• diet
• malnutrition
• neuroendocrine tumor
• nutrition

• Aged
• Cross-Sectional Studies
• Female
• Humans
• Longitudinal Studies
• Male
• Malnutrition/diagnosis
• Malnutrition/epidemiology
• Malnutrition/etiology
• Middle Aged
• Neuroendocrine Tumors/complications
• Neuroendocrine Tumors/epidemiology
• Nutritional Status
• Prevalence
• Prospective Studies
• Quality of Life
• Weight Loss

• PRRT
• everolimus
• health-related quality of life
• lanreotide
• neuroendocrine tumor
• octreotide
• patient-reported outcomes

• EORTC QLQ-C30
• EORTC QLQ-G.I.NET21
• NETs
• neuroendocrine tumors
• quality of life

• anxiety
• coping
• depression
• neuroendocrine tumors
• psychological distress
• resilience

• Female
• Humans
• Intestinal Neoplasms/psychology
• Neuroendocrine Tumors/psychology
• Pancreatic Neoplasms/psychology
• Psychological Distress
• Resilience, Psychological

• HRQoL
• anxiety
• carcinoid
• depression
• post-traumatic stress disorder

• 2020 Associazione per la Ricerca Biomolecolare Onlus, Acquaviva, Italy
• 23583 Associazione Italiana per la Ricerca sul Cancro

• Antidepressants
• Carcinoid syndrome
• Neuroendocrine tumors
• Serotonin
• Serotoninergic brain dysfunction

• Anxiety
• Anxiety Disorders
• Brain
• Humans
• Neuroendocrine Tumors
• Quality of Life

• Carcinoid syndrome
• Costs
• Neuroendocrine tumour
• Resources
• Somatostatin analogues

• heterogeneity
• metastases
• neuroendocrine tumor
• quality of life
• resilience
• severity

• Adult
• Aged
• Biological Variation, Population/physiology
• Cross-Sectional Studies
• Female
• Humans
• Italy/epidemiology
• Male
• Middle Aged
• Neuroendocrine Tumors/epidemiology
• Neuroendocrine Tumors/pathology
• Neuroendocrine Tumors/psychology
• Neuroendocrine Tumors/therapy
• Psychosocial Functioning
• Quality of Life
• Resilience, Psychological
• Severity of Illness Index
• Social Interaction
• Young Adult

• neuroendocrine neoplasms
• proportionate mortality ratio
• risk factors
• score
• suicide

Gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are slow-growing cancers that arise from diffuse endocrine cells in the gastrointestinal tract (GI-NETs) or the pancreas (P-NETs). They are relatively uncommon, accounting for 2% of all gastrointestinal malignancies. The usual treatment options in advanced GEP-NET patients with metastatic disease include chemotherapy, biological therapies, and peptide receptor radionuclide therapy. Understanding the impact of treatment on GEP-NET patients is paramount given the nature of the disease. Health-related quality of life (HRQoL) is increasingly important as a concept reflecting the patients’ perspective in conjunction with the disease presentation, severity and treatment.

To conduct a systematic literature review to identify literature reporting HRQoL data in patients with GEP-NETs between January 1985 and November 2019.

The PRISMA guiding principles were applied. MEDLINE, Embase and the Cochrane library were searched. Data extracted from the publications included type of study, patient population data (mid-gut/hind-gut/GI-NET/P-NET), sample size, intervention/comparators, HRQoL instruments, average and data spread of overall and sub-scores, and follow-up time for data collection.

Forty-three publications met the inclusion criteria. The heterogeneous nature of the different study populations was evident; the percentage of female participants ranged between 30%-60%, whilst average age ranged from 53.8 to 67.0 years. Eight studies investigated GI-NET patients only, six studies focused exclusively on P-NET patients and the remaining studies involved both patient populations or did not report the location of the primary tumour. The most commonly used instrument was the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (n = 28) with consistent results across studies; the GI-NET-specific module Quality of Life Questionnaire-GINET21 was used in six of these studies. A number of randomised trials demonstrated no HRQoL changes between active treatment and placebo arms. The Phase III NETTER-1 study provides the best data available for advanced GEP-NET patients; it shows that peptide receptor radionuclide therapy can significantly improve GEP-NET patients’ HRQoL.

HRQoL instruments offer a means to monitor patients’ general disease condition, disease progression and their physical and mental well-being. Instruments including the commonly used European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and GINET21 lack, however, validation and a defined minimal clinical important difference specifically for GI-NET and P-NET patients.

• Gastroenteropancreatic neuroendocrine tumours
• Health-related quality of life
• Systematic literature review
• Chemotherapy
• Biological therapies
• Peptide receptor radionuclide therapy

• Aged
• Female
• Humans
• Intestinal Neoplasms/therapy
• Middle Aged
• Neuroendocrine Tumors/therapy
• Pancreatic Neoplasms/therapy
• Quality of Life
• Stomach Neoplasms/therapy

• Coping
• Patient reported symptoms
• Quality of life
• Small-intestinal neuroendocrine tumour
• Somatostatin analogue

To understand the quality of life (QoL) for patients with neuroendocrine tumors (NETs) through comparison of QoL questionnaires and symptom tracking as well as journaling via the Carcinoid NETs Health Storylines mobile application (app).

