Questions for surgeon-considerations choosing PRRT or surgery

There's a good chance of you having both treatments when all is said and done. For me they used PRRT first to reduce the tumor size. There was still plenty left for the surgeon though - tail of the pancreas, spleen and gallbladder plus liver ablation. Other times they do surgery first then use PRRT or chemotherapy later.

Thanks for sharing. What was the size of your larger tumors? What type of ablation did you have? They did not need to surgically remove any of the tumors from the liver they were able to remove them with ablation? Who did your surgery?

@splendrous: I was in similar situation last year. If I were you I would get Gallium 68 PET scan to reveal tumors reactive to PRRT targeting. I believe PRRT can eliminate small tumors and reduce size of larger ones - that’s the response I got from Lutathera PRRT and it continues to reduce tumor size with three MRI Evoist scans since the final treatment Dec 2024! We NET patients are all different. After the GA68 PET results I would get 2nd NET Oncologist expert consultation & also 2nd opinion from NET surgeon. Of course we all lean towards the less invasive treatment and may choose to avoid complications resulting from surgery; however, we also want longest-lasting tumor control. The more info you accumulate I think will lead you to your best decision. My best thoughts are with you! dbamos1945

Surgery was done at Trinity Hospital in Ann Arbor Mich, not at Mayo. All my treatment was there except for PRRT at University of Michigan cancer center.
The primary tumor was pancreatic, about 1.5 to 2 cm as I recall. They did liver ablation with radio frequency but didn't surgically remove anything from the liver so far as I know. The chart says they focused on two large masses in the liver and had "excellent results". Later in the report the surgeon says "No real surprises, just what we expected." Well before any of these other treatments they had also done a hepatic artery embolization to block the blood supply to the tumors.

Hello were you prescribed other treatments after PRRT? My husband will be doing PRRT soon but our NET are small / microscopic and may be in the head of the pancreas... would like to anticipate what to expect after PRRT.

@blee123: As you are aware, NET patients do not react the same to treatments; but my PRRT Lutathera treatment (June 2024-Dec 2024) eliminated some smaller NETs from MRI Eovist scan, the larger tumors were drastically shrunk, and one was stabilized. NET Oncoligist was very pleased with my body’s response and requested I have repeated MRI Eovist scans every 3-6 months in future to remain vigilant. Super!
The follow-up scans have continued to show reduced size of tumors.
Of course NET tumors can grow again anywhere and since I have small intestine primary with liver metastases, it is a probability that I may need more treatments as situation changes; but I have gained at the least MORE TIME to enjoy this life.
I suggest you both remain positive during treatment and visualize tumors “blowing up into oblivion” - if I felt a little ache or twang I applauded the Lutathera “working”!
I wish you great success with PRRT.