Earlier this week, I met some fellow cancer fighters and the conversation turned to what inspired us to ‘do what we do’. When it came to my turn, I was already prepared to regurgitate my usual 'spiel'. As sometimes happens, a listener queried me with the words "Neuroendocrine - what's that?". Another focussed on 'Neuro' enquiring whether my nervous system had somehow become cancerous. Deja vu - here we go again!
Two days later, I was speaking to one of my on-line friends who was having similar problems explaining this cancer to family and friends. Again 'Neuro' was proving difficult with the assumption that it’s somehow related to the brain. Technically not far from the truth but context is really important given that most people look at cancer in anatomical terms.
I've struggled over the past 5 years to explain this disease in layperson terms. It's actually one of the reasons for my 'study' and my blog. It's getting easier, particularly when answering questions. However, if Neuroendocrine Cancer knowledge was an iceberg, I'd still be at the tip! I did write a blog last year entitled Horrible Hormones which supports an explanation. You might like to read it - perhaps helpful to aid your overall understanding of this blog.
The other difficult aspect of explaining Neuroendocrine Cancer is the extent of the Anatomy and Physiology of the Neuroendocrine system which appears in numerous parts of the body. I've written about this before at a time when I was fed up with newspaper reports and on-line articles implying that Neuroendocrine Cancer didn't exist - e.g. by frequently describing Neuroendocrine Tumours of the Pancreas as Pancreatic Cancer and Neuroendocrine Tumours of the Lung as Lung Cancer. During some of my own verbal discussions, mention of the small intestine was frequently met with "so you have Bowel Cancer". NO! Good time to refresh yourself with my blog post The Anatomy of NET Cancer. This thinking needs to be challenged at every opportunity including while explaining to family and friends.
I've therefore decided to attempt a short, generic but still sufficiently detailed explanation of 'Neuroendocrine' in relation to my Cancer. I suspect by the end of this blog, it will not be as short as I had wished. I do like a challenge :-) Here goes:
The neuroendocrine system is made up of a network of cells that are distributed throughout the body. The word neuroendocrine refers to 2 qualities of these cells: they have a similar structure to nerve cells (neurons) and produce hormones like endocrine cells. Neuroendocrine cells release hormones into the bloodstream in response to chemical signals from other cells or messages from the nervous system. Basically hormones travel in the bloodstream and makes things happen in another part of the body.
These neuroendocrine cells are scattered throughout the body performing different roles based on location, e.g.
- Neuroendocrine cells in the digestive system regulate intestinal movements and the release of digestive enzymes
- Neuroendocrine cells in the respiratory system are believed to play a role in the developmental stages of the respiratory organs. They also regulate respiratory function.
- There are many others including some which control or can affect blood pressure, heart rate, blood glucose sugar levels and many other substances.
When Neuroendocrine tumours develop in these cells, they can not only then spread to other locations but they can also secrete excess amounts of hormones and substances which can cause an adverse effect on the body's natural rhythm. A collection of these symptoms is known as a syndrome. There are several different syndromes depending on the location and type of Neuroendocrine Tumour (classified as Foregut, Midgut or Hindgut).
The presence of the syndrome nearly always indicates the disease has metastasized (spread) and that the tumours are functional. Sometimes tumours are non-functional (i.e. they do not secrete excess hormones) - even more difficult to diagnose than their functional counterparts often leading to presentation at very advanced stages.
Most Neuroendocrine Tumours are slow-growing and therefore offer good prognosis if identified as early as possible and treated. Even for metastatic patients, the outlook is relatively good with the right treatment and surveillance. However, one of the biggest challenges for Neuroendocrine Tumour patients is the maintenance of a decent quality of life which can sometimes be impacted by the effects of their syndrome and/or the treatment.
It's quite difficult to write a short and generic explanation of the word Neuroendocrine in relation to cancer - no wonder I seem to spend 10 minutes verbally explaining to people and...... no wonder they sometimes look at me with glazed eyes :-) However, this is my offer. This is as brief as I can make it to provide understanding. I've cut out more than I've left behind and feel like I'm short-changing you! However, it needs to be basic and it needs to be short. Explanations which comprise lists of complex and unpronounceable words each with their own constraints and variable meanings leads to chaos. I could have just referred to one of the excellent publications on the web but this isn't really practical when in an impromptu conversation with wide-eyed listeners. That said, I believe the combination of this post and (if you see light-bulbs) the other 2 linked posts within, is a good way to answer the question if someone is willing to listen (and read a short reference). You may therefore need to follow-up the 'verbal' with the 'written'.
I intentionally made this explanation as generic as possible. Trying to explain every single type of Neuroendocrine Cancer will confuse and tire the best listener. If I was using this today, I would add my own additional comment about where my tumours were found and what treatment I've had - this I can do without a script! However, if you think this explanation is of use when verbally explaining Neuroendocrine in relation to your cancer, please feel free to share my blog post to aid understanding.
Thank you
Ronny
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