Expert: Claes-Gustaf Nordquist, M.D. - 7/17/2008

Question
QUESTION: MY HUSBAND HAS NEUROENDOCRINE CANCER OF THE PANCREAS,LIVER, LYMPH NODES IN THE CHEST AND ADRENAL GLANDS. RECENTLY HE WAS DIAGNOSED WITH CARCINOID OF THE BRAIN. THERE IS A TOTAL OF 15 LESIONS IN HIS BRAIN WITH THE LARGEST BEING ABOUT 1 INCH PRESSING ON HIS BRAIN STEM. I WOULD LIKE TO KNOW IF THERE IS ANY THING BUT RADIATION THAT CAN BE DONE. HE IS PRESENTLY ON CHEMO AND JUST STARTED RADIATION. DO WE HAVE ANY HOPE THAT HE WILL BEAT THIS AND HOW LONG CAN I KEEP HIM?

ANSWER: A straight question deserves a straight answer even if it is painful both to give and to receive.  Radiation therapy and chemo therapy can at best only slow the process down somewhat here. No cure is unfortunately possible at present. His survival time can at most be measured in months but may be shorter. I'm very sorry I have nothing better to tell you!


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QUESTION: COULD YOU PLEASE TELL ME IF THIS WOULD BE THE SAME ANSWER WITH HIM HAVING THE NEUROENDROCRINE TYPE OF CANCER WHICH IS TO MY UNDERSTANDING IS THE SLOW GROWING KIND? HE HAS BEEN ON THE CHEMO FOR SEVERAL MONTHS BUT HAS HAD TO HAVE THE CHEMO DRUG CHANGED SEVERAL TIMES DUE TO EITHER AN ALLERGY OR AN INCREASE IN THE LIVER LESION. THANK YOU FOR YOUR HONEST ANSWER EVEN IF IT IS NOT THE ANSWER I WAS HOPING FOR. ALSO WILL HE SUFFER ANY FROM THIS DISEASE?  PAT

Answer
Since it has reached his brain it is probable that the process now will be faster. Both patients and tumors are individuals not identical copies/clones so there is always a lot of uncertainty in predicting survival times. My prediction was based on the fact that it has reached his brain. It is still uncertain but the prediction I gave you is the best I can give you.