s********o
发帖数: 3319 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: rereveal (xinyingxiangsui), 信区: MedicalCareer
标 题: 有人了解carcinoid tumor (神经内分泌肿瘤）吗？急求帮助！！
发信站: BBS 未名空间站 (Wed Jun 1 23:02:18 2011, 美东)
国内的亲人得了carcinoid tumor, 直肠是病源，现已做了手术切除。肝上面有多发的
小转移病灶。
国内医生不建议化疗，因为这种肿瘤对化疗不敏感。
家人一直在四处寻医，但问了几个医生，得到的答案都不一样，因为临床病例少，医生
缺乏治疗经验，基本是不知道下一步怎么治疗。
现在美国这面查到这种病情可以用药物（sandostain LAR，国内没有该药进口)控制，
加上一些积极的治疗手段。
专门打电话给carcinoid support group的人，被告知不少病人可以在治疗下控制很多
年。
因为很多美国的调查是自己在网上找的，或者道听途说，不是很确信。请问懂行的专家
，这病中美治疗是否差距很大？是不是应该到美国来求医？
Any related suggestion or information will be greatly appreciated!! |
r******l
发帖数: 81 | |
r******l
发帖数: 81 | 3 活检：CK＋，CAM5.2+, SY+ CHG-A+,CD56+, Ki67<2% |
C*****D
发帖数: 1299 | 4 早改名了(exept in lung)。这应叫neuroendocrine carcinoma. 根据病理再分well
differentiated and poorly differentiated. 我们这儿tumor board 上,是尽量把肝
转移灶切掉, 不行就放疗. 化疗得悠着点.
Steve Job得了胰腺endocrine carcinoma,最后还得肝移植.
这病在美国也不常见,不到NCI DESIGNATED 中心治,治坏的可能更大一些. 不要太迷信
CLINICAL TRIAL. |
r******l
发帖数: 81 | 5 谢谢ChiUSMD！ 我看这儿的patient也提到做切除手术，尽量切，也许不是完全切干净
？ 国内外科医生也许凭腺癌的经验，认为切不干净的话加速转移，所以不建议切？
这都是我个人的推断，可能是错的，请指正。
可以推荐治这病的医院吗？
肝移植可行吗？ |
C*****D
发帖数: 1299 | 6 Let me confirm with our surgical oncologist when I see him, I remember once
he told me that up to 80%, but usualy they won't go that far. American are
much stronger, I don't think liver transplatation is a good option. just my
opinion. |
r******l
发帖数: 81 | 7 请帮我问问，确实，American are much stronger.所以他们适用的治疗方法到了我们这
儿可能不适用。 |
C*****D
发帖数: 1299 | 8 Per our oncologist, the well differentiated one, liver mets need to be cut
aggressively, survival rate is pretty high with disease free.
If can't be cut,the prognosis is not good. Radioablation and drug are the
options. though the recent study showed the drug has some promising result,
he still prefer aggressive surgery.
My suggestion is to find out whether the liver mets are resectable or not.
The cost will be very high for liver rescetion in USA due to long post-
surgery care |
A*******s
发帖数: 9638 | 9 I heard Steve Jobs got the poor defferentiated type. He has been on the
transplant list. The oncologist I talked with went crazy about this.
Well, he has the money.
result,
【在 C*****D 的大作中提到】
: Per our oncologist, the well differentiated one, liver mets need to be cut
: aggressively, survival rate is pretty high with disease free.
: If can't be cut,the prognosis is not good. Radioablation and drug are the
: options. though the recent study showed the drug has some promising result,
: he still prefer aggressive surgery.
: My suggestion is to find out whether the liver mets are resectable or not.
: The cost will be very high for liver rescetion in USA due to long post-
: surgery care
|
r******l
发帖数: 81 | 10 应该是 well differentiated one.
国内外科大夫没有建议手术。ChiUSMD,我手头有病人的CT和MRI光盘数据，能拿给你认
识的oncologist看一下，看看美国的大夫是否认为应该手术？ |
|
|
A*******s
发帖数: 9638 | 11 我不赞成这种做法，ID的privacy应该得到尊重。
【在 r******l 的大作中提到】
: 应该是 well differentiated one.
