Differences in NC
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Different neuroendocrine cancers affect people in different ways depending on where they are, how slowly or rapidly they are growing, their differentiation, whether they are functioning or non-functioning, whether they are associated with symptoms or not, what stage they are at and whether they have a genetic link or not.
They can also appear to behave differently when other factors are in play, for example; other health conditions, age, access to expert healthcare, treatments, responses to treatment and decisions made regarding care and treatment.
Although neuroendocrine cancers may share similar characteristics, the diagnosis and the way the cancer may behave can be different between people.
Looking at the staging, grading and function of your cancer together enable your care team to understand your particular Neuorendocrine Cancer and to recommend the best type of treatment for you.
Differences in Neuroendocrine Cancer –
Where in the body it occurs – e.g. Lung, Small bowel, Pancreas, Skin, etc.
The rate at which it grows – this is an assessment, using a microscope, to examine cells to see how many are actively replicating and growing. You might see ‘Ki67’ or ‘Mitotic Index’ mentioned in your clinic letters or medical reports alongside a Grading – G1, G2 or G3.
‘Mitotic rate’ (MiB1) or Ki67 are the measurements used to assess the rate at which your cancer is growing.
Ki67 is a protein that is present during all of the active stages of the cell cycle – a useful marker of proliferation (cell division and growth) – often expressed as a percentage (%)
- Grade 1 is where the Ki67 is less than 3% and cells are ‘well-differentiated’
- Grade 2 is where the Ki67 is between 3 and 20% and cells are ‘well-differentiated’
- Grade 3a is where the Ki67 is above 20% and the cells are ‘well-differentiated’
- Grade 3b is where the Ki67 is above 20% but the cells are ‘poorly-differentiated’.
Grade 3b is treated differently to Grades 1-3a – further information about Neuroendocrine Carcinoma here.
The degree of abnormality of the cancer cell:
- Well-differentiated refers to abnormal cancer cells that retain some similarity to their original cell
- Poorly differentiated cells have lost most, if not all, similarity.
Refers to the hormone and chemical production and release by these cells.
- Non-functioning neuroendocrine cancer cells usually retain their ability to release normal amounts of hormone or chemicals
- Functioning neuroendocrine cancer cells produce and release abnormal amounts of the hormone or chemical they are usually responsible for.
This abnormal release can result in symptoms and / or syndromes. For more information about Syndromes click here.
N.B. Functioning may also be used as a term to describe whether your cancer is ‘positive’ on scans, that is, can it be seen on ‘functional imaging’ such as Octreotide, Gallium and / or FDG-PET scans.
Tells us whether the cancer is localised (limited to the area in which it arises) or disseminated (has spread to other places in the body). Staging is usually assessed by scans. Commonly, there are 4 stages:
- Confined to the area in which it starts
- Has spread to surrounding cells or tissue
- Has spread beyond surrounding tissues and to nearby lymph nodes
- Has spread to another place within the body, including lymph nodes.
Familial or Sporadic is, whether the cancer has developed as part of a genetic condition or not. For more information about Familial (Genetic) conditions associated with Neuroendocrine Cancer visit AMEND.
Ki67 is a protein that is present during all of the active stages of the cell cycle – a useful marker of proliferation (cell division and growth). You might see ‘Ki67’ or ‘Mitotic Index’ mentioned in your clinic letters or medical reports. They are the measurements used to assess the rate at which your cancer is growing.
Neuroendocrine Cancer UK is a UK wide charity solely dedicated to providing support and information to those affected by Neuroendocrine Cancer.
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