Ronald Van Iwaarden Journey

 

Hey!  Welcome to the club!!!

 

 I was first diagnosed in October of 2001 with a complete small bowel

 obstruction due to a 1.6cm tumor.  I had 15cm of the Illium removed

 along with a wedge of a few mescenteric lymph nodes and a tiny wedge

 of liver.  All the lymph nodes (I think three) showed tumor and the

 small section of liver did as well but also had clear margins so the

 small amount they removed had all the tumor in that spot.

 

 As you have probably heard, Carcinoid is a very slow growing cancer

 but don't let anyone tell you that it is benign.  Carcinoid cancer

 often has some annoying side affects called carcinoid syndrome. 

 Carcinoid syndrome often manifests itself in many ways, the most

 common being diarrhea and flushing (redness and heat) in the face. 

 Syndrome is often aggravated by other tings such as alcohol,

 exercise/exertion/excitement, or some medications including those

 whose names end in 'ine' (Morphine, Epinephrine, ...).

 

 I am treated both locally by an oncologist in Colorado Springs as well

 as an expert (Dr. O'Dorisio) at the Univerity of Iowa in Iowa city. 

 The reason for both is that Carcinoid is a very rare cancer and it is

 not likely that many non experts have seen more than half a dozen

 cases in their careers.  There are many experts throughout the country

 and I chose Dr. O'Do after checking with a few but there are many

 excellent choices.  My local oncologist is usually very good about following Dr.

 O'Do's recommendations.  The carcinoid specialists are all wonderful

 and usually give out email addresses, cell phone numbers and other

 ways to contact them.

 

 As to treatment, you almost certainly need treatment of some sort. 

 The most standard treatment for Carcinoids is Sandostatin which is

 given sub-cutaneously three times a day or through Sandostation-LAR

 which is given intra-muscular once every 28 days.  This medication

 reduces the amount of carcinoid syndrome you will experience and tends

 to slow the growth of the tumors.

 

 Things you need to start:

 

 1) Get a carcinoid panel done on a regular (every 3 month) basis. 

 This panel is done by Intra Sciences Institute (ISI) and can be drawn

 by your local lab (Qwest does mine).  It does require a 'Z' tube which

 is a bit non-standard.  There are two measures from this panel that I

 follow

 regularly: Chromogranin-A and Pancreostatin.  Your exact level is not

 too important but what is important is to follow the trend of those

 numbers.  You want level or decreasing but we all eventually start

 increasing (mine did about 6 months ago after 6 years of level).

 

 2) Start getting information.  Medicine should always be done with

 knowledge of both the patient and the Doctor.  Doctors often know more

 than we do but make sure you are on top of what is currently going on.

 You probably want to get connected to the Yahoo carcinoid newsgroup as

 it is moderated and only provides information.  There is another group

 on ACOR but it often gets a bit annoying with bickering.

 

 A support group just started in the last couple of weeks up in Denver

 and our next meeting will be in about 3 months.  I cc'ed the

 coordinator of the meeting, Jeanne Lambert, on this email. 

 Additionally, there is going to be a run for hope 5k in Fort Collins

 in July which I am going to join in and many other noids will be there as well.

 

 You can also go to the following web sites for more information:

 

 http://www.carcinoid.org/

 http://www.runforhope.net/

 http://www.caringforcarcinoid.org/

 

 I have been living with this for 6.5 years now and, most of the time,

 it leaves me alone as long as I get my dose of Sandostatin-LAR.  I

 coach my 7 year old son's soccer team, play ice-hockey 2-3 times a week and set

 a new personal best this past winter:  30 ski days!  All cancer sucks

 but at least we have the 'diabetes' of cancer.  If you would like you

 can also feel free to give me a call:

 

 Home/Evenings: (719)481-5647

 Work: (719)721-9873 (not often at desk but you can try)

 Cell: (719)459-2328 (Doesn't work at work...)

 Ronald Van Iwaarden [ron@vaniwaarden.org]

 --Ron