Medical Oncologist with interests in neuroendocrine tumours and theranostics
Joined September 2018
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David Chan retweeted
Patient asks if I can also fix teddy bear just before being put off to sleep... how could I say no?
David Chan retweeted
A12 6./ Research has yielded a host of treatment options that weren’t available to our fellow NET patients even a few years ago. We have miles to go before we sleep, but we have also come so far.
In new understanding lies progress.
In progress lies hope.
#PancChat
David Chan retweeted
A10 4./ In fact, I think delayed or mis-diagnosis is all too common in NETs. Not only does it lead to finding tumors at later stages, but I believe it can also engender mistrust of the medical community, which is truly a tragedy. #PancChat
David Chan retweeted
A9 5/. there is even a putative role for combining the two types of PET scans to generate a 'NETPET score', i.e. looking for tumor avidity for both FDG and gallium-68 DOTATATE, or “dual tracer” #PancChat ncbi.nlm.nih.gov/pmc/article…
A9/2: Uptake on this second PET scan (or octreoscan if DOTATATE PET isn't available) is needed for PRRT (radionuclide therapies eg Lutate) to be effective. Both scans at the same time might be useful in tricky cases #pancchat
A9/1: "Normal" PETs (FDG PET) look for faster-growing tumors and may be negative in low-grade tumors. 68Ga-DOTATATE/DOTATOC PET scan looks for low-grade tumors. This scan is more accurate than the Octreoscan. #Pancchat
A8. Yes, there are lots of trials going on for PNETs! Even though it is harder to do randomized trials (because PNETs are uncommon and those trials need lots of patients) we need new options for this often-neglected disease #PancChat
David Chan retweeted
A8. 1/. Clinicaltrials.gov is a terrific search engine (think of it like Google just for research) that, in my opinion, has become a lot more user-friendly in the past year, for docs and patients alike. #PancChat
A7. Treatment is totally different for PNETs. If surgery is not possible, low-grade tumors may be treated with somatostatin analogs (injections), targeted therapies (tablets), PRRT or other procedures. High-grade tumors are often treated with chemotherapy #pancchat
David Chan retweeted
PNETs can be
'functional' and cause: diarrhea, flushing, low/high blood glucose, wheezing
or
'nonfunctional' and cause compression/mass effect
#PancChat
Well said. And increasingly #nuclearmedicine as PET scans become more available worldwide..
#PancChat It's important to have a multidisciplinary #dreamteam to treat #pnet- #oncology #surgery #radiationoncology #interventionalradiology #endocrinology and more!
This is such a key point for NET patients - to know about their grade of disease - I couldn't agree more!
Most of my patients are conditioned to have their Ki67 scores memorized :) #PancChat
#PancChat Although some PNETs are very slow-growing, others (high-grade or Grade 3 NETs) do behave aggressively and have a prognosis similar to panc adenoca. The grade is vitally important in determining prognosis and the best treatment options.
David Chan retweeted
Tonight is #PancChat! Join us at 8pm ET / 5pm PT to discuss Pancreatic Neuroendocrine Tumors a/k/a PNETs. We will be joined by special guest @marklewismd who will discuss his personal PNET journey.
