神经内分泌肿瘤幸存者无视赔率

Curtis Crump is serious about staying in shape. With his job, he has to be.

“I’m an airplane and helicopter pilot with the Harris County Sheriff’s Department,” he explains. “I conduct aerial surveillance that helps officers on the ground track down and catch criminals on the run. It’s demanding work, and physical fitness is a requirement.”

But Curtis wasn’t always so healthy. Four years ago, doctors foundneuroendocrine tumors在他的结肠和肝脏中。

A neuroendocrine tumor diagnosis

第一个警告在周日晚上很晚。柯蒂斯（Curtis）拜访了他当时在圣安东尼奥（San Antonio）的女友后开车回家。回家中途，他在右侧出现了刺痛的疼痛。

“It was agonizing,” he says. “I thought I had appendicitis.”

He pulled into an urgent care center, where aCT scandetected a tumor the size of a tennis ball in his colon.

“After that,” he says, “everything happened quickly.”

An ambulance took Curtis to a nearby hospital, where a活检confirmed the tumor was cancerous. Scans showed cancer cells had crept outside the colon and spread to his liver.

“The doctor told me my liver was saturated with neuroendocrine tumors,” Curtis recalls. “When I asked, ‘How many tumors?’ he said, ‘Too many to count.’”

Curtis was given a stage IV neuroendocrine tumor diagnosis and six months to live.

神经内分泌肿瘤可以在体内任何地方形成

神经内分泌肿瘤在制造激素的专用细胞内生长 - 控制和协调体内几乎所有过程的化学物质，包括生长和发育，情绪，情感，性功能甚至睡眠。

When one of these hormone-producing cells mutates and begins rapidly multiplying, it develops into a neuroendocrine tumor.

神经内分泌肿瘤可以在体内任何地方形成, but about half start in the gastrointestinal tract, which includes the stomach, small and large bowel, pancreas and rectum.

Some neuroendocrine tumors can be aggressive, but most grow slowly and take years to develop.

医学肿瘤学家说：“新诊断的患者学习癌症已经扩散并不罕见，因为神经内分泌肿瘤可能不会在早期引起症状。”Craig Kovitz，医学博士

A second opinion offers hope

柯蒂斯病情的消息迅速传播。一个护士敦促他寻求一个的朋友second opinionat MD Anderson.

“She said MD Anderson has a track record of fixing what others can’t,” Curtis says. “That’s what I needed – a doctor who wouldn’t give up on me.”

At MD Anderson, Curtis met Kovitz, his new oncologist.

The doctor didn’t mince words.

他说：“一旦神经内分泌癌蔓延到肝脏，它们就不可治愈。”“我们也许可以缩小肿瘤并为您购买一些时间，但是治愈是不现实的。”

柯蒂斯明白。

他说：“我知道没有保证，但是我们必须尝试。”

Dealing with depression after a neuroendocrine tumor diagnosis

Curtis began treatment in November 2017 with eight rounds of twochemotherapydrugs – carboplatin and etoposide.

“It was rough,” Curtis says, “not only because of the toll chemotherapy took on my body, but also because I wasdepressed. That can happen with a diagnosis like mine.”

For two weeks, he lay in bed. He stared at the ceiling, unable to sleep. He lost his appetite. His girlfriend left him.

Then, he suddenly snapped out of it.

“我跳下床，告诉自己，‘如果我要倒下，那将不会没有打架。’”

Curtis returned to the gym and worked out three hours every day – even on the days he received chemotherapy.

“I’ve always exercised regularly, but I went into overdrive,” he says. “I didn’t want cancer to make me look frail.”

He began attending weekly church services and got baptized.

然后他回去工作。

“博士Kovitz建议我停止飞行直到化疗结束，所以我处理了桌面职责。”他解释说。“我的结肠中的肿瘤仍然足够大，可以打孔我的肠子。如果我在空中时发生了，那么……我会遇到一些严重的麻烦。”

Neuroendocrine tumor surgery and a cancer recurrence

到2018年3月，柯蒂斯（Curtis）完成化疗时，他的肿瘤已经停止生长。有些甚至缩水或消失了。

He was now stable enough to undergo surgery. Colon and rectal surgeonCraig Messik, M.D., removed the tumor in Curtis’ large intestine.

With the colon tumor gone and the liver tumors’ growth on hold, Curtis enjoyed a four-month respite from treatment.

Then, the liver tumors began to multiply.

“Neuroendocrine tumors often respond to chemotherapy at first,” Kovitz told him. “But they can become resistant to the chemotherapy drugs that initially seemed to help. So you try other drugs.”

神经内分泌肿瘤的免疫疗法试验

在接下来的六个月中，科维兹开了两种不同的化学疗法方案，以缩小柯蒂斯肝脏的肿瘤。一个人短暂地工作，一个根本没有。

With the cancer spreading and his options dwindling, it was time for Curtis to try something different.

“When standard treatments stop working,” Kovitz explains, “the next step is aclinical trial.”

他将柯蒂斯转交给了MD Anderson的Clinical Center for Targeted Therapy, where researchers test experimental drugs and drug combinations so new that they are not yet approved by the Food and Drug Administration (FDA).

这些临床试验之一，由Apostolia Tsimberidou, M.D., Ph.D.，正在测试两个组合免疫疗法drugs – nivolumab and ipilimumab – for the treatment of neuroendocrine tumors.

Unlike chemotherapy that directly destroys cancer cells, immunotherapy trains a patient’s own natural immune system to identify, target and eliminate cancer cells.

“Because these immunotherapy drugs had created prolonged clinical responses and improved overall survival in a number of different tumor types, we hypothesized that they might boost patients’ immune systems to eliminate neuroendocrine tumors as well,” explains Tsimberidou.

No signs of cancer after clinical trial

Three months after he joined the clinical trial, Curtis’ tumors had shrunk by 65%. In another three months, they’d shrunk by 80%.

“I was hoping the immunotherapy would slow down my cancer’s growth and buy me more time,” he says. “But I got much more than I’d hoped for.”

柯蒂斯（Curtis）加入临床试验九个月后，CT扫描未检测到肿瘤的证据，活检中没有发现肝脏中的癌细胞。

柯蒂斯说：“医生说我做出了完全的反应，这意味着该疾病的所有迹象都消失了。”

Two years have passed since Curtis completed the trial. He still shows no signs or symptoms of cancer.

Tsimberidou解释说：“免疫疗法可以长期保护癌症，因为它可以训练免疫系统以识别和记住癌细胞的外观。”“治疗完成后，这种免疫'记忆'可以持续数十年。”

Life after neuroendocrine tumor treatment

Today, Curtis is back in the air and flying high. He’s been promoted from deputy to sergeant. He has a new girlfriend, a new house and a new offshore fishing boat. When he’s not working, he’s in the gym or at the beach. Life is good.

他说：“我有很多值得感谢的事。”“ MD Anderson改变了我从癌症患者转变为幸存者的预后。”

He offers this advice to others facing a challenging diagnosis: "Never give up, and don't accept the first prognosis you receive. I was given six months to live. Then I came to MD Anderson, and look at me now."

Request an appointment at MD Anderson onlineor by calling 1-877-632-6789.