Neuroendocrine Tumors and Their Survivors
Kathleen Spinosa was told she had 6 to 12 months to live when she was diagnosed with a neuroendocrine tumor that metastasized to the liver. The only treatment options given to her were chemotherapy and radiation.1
According to Kathleen’s testimonial, no physician was willing to operate on her because of the complexity of her disease, stating, “they had heard the story before… they did not care.” To those physicians credit, there is a preponderance of evidence that suggests surgery debulking may prove to be pointless for cases such as Kathleen’s, and difficult. 6 However, in the darkest of hours, what gives us hope is frequently that small degree to which we fight for our own survival and the ones who every so often champion us.
A Cancer Survivor Testimonial
Treatment of Neuroendocrine Metastatic Liver Cancer
Kathleen discovered Dr. Anton Bilchik 5 months after she was terminally diagnosed back in 2014 with neuroendocrine cancer that metastasized to the liver. She was then living in Indiana.
When Kathleen came to California, Dr. Bilchik explained to her he would examine the tumors surgically and attempt to remove them. However, he also advised that if there was nothing he could do, he would end the surgery. In her testimonial, Kathleen admits she gave him full authority to perform surgery with an understanding nothing may come of it; immediately alleviated after 5 months of searching for a different outcome other than chemotherapy and radiation treatments.
Dr. Bilchik recalls Kathleen’s history which included a prior bout with cancer. “[She] first had her tumor removed from the colon in 2010,” asserts Dr. Bilchik. “It then came back in the liver in 2014, and these tumors were successfully removed. Almost 4 years ago, the tumors came back in a very difficult location in the lower abdomen, where 16 tumor nodules were removed. The surgery was very complex and required reconstruction of her ureter. It is remarkable that she continues to be free of recurrence.”
Dr. Anton Bilchik is Chief of General Surgery, Director of Gastrointestinal and Hepatobiliary Program & Gastrointestinal Research, and Professor of Surgical Oncology at Saint John’s Health Center and Cancer Institute.
Why Are Neuroendocrine Tumors That Metastasize To The Liver Difficult To Cure?
Liver metastases are tumors that originate in other parts of the body and spread to the liver. Such as from the colon, rectum, pancreas, stomach, esophagus, breast, lung, and melanoma.1
Neuroendocrine tumors are very rare, slow growing, and originate in specialized cells called neuroendocrine cells.2,3 According to the University of Pittsburg Medical Center, “It is estimated that fewer than 2,000 new cases occur in the United States.”4
The most common neuroendocrine tumor is the carcinoid, which causes liver metastases, and resection of liver metastases from neuroendocrine tumors is appealing because, “the natural history of these tumors is protracted.”5
According to Dr. Bilchik, “these tumors are very resistant to chemotherapy and radiation. Surgical resection has provided [Kathleen] the only chance for surviving 7 years since her original diagnosis, even after spreading to her liver and other parts of her abdomen.”
The reason prior physicians to Dr. Bilchik did not consider surgery may be because, “Surgical debulking is…frequently impossible due to the extent of the disease,” as stated by the World Journal of Surgical Oncology.6
Even more so, liver metastases are often referred to as the “secondary liver cancer.” These patients have a significantly worse prognosis and a “5-year survival.” Without treatment, such as with Kathleen’s original prognosis, “patients who develop liver metastases live an average of 8.7 months.”7
More importantly to note, once cancer has spread from its primary location, it is very difficult to manage. “I.e., metastatic cancer cannot be cured with current treatments,” which often includes, and is not limited to, chemotherapy and radiation.8
A Cancer Story For The Records
“Kathleen is a remarkable person who has a zest for life,” remarks Dr. Anton Bilchik, “[she] is kind, compassionate and very resilient. She will not allow cancer to take her down. She continues to travel from Arizona for her visits and always has a big smile on her face. There is nothing more satisfying for a cancer surgeon than the appreciation shown by a patient diagnosed with an aggressive cancer who is cancer free 11 years after her original diagnosis.”
Surgery may be the ultimate route for rare cases such as Kathleen’s. Just as Dr. Bilchik says, surgery was the only opportunity of survival for Kathleen and fortunately, she did not abandon hope; she found the one surgeon willing to endeavor the impossible for her.
If you have questions regarding gastrointestinal and hepatobiliary diseases, please reach out to the Center of Excellence for Gastrointestinal and Hepatobiliary Tumors: 310-449-5206.
Sources:
- Department of Surgery – Liver Metastases (ucsf.edu)
- What Are Neuroendocrine Tumors (NETs)? What are the Symptoms? (webmd.com)
- Neuroendocrine Tumors: Introduction | Cancer.Net
- Symptoms, Diagnosis, and Treatment of Neuroendocrine Carcinomas (upmc.com)
- Neuroendocrine tumors metastatic to the liver – Surgical Treatment – NCBI Bookshelf (nih.gov)
- Liver metastases of neuroendocrine tumours; early reduction of tumour load to improve life expectancy
- What is the Prognosis for Liver Metastases? (epainassist.com)
- What is the Major Cause of Liver Metastases? (epainassist.com)