Metastatic Neuro-endocrine tumour of Pancreatic Origin with Liver Metastases

My copy of the latest Oncology report to my GP arrived today. Previous such reports were headed as per the subject line above, but this ones got some codes added to the end, namely "G3 Ki67 37%".

Google can be very useful, but at other times can be quite dangerous. As I understand Google, Ki67 refers to the small intestine; G3 is some sort of seriousness level grouping but I couldn't determine whether G1 or G3 was the worst; and, 37% seemed to indicate a survival rate.

Treatment is currently suspended, due to chest pains, until I get an Echocardiogram and Cardiologist's report, although the pains have virtually disappeared after my GP prescribed Famotidine. The Echo is booked for late April - the Oncologist would like a stress one, but I've not heard as yet if it will be.

I don't see the Oncologist again until early May, so would be grateful for a little clarity on these codes, if possible in English!!!

Very many thanks.

  • Hello WeDontByte,

    Thank you for getting in touch with us, and welcome to our online community. My name is Annerose, I am one of the Cancer Information Nurses on the Macmillan Support Line.

    I can see from your online profile, that your cardiac side effects have eased off over the last two weeks, and I hope you are continuing to feel better.

    I understand from your information, that you have a Neuroendocrine tumour (NET) of Pancreatic origin which has spread to the liver. 

    Medical terminology can be a bit confusing at times and although Google has its uses, we agree with you, that it can be dangerous, and do not encourage the use of it too much.

    However, you have it right in some parts, the G3 in terms of cancers refers to how different the cancer cells look from the original cells, and this gives the team an idea on how quickly a tumour is able to grow.  G1 looks very much like the original cell type, and is likely slow growing and G3 looks very abnormal and has not much in common with the original cell type anymore, it tends to grow fast, it’s sometimes also called high grade.

    Ki67 is a specific test for Neuroendocrine tumours to look at the cell division in these tumours. It does not indicate survival rate as such. But as with the Grading numbers, the lower the number, the slower the cell division, the slower the tumour will grow.

    A Ki67 index of 37% could mean that 37% of the NET cells are dividing, which would indicate a fast growth rate, and this is indicative for a Grade 3 NET.

    Cancer Research UK have some information on this. Neuro endocrine tumours slightly differ from other cancer types, you might find more information via the Pancreatic Cancer UK website, and indeed on the Neuroendocrine Cancer UK website.

    I hope this has been helpful. If you’d like to talk to one of our nurses or advisors, please don’t hesitate to give us a call on the support line on 0808 808 0000. We’re open from 8am until 8pm every day. We’d love to hear from you.

    Best Wishes, and all the best

    (Cancer Information Nurse Specialist)
  • Hi Annerose

    Very many thanks for the reply, I found it very helpful in understanding what's going on inside me! There were also some very useful information links that I followed. I don't really know why but we'd never really had a clear explanation from the Oncologist (probably should have asked more questions, but this always comes as a shock) although he was always very positive about the treatment and what was involved.

    As I said above, the Famotidine seems to have stopped the chest pains (or more specifically, the central chest pains), but I've now developed pains in my right hand spreading from my little finger, occasional pains under my ribs, AND excruciating pains in my left knee; I had keyhole surgery on my left knee for a torn ligament in 2015 and its been no bother since, but now it's started making me really hobble. Even more strangely, if I continue to walk the pains ease off and disappear completely until a bit later they come back with a vengeance and I have to repeat the process of walking carefully until the pains disappear. Don't understand it. Anyway, got a GP appointment next week so she can have a look, in the meantime, I've got it strapped up and am rubbing voltarol into it twice a day.

    Thanks again for all your help.