Preparing for Appointment: Dr. Maloney Patel

Tomorrow is my appointment with Dr. Maloney Patel, who is a colon-rectal surgeon at RWJ. Hopefully, some of our questions will be answered:

First, starting with what I do know:

Cancer Type: Gastrointestinal Carcinoid Tumor aka Neuroendocrine Tumor (NET)

Date of Diagnosis: April 21, 2010

Tumor Size: 3cm

Primary Origin: Appendix

Now, what I don't know:

What stage is my cancer in?

Stage Determination based on Point of Origin and TNM

T - size (cm)

N - extent spread (regional)

M - extent spread (distant)

Staging for Appendiceal Carcinoid Tumor according ACS:

Stage I: (only for tumors less than 2cm)

Stage II: T2 or T3, N0, M0: the tumor is either larger than 2 cm OR it has grown into the cerum (T2) or ileum (T3). The cancer has not spread to nearby lymph nodes (N0) or to distant sites (M0).

Stage III: either
T4, N0, M0: The tumor has grown into nearby organs or tissues. The cancer has not spread to nearby lymph ndoes (N0) or to distant sites (M0).
OR
Any T, N1, M0: The tumor can be any size and may or may not have grown into nearby structures (any T). It has spread to nearby lymph nodes (N1), but not to distant sites (M0).

Stage IV: Any T, any N, M1: The tumor can be any size and may or may not have grown into nearby structures (any T). It may or may not have spread to nearby lymph nodes (any N). The cancer has spread to distant sites (most often the liver).

NET Tumors: When Size Matters

Because carcinoid tumors are "slow growing" cancers, the likelihood of whether or not the tumor metastasized (spread) is directly proportional to its size. Typically:

If the tumor is less than 1 cm, then there is only a 5% chance that it has metastasized

If the tumor is 1-2 cm, then there is a 40-45% chance that it has metastasized

If the tumor is over 2 cm, then then there is more than a 50% chance it has metastasized.

About 50% of carcnoid tumors occur in the digestive system, 30% in the lungs, and 20% in other organs.

The carcinoid tumor, found in my appendix, was 3cm when it was removed. My gynecological oncologist explained that the treatment for a carcinoid tumor of this size was a right hemicolectomy, and she arranged for me to meet with a doctor she's worked with at RWJ in the past (Dr. Maloney Patel).

Carcinoid Cancer Awareness

Zebra stripes are used to symbolize rare or “camouflaged” conditions. The Carcinoid community wants med students to flip the old adage, and think: “When you hear hoof beats don't assume it's a horse, it might be a zebra.”







Wearing a zebra pin or a zebra-striped bracelet or ribbon shows your support to promote awareness and to fund the education and research needs related to carcinoid cancer.

TWO GOOD WEBSITES:
www.caringforcarcinoid.org
www.carcinoid.org

Carcinoid Cancer Survivor

Someone once said that the minute you decide to fight your cancer after diagnosis you can call yourself a survivor. I like that. On the morning of Tuesday, April 27, 2010, I was diagnosed with appendiceal carcinoid cancer. On the evening of Tuesday, April 27, 2010 I became a carcinoid cancer survivor.