All of the doctors and oncology staff are prepared to help you on this pathway which, for many, can result in long-term tumor control, if not cure. If you would like to learn more about carcinoid tumors and neuroendocrine tumors, we have provided several links at the right to authoritative sources about the disease, treatments and support.

© Lynn Herbert Ratner MD

Carcinoid and Neuroendocrine Cancer Basics disclaimer

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Any diagnosis of cancer is a frightening experience and we know that you are worried and have many questions. Gaining knowledge of your disease and the options available to deal with it will help you adjust to this new reality of your life. In our practice we place a high priority on helping you understand the disease and your options and to assist you in dealing with the many concerns that such a diagnosis is sure to bring with it.

Carcinoid cancer and neuroendocrine tumors (NETs) are an entire family of disorders and they constitute a special area of interest for our practice. We have formed links to The Carcinoid Cancer Foundation and The North American Neuroendocrine Tumor Society (NANETS) and ENETS (The European Neuroendocrine Tumor Society). Dr. Ratner's interest in this family of disorders dates back to 1965 when he was a resident in Medicine at New York Memorial Sloan Kettering Cancer Center, and he has also fostered close relationships with the physicians in the Neuroendocrine Tumor Section at Mount Sinai, NY.

These tumors are usually slow growing and small in nature and, compared to other types of cancers, they usually take many years before they become sizable or cause symptoms. They are usually found in the gastrointestinal system but can arise in other parts of the body such as the pancreas and lung.

A characteristic of these tumors is the creation of hormone producing cells that line the small intestine and which can produce hormone-like substances with names such as serotonin, bradykinin, histamine and prostaglandin. Levels of these hormonal substances can become high enough to produce hormonal effects such as flushing and diarrhea, among other symptoms.

As with many other tumors, staging (determining the current status of the disease) becomes a very important part of the process. When you are initially diagnosed with either carcinoid tumor or neuroendrocrine tumor, your doctors will need to establish whether the tumor is invasive or not and whether it has spread from its original site and, if so, to what extent. This is done with various lab tests and imaging studies.   You may hear the term TNM used in staging discussions. T refers to the size of the tumor, N refers to the number of lymph nodes involved, if any, and M refers to metastases (whether or not the tumor has spread to other areas of the body).

We mentioned earlier that these tumors secrete hormones and this hormonal production of the tumors can be used to help image the tumors using specialized techniques such as an Octreotide scan or a PET/CT scan. We interact frequently with the Mount Sinai Hospital Neuroendocrine Tumor Section and the Lenox Hill Hospital Gastroenterology Division to measure tumors and also to plan and carry out appropriate treatment.

And because the tumors produce these unique hormonal substances, there are medications which have been developed that can facilitate in the medical management of symptoms of the disease. A new age of therapies has been developed as well with non-chemotherapeutic means of managing the disease using so-called targeted agents specifically designed to work at the site of the disease.

The initial phase of our interaction with you will be to stage the disease and then to discuss and agree on the appropriate treatment program for you. We will take into account your disease characteristics, extent of disease (stage), your overall health status and other medical conditions. We will also consider your degree of risk, your personality, lifestyle, family situation and philosophy.  You will be a part of the team with your doctor and other healthcare professionals. As the treatment progresses, we will frequently interact with other members of the multi-disciplinary team including Nuclear Medicine specialists, radiologists, surgeons, and the team of specialized gastroenterologists who are interested in this group of diseases.

Valuable Carcinoid and Neuroendocrine Cancer Resources

The National Cancer Institute information for patients about carcinoid tumors

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The National Library of Medicine
information for patients about carcinoid tumors

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The American Cancer Society infprmation about carcinoid tumors

Lynn H Ratner MD
Paul A C Greenberg MD

112 East 83rd Street
New York City, NY 10028
tel: 1-212-396-0400 fax: 1-212-396-9800

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Doctors Ratner and Greenberg

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The Carcinoid Cancer Foundation information for patients

Cancer.NET information from the American Society of Clinical Oncology