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Learning more about rare types of cancer

By Athena Karsera

Great strides are being made in the timely diagnosis and treatment of types of cancer that were, until fairly recently, shrouded in mystery.

The Director of the Department of Medical Oncology at the Bank of Cyprus Oncology Centre in Nicosia Dr. Demetris Papamichael on Monday spoke to journalists about Neuroendocrine tumours (NETs) on the invitation of Novartis Pharma Services Inc. Cyprus.

Positive changes

In a brief presentation, Papamichael noted that little had been known about NETs when he graduated from medical school some 20 years ago but that since then “things have changed dramatically and very positively”.

He said NETs were not as prevalent as other types of cancer, giving the example of around 500 instances of breast cancer being diagnosed in Cyprus per year and only 15 to 18 of NETs.

This low rate of prevalence is also the main reason why any significant research into these types of cancer is fairly recent. It has only been since oncology centres around the world began to work together and exchange information on their NETs patients that significant ground has been covered.


Because symptoms of NETs vary greatly and often do not appear until later on, doctors are sometimes slow to diagnose them.

An increase in the number of diagnoses over recent years, Papamichael continued, is also most likely because doctors are now becoming more aware of NETs and more often taking them into consideration when diagnosing a patient.

“An oncologist such as myself will probably be familiar with NETs but a pathologist, for example, may just have some recollection of hearing about them at medical school,” he said, adding meetings were being carried out to remind doctors with other specialities to consider NETs when trying to pinpoint what is ailing their patient.

“It is also important for doctors to be aware that there are many more treatment options now than before when chemotherapy was the only option,” Papamichael noted.

Equal prevalence

With close to equal prevalence between men and women, NETs can appear anywhere in the body but are most prevalent in the rectum (17%) and jejunum which is the second part of the small intestine (13.4%).

Carcinoid syndrome, which occurs when a rare cancerous tumour called a carcinoid tumour secretes certain chemicals into your bloodstream, has, in Papamichael’s experience, only been found in around 8% of NETs cases although, internationally, they are reported at between 8% and 35%.


Treatments which according to Papamichael are generally available in Cyprus, include somatostatin analogue treatment, chemotherapy, mTOR inhibitors, biological therapy, angiogenesis inhibitors, and Peptide Receptor Radionuclide Therapy (PRRT).

“My advice to patients would always be not to ignore persistent symptoms of any kind. If something has been wrong for a while, get it checked out,” he said, referring to all health problems including NETs.

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