: 国内外科大夫没有建议手术。ChiUSMD,我手头有病人的CT和MRI光盘数据，能拿给你认
: 识的oncologist看一下，看看美国的大夫是否认为应该手术？
|
s********o
发帖数: 3319 | 12 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: rereveal (xinyingxiangsui), 信区: MedicalCareer
标 题: 有人了解carcinoid tumor (神经内分泌肿瘤）吗？急求帮助！！
发信站: BBS 未名空间站 (Wed Jun 1 23:02:18 2011, 美东)
国内的亲人得了carcinoid tumor, 直肠是病源，现已做了手术切除。肝上面有多发的
小转移病灶。
国内医生不建议化疗，因为这种肿瘤对化疗不敏感。
家人一直在四处寻医，但问了几个医生，得到的答案都不一样，因为临床病例少，医生
缺乏治疗经验，基本是不知道下一步怎么治疗。
现在美国这面查到这种病情可以用药物（sandostain LAR，国内没有该药进口)控制，
加上一些积极的治疗手段。
专门打电话给carcinoid support group的人，被告知不少病人可以在治疗下控制很多
年。
因为很多美国的调查是自己在网上找的，或者道听途说，不是很确信。请问懂行的专家
，这病中美治疗是否差距很大？是不是应该到美国来求医？
Any related suggestion or information will be greatly appreciated!! |
r******l
发帖数: 81 | |
r******l
发帖数: 81 | 14 活检：CK＋，CAM5.2+, SY+ CHG-A+,CD56+, Ki67<2% |
C*****D
发帖数: 1299 | 15 早改名了(exept in lung)。这应叫neuroendocrine carcinoma. 根据病理再分well
differentiated and poorly differentiated. 我们这儿tumor board 上,是尽量把肝
转移灶切掉, 不行就放疗. 化疗得悠着点.
Steve Job得了胰腺endocrine carcinoma,最后还得肝移植.
这病在美国也不常见,不到NCI DESIGNATED 中心治,治坏的可能更大一些. 不要太迷信
CLINICAL TRIAL. |
r******l
发帖数: 81 | 16 谢谢ChiUSMD！ 我看这儿的patient也提到做切除手术，尽量切，也许不是完全切干净
？ 国内外科医生也许凭腺癌的经验，认为切不干净的话加速转移，所以不建议切？
这都是我个人的推断，可能是错的，请指正。
可以推荐治这病的医院吗？
肝移植可行吗？ |
C*****D
发帖数: 1299 | 17 Let me confirm with our surgical oncologist when I see him, I remember once
he told me that up to 80%, but usualy they won't go that far. American are
much stronger, I don't think liver transplatation is a good option. just my
opinion. |
r******l
发帖数: 81 | 18 请帮我问问，确实，American are much stronger.所以他们适用的治疗方法到了我们这
儿可能不适用。 |
C*****D
发帖数: 1299 | 19 Per our oncologist, the well differentiated one, liver mets need to be cut
aggressively, survival rate is pretty high with disease free.
If can't be cut,the prognosis is not good. Radioablation and drug are the
options. though the recent study showed the drug has some promising result,
he still prefer aggressive surgery.
My suggestion is to find out whether the liver mets are resectable or not.
The cost will be very high for liver rescetion in USA due to long post-
surgery care |
A*******s
发帖数: 9638 | 20 I heard Steve Jobs got the poor defferentiated type. He has been on the
transplant list. The oncologist I talked with went crazy about this.
Well, he has the money.
result,
【在 C*****D 的大作中提到】
: Per our oncologist, the well differentiated one, liver mets need to be cut
: aggressively, survival rate is pretty high with disease free.
: If can't be cut,the prognosis is not good. Radioablation and drug are the
: options. though the recent study showed the drug has some promising result,
: he still prefer aggressive surgery.
: My suggestion is to find out whether the liver mets are resectable or not.
: The cost will be very high for liver rescetion in USA due to long post-
: surgery care
|
r******l
发帖数: 81 | 21 应该是 well differentiated one.
国内外科大夫没有建议手术。ChiUSMD,我手头有病人的CT和MRI光盘数据，能拿给你认
识的oncologist看一下，看看美国的大夫是否认为应该手术？ |
A*******s
发帖数: 9638 | 22 我不赞成这种做法，ID的privacy应该得到尊重。
【在 r******l 的大作中提到】
: 应该是 well differentiated one.
: 国内外科大夫没有建议手术。ChiUSMD,我手头有病人的CT和MRI光盘数据，能拿给你认
: 识的oncologist看一下，看看美国的大夫是否认为应该手术？
|
