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Carcinoid Disease: A Personal Look

Posted Aug 24 2008 1:49pm
ANNOUNCER: Linda Ashbey spent 13 years making appointments with doctors and undergoing test after test, trying to find out why she had diarrhea. Diarrhea so bad it could strike 12 or 15 times a day.

LINDA ASHBEY: And they come back and tell me that they didn't find anything and that maybe it was irritable bowel syndrome, which was usually one of their better guesses. Or stress, and they would offer me nerve pills. They would tell me to watch what I ate.

I was angry. Because I knew I was in pain. I had real pain, and I just felt like they weren't doing enough to help me.

LOWELL ANTHONY, MD: Her complaints lasted for years and literally nothing helped her.

LINDA ASHBEY: In July of 2001 I went to the doctor because I was passing blood, and he was examining me and he was pressing on my stomach and he said, "Oh, this is a carcinoid cancer tumor." And I of course panicked and jumped up off the table and said, "What do you mean cancer," you know, "I don't have cancer."

ANNOUNCER: A CAT scan supported the diagnosis. Surgery was scheduled quickly.

LOWELL ANTHONY, MD: The surgery that Mrs. Ashbey had comprised of the removal of that segment of the intestines that contained her primary tumor. Her primary tumor had already grown through the wall of the small bowel. And there had been droplets, or tumorlets, that had implanted around her abdominal cavity.

ANNOUNCER: Carcinoid tumors are very slow-growing tumors of cells that secrete hormones. These hormones can cause symptoms, such as the diarrhea Mrs. Ashbey experienced. It was impossible for the surgeon to remove every cancerous cell, so Mrs. Ashbey will face a life-long battle.

LOWELL ANTHONY, MD: She could not be clearly rid of all cancer cells at the conclusion of her surgery. So this puts her at a situation where these tumors can continue to grow. These are metastatic disease sites, and they can release hormones. They could potentially spread to other parts of her body, and this is part of the management of her disease, is to see how stable those areas of involvement of the disease is.

ANNOUNCER: The cancer that was left behind, coupled with the surgery to the bowel, meant Mrs. Ashbey continued to experience diarrhea, although not as severe as before.

LOWELL ANTHONY: Mrs. Ashbey, post-operatively, has continued to experience some degree of diarrhea which could be contributed to the carcinoid tumor that's left in her body or the shortened gut that has occurred with her operation.

LINDA ASHBEY: It was very, you know, very aggravating because I felt like I had been through a lot, and I didn't anticipate that, you know, I thought I was just going to wipe it all away.

ANNOUNCER: Doctors first tried to treat the ongoing diarrhea with common anti-diarrhea drugs: Lomotil and Imodium.

When Mrs. Ashbey's diarrhea continued, Dr. Anthony tried another type of medicine called a somatostatin analogue.

LOWELL ANTHONY, MD: Somatostatin analogues are administered either underneath the skin or in the muscle, either in an immediate form or a slow form, and they're transported to the actual tumor cell through the blood, where they bind to a very special substance that we call the somatostatin receptor. When this occurs, then there's a whole, set of events that happen within the cell, one of which is to decrease the amount of hormones that are secreted.

ANNOUNCER: With the reduction of those hormones, fewer fluids are released into the intestines, and the passage of stool through the intestines is slowed, allowing for more absorption of fluid.

LOWELL ANTHONY, MD: With the somatostatin analogues, we are attacking the specific underlying cause of the disease.

ANNOUNCER: Mrs. Ashbey's cancer is being monitored, and the disease is under good control. She still experiences diarrhea. But it is much less frequent and severe than before, when it significantly impacted on her life.

LINDA ASHBEY: I'm able to make plans and go on trips. I've been on several cruises, and we can go out of town in a car and travel on the highway. I can go to weddings and out to dinner and to a movie, and basically, you know, and enjoy all the things that life has to offer now.

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