks up. Secondly, neuroendocrine liver metastasis have more favorable prognosis then colorectal and lung metastasis and surgeon should always try to operate it except when there is major vessels infiltration. It is impossible to predict survival. It depends how will she react on chemo and how fast would tumour grow but I consider that it should be several years.YOu should show PET CT to expert surgeons and see is there possibility of surgical procedure. Wish you good luck.
I find this answer helpful
General Surgeon Dr. Dr. Ivan Romich's  Response
Hi and welcome to HCM.
It would be better if you posted PET CT images. First, this should have been prevented and discovered at the time tumour was operabile. She should have had more frequent CT checks up. Secondly, neuroendocrine liver metastasis have more favorable prognosis then colorectal and lung metastasis and surgeon should always try to operate it except when there is major vessels infiltration. It is impossible to predict survival. It depends how will she react on chemo and how fast would tumour grow but I consider that it should be several years.YOu should show PET CT to expert surgeons and see is there possibility of surgical procedure. Wish you good luck.
I find this answer helpful
General Surgeon Dr. Dr. Ivan Romich's  Response
Hi and welcome to HCM.
It would be better if you posted PET CT images. First, this should have been prevented and discovered at the time tumour was operabile. She should have had more frequent CT checks up. Secondly, neuroendocrine liver metastasis have more favorable prognosis then colorectal and lung metastasis and surgeon should always try to operate it except when there is major vessels infiltration. It is impossible to predict survival. It depends how will she react on chemo and how fast would tumour grow but I consider that it should be several years.YOu should show PET CT to expert surgeons and see is there possibility of surgical procedure. Wish you good luck.
I find this answer helpful
General Surgeon Dr. Dr. Ivan Romich's  Response
Hi and welcome to HCM.
It would be better if you posted PET CT images. First, this should have been prevented and discovered at the time tumour was operabile. She should have had more frequent CT checks up. Secondly, neuroendocrine liver metastasis have more favorable prognosis then colorectal and lung metastasis and surgeon should always try to operate it except when there is major vessels infiltration. It is impossible to predict survival. It depends how will she react on chemo and how fast would tumour grow but I consider that it should be several years.YOu should show PET CT to expert surgeons and see is there possibility of surgical procedure. Wish you good luck.
I find this answer helpful
Oncologist, Radiation Dr. Subhas Pandit's  Response
Hello
Welcome to healthcaremagic.
Neuro-endocrine tumor are uncommon tumors and ompared to common cancer of pancreas-adenocarcinoma ,they have relatively slower course and better outcome.
It is unfortunate that your mother has aggressive type of tumor because she developed metastasis in relatively short time.
Most appropriate treatment of hepatic metastasis for lung term survival is surgery. But since her tumor in not operable she should undergo chemotherapy with frequent assessment in between to see if tumor shrinks and becomes operable.

Although it is difficult to quantify her life because every person has different disease course, statistically survival in patients with hepatic metastases is 2–4 years.

Regards

I find this answer helpful
Oncologist, Radiation Dr. Subhas Pandit's  Response
Hello
Welcome to healthcaremagic.
Neuro-endocrine tumor are uncommon tumors and ompared to common cancer of pancreas-adenocarcinoma ,they have relatively slower course and better outcome.
It is unfortunate that your mother has aggressive type of tumor because she developed metastasis in relatively short time.
Most appropriate treatment of hepatic metastasis for lung term survival is surgery. But since her tumor in not operable she should undergo chemotherapy with frequent assessment in between to see if tumor shrinks and becomes operable.

Although it is difficult to quantify her life because every person has different disease course, statistically survival in patients with hepatic metastases is 2–4 years.

Regards

I find this answer helpful
Oncologist, Radiation Dr. Subhas Pandit's  Response
Hello
Welcome to healthcaremagic.
Neuro-endocrine tumor are uncommon tumors and ompared to common cancer of pancreas-adenocarcinoma ,they have relatively slower course and better outcome.
It is unfortunate that your mother has aggressive type of tumor because she developed metastasis in relatively short time.
Most appropriate treatment of hepatic metastasis for lung term survival is surgery. But since her tumor in not operable she should undergo chemotherapy with frequent assessment in between to see if tumor shrinks and becomes operable.

Although it is difficult to quantify her life because every person has different disease course, statistically survival in patients with hepatic metastases is 2–4 years.

Regards
I find this answer helpful
Oncologist, Radiation Dr. Subhas Pandit's  Response
Hello
Welcome to healthcaremagic.
Neuro-endocrine tumor are uncommon tumors and ompared to common cancer of pancreas-adenocarcinoma ,they have relatively slower course and better outcome.
It is unfortunate that your mother has aggressive type of tumor because she developed metastasis in relatively short time.
Most appropriate treatment of hepatic metastasis for lung term survival is surgery. But since her tumor in not operable she should undergo chemotherapy with frequent assessment in between to see if tumor shrinks and becomes operable.

Although it is difficult to quantify her life because every person has different disease course, statistically survival in patients with hepatic metastases is 2–4 years.

Regards
I find this answer helpful
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Have Neuroendocrine Carcinoma. PET Shows Liver Metastasis. Starting Chemotherapy. Want Second Opinion

Hi and welcome to HCM. It would be better if you posted PET CT images. First, this should have been prevented and discovered at the time tumour was operabile. She should have had more frequent CT checks up. Secondly, neuroendocrine liver metastasis have more favorable prognosis then colorectal and lung metastasis and surgeon should always try to operate it except when there is major vessels infiltration. It is impossible to predict survival. It depends how will she react on chemo and how fast would tumour grow but I consider that it should be several years.YOu should show PET CT to expert surgeons and see is there possibility of surgical procedure. Wish you good luck.