← Return to Just diagnosed with PNET: Any thoughts on watch & wait approach?

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@tomrennie

"Cutting it out is the only cure!!!!" I have been belittled with that statement many times. I will share my thoughts. I am alive. I am thriving. Part of that thriving is an understanding that chemo sux. It is ok. It could be worse.

When I was first diagnosed with my metastatic PNETs, I met about 6 folks on here with a very similar diagnosis. Most had the cut it out is the only cure mentality. Unfortunately, several are either gone or struggling with the side effects of surgery that resulted in other surgeries. I believe that they have it far worse than I do. Learning from other personal surgeries in the past, the results are not a certainty. EM's experience gives some glimpses of that. Complications happen during the procedure. Recovery has its own set of complications. I also don't believe there is a cure for NETs. Through my journey, my NETs pop up all over on scans. But, most tend to go away. Those that don't, my care team at Mayo Arizona and I know exactly where they are. After 1 year of CAPTEM and now 1.5 years of just Capecitabine, I still get a slight decrease in metastasis every time. I will quote my main doc at Mayo. "If it ain't broke, don't fix it." I won't do surgery unless I absolutely have to. With the introduction of AI into clinical studies, pretrial research that took years will be compressed to months. The data analysis of ongoing and new trials will significantly reduce. Also, the cross referencing of drug successes across multiple cancers will be a lot easier to do. For example, I am on capecitabine now. Its original FDA approval was for colorectal cancer in 2001. It has also been effective for treating breast cancer. During a dermatologist appointment, I was asked why did all of my squamous cell spots on his watch list disappear. I learned that he prescribes capecitabine for challenging squamous cell skin care patients. He had no idea that capecitabine was being used for PNETs. He really didn't know what PNETs were. He is a great doctor that I have been going to for 25 years. Oh by the way, he is at Mayo.

I believe in riding the capecitabine train as long as I can. If something better comes along, I will consider that route. I don't feel anything else is better currently. We are all different. My main suggestions are do your homework. Listen to your doctors. But ultimately, you make the decisions. You will be the one dealing with the consequences.

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Replies to ""Cutting it out is the only cure!!!!" I have been belittled with that statement many times...."

I am one of Colleen's tagged names. We all been where you are, I can only imagine how you feel. We all thought it was over after hearing about we had cancer, not knowing anything about what the heck is NET. Fortunately, we had a oncologist, that quickly explained to hold the horses on thinking your dieing tomorrow. He quickly taught us about NET, about there are many different ways it is sneaky in the body, growing so slow, sometimes for so long before anyone catches it. Then the battle starts, our oncologist had only seen 2 cases in 40 years of pracitice, and knew he had to get us the best in our area. He referred us to multi-discipline team, including a NET Specialist that guided us the past two years, and in my opinion saved her life. Although, different than your case, she had a tumor on the tail of the pancreas, which spread to the liver. We couldn't operate on it at first, the tumors in both spots where too big. So 9 months on CAP/TEM fixed that and reduced it by 70%, then surgery was allowed, that eventually was followed by PRRT, which killed more it, to a point that we were given a choice by our team, which we got 2 other opinions to possibly get a liver transplant, since after the 1st surgery the only NET that was in her body(that they knew of) was on the liver. It was a very tough decision, and after much thought, we chose to do it. It has been very difficult since the surgery in January 2025. After a total of 3 surgeries and 4 procedures, she is tracking better, with some challenges to overcome still, but the moral of all this, that applies to your story, is to make sure you have a team, that includes a NET Specialist, and follow their advice in your case, then it will be your decision to go forward or possibly get a 2nd opinion. You see we can't tell you what to do, we can tell you what we did, but every case is different, and you have to get all the advice you can get from your team, and go with your gut. We all got you, you got this! Let us know how we can help.