Time for a Vocabulary Lesson

Whenever a dramatic diagnosis comes your way, you develop a whole new vocabulary that is specific to your situation.  These words are beyond the scope of ordinary, every day life.  So let's jump into the educational portion of this journey.  

Oncologist--a doctor dealing specifically with cancer.  Mine also is a hematologist--a doctor who deals with blood disorders as well. 

Neuroendocrine tumors--tumors that arise from specific cells in the body that are termed "neuroendocrine" cells. These cells are concentrated in the pituitary, in the pancreas, in certain other places of the gastrointestinal system. They're not tumors of nerves or the central nervous system.

Chromogranin-A--blood test to determine the activity of the tumors

5-HIAA--24 hour urine collection to determine serotonin production.  It stands for five hydroxyindoleacetic acid.  One of the dangers of these tumors is excess serotonin--a necessary hormone that is your "feel good" hormone.  A surfeit of serotonin over a long period of time can erode the tri-cuspid valve in the heart.  Not a good thing to have happen.  

Octreo-Scan--is a nuclear medicine test very similar to a bone scan where someone is injected with a very small amount of radioactivity and the tag here localizes to the tumor.  This test takes two days.  The injection of the radioactive agent, followed by a scan five hours later.  Then a second scan is taken twenty-four hours later.  The scans require the body to be totally immobilized for the duration, taking up to two hours for the scans.  Yes, I had one of these done. 

Sandostatin or Octreotide--this is the drug used to treat my tumors.  It helps prevent serotonin production from the tumors.  There is a similar drug called Lanreotide that works in much the same way.  Just for a point of reference, the Sandostatin is given with a 19 gauge needle about two inches long.  Injections for cattle are given with an 18 gauge needle, the smaller the number, the larger bore the needle is.  A blood draw is done with a 22 gauge needle. 

Y-90 or Yttrium-90--a treatment used to inject radiation directly into the tumors through the femoral artery.  The side effect of this is that the Y-90 can cause radiation burns to the liver that will create problems later on, personal experience. This is also called Radio-Embolization.  There is a similar treatment called Chemo-Embolization that injects chemo drugs (doxorubicin) directly into the tumors.  Both of these treatments have dual purposes--to kill tumor cells while creating blockage to the blood supply to the tumors. 

IMRT--Intensity Modulated Radiation Therapy--this is a targeted radiation therapy that doesn't harm other nearby organs.  I had this done to treat one tumor that was the size of a tennis ball located outside my liver.  This was done primarily as a palliative measure because of the discomfort this particular tumor was causing.  It shrank to the size of a golf ball before the treatment was finished, and continued shrinking to the size of a marble.  

SRT--Stereotactic Radiation Therapy (SRT) is a type of external radiation therapy which uses special equipment to precisely position the patient in order to deliver radiation to a well-defined cancerous tumor. With SRT, the total dose of radiation is divided into several smaller doses given over several days.  Instead of five days a week for six weeks, this treatment is given over five days and is done.  This is the treatment I would have had, except for the fact that my insurance company was dumb.  Even though this was less expensive and shorter duration, they decided, in their infinite wisdom, that I needed the longer, more expensive kind of therapy.

Ascites--free floating fluid in the abdomen caused by damage to the liver. 

Paracentesis--mechanically draining the ascites for comfort. It is a tiring procedure that really isn't all that taxing, but it does lay me low for a day. Generally they drain 4 liters of ascites every three to four weeks. That's nearly nine pounds for the non-metric users.

As the days go by, I am gaining new vocabulary with each new development in my situation.  These are just some of the things I've been through.