This was a 12-week prospective, observational study of US patients with NET who were taking long-acting somatostatin analogs. National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) and European Organisation for Research and Treatment of Cancer (EORTC) questionnaires were administered three times. Patients also monitored symptoms, mood, bowel movements, food, activity, and sleep, and they journaled in their app, which was coded by theme and sentiment for qualitative analysis.

Of the 120 patients with NET, 78% were women (mean age, 57 years); 76% had gastroenteropancreatic NETs, and 88% had metastases. Lanreotide depot and octreotide long-acting release (LAR) were used by 41% and 59%, respectively. The most common symptoms at baseline were fatigue (76.7%), diarrhea (62.5%), abdominal discomfort (64.1%), and trouble sleeping (57.5%). The majority completed five of six survey assessments (median, 5; mean, 5.1) and tracked four symptoms in the app (median, 4; mean, 5.5); the average frequency was 41.6 days for each symptom (median, 43; mean, 41.6; range, 1 to 84 days [12 weeks]). Without treatment change, most EORTC-assessed physical symptoms decreased from baseline to midpoint (eg, 59.3% at baseline v 33% at midpoint reported “quite a bit” or “very much” diarrhea; P = .002). App-based symptom tracking revealed large day-to-day variation, but weekly averages correlated well with survey scores. Journal entries showed that more patients made predominantly negative unsolicited entries about their injection experience with octreotide LAR compared with lanreotide (13 of 17 v two of 13; P < .001).

Patients with NET experience a large symptom burden that varies daily. A decrease in physical symptoms on QoL surveys suggests an effect from daily app-based monitoring or journaling, which may reduce recall bias and benefit the patient’s experience of symptoms.

• Antidepressive agents
• Carcinoid tumor
• Malignant carcinoid syndrome
• Neuroendocrine tumors
• Psycho-Oncology
• Quality of life
• Serotonin uptake inhibitors

Background: Gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are neoplasms derived from the endocrine system in the gastrointestinal tract and pancreas. Treatment options include surgery; pharmacological treatments like somatostatin analogues (SSA), interferon alpha, molecular targeted therapy and chemotherapy; and peptide receptor radionuclide therapy.

The objective of this study was to describe treatment patterns and survival among patients with metastatic GEP-NET grade 1 or 2 in Sweden.

Methods: Data was obtained via linkage of nationwide registers. Patients diagnosed with metastatic GEP-NET grade 1 or 2 in Sweden between 2005 and 2013 were included (n=811; National population). In addition, medical chart review was performed for the subpopulation diagnosed at Sahlgrenska University Hospital, Gothenburg (n=127; Regional population). Treatment patterns, including treatment sequences, and overall survival were assessed.

Results: Most patients had small intestinal NET (76%). In the regional population, 72% had grade 1 tumours; 50% had functioning tumours. The two most common first-line treatments were surgery (57%) and SSA (25%). After first-line surgery, 46% received SSA, while 40% had no further treatment. After first-line SSA, 52% received surgery, while 27% had no further treatment. Overall median survival time from date of diagnosis was 7.0 years (95% CI 6.2-not reached). Among patients with distant metastases, pancreatic NET (vs. small intestinal NET) was associated with poorer survival (HR 1.9; 95% CI 1.1-3.3), as were liver metastases (HR 3.2; 95% CI 1.5-7.0).

Conclusions: First-line surgery was typically followed by SSA or no further treatment. Among patients with distant metastases, pancreatic NET or liver metastases were associated with a poorer survival.

• GEP-NET
• SSA
• metastatic
• surgery
• survival.
• treatment patterns

Gastroenteropancreatic neuroendocrine tumors (GEP NETs) are a heterogeneous group of tumors with distinct effects on the body due to their potential to secrete hormones and peptides. The incidence and prevalence of GEP NETs in Australia are rising. During 2000-2006, the annual incidence was approximately 3.3 per 100,000 population. To date, there has been development of clinical practice and consensus guidelines for NETs covering best practice for diagnosis, treatment, and medical management; however, the supportive care needs and optimal nutritional management of patients affected by NETs remains underresearched, and evidence to guide clinical practice is lacking. While there is emerging research describing the extent of morbidity in different types of GEP NET patients, little is known about the experience of people affected by these tumors and how nutritional status is impacted by either diagnosis or treatment.

The objective of this study was to explore nutrition-related complications and quality of life of patients diagnosed with a GEP NET and to generate evidence to inform future research and development of nutrition screening and management practices.

Patients diagnosed with a GEP NET at two metropolitan recruitment sites will be invited to participate in a 6-month, mixed-methods longitudinal study. Participants recruited to the study will receive usual care and participate in data collection for the study at 4 time points (at recruitment and 2, 4, and 6 months postrecruitment). Study data will include nutritional status, body weight, fat-free mass, and patient-reported outcome measures (dietitian contact, disease-related symptom presence and severity, dietary habits, health-related quality of life, psychological morbidity, and financial impact). At recruitment and 6 months postrecruitment, complete nutrient testing, including relevant plasma vitamin levels, will also be undertaken. A purposive sample of participants will be invited to take part in semistructured interviews to explore the experience of living with a GEP NET and associated nutrition complications.

Ethics approval has been obtained, and study recruitment and data collection are underway.

This study will provide the first in-depth, comprehensive description of nutritional issues in patients with GEP NETs. Results will advance the knowledge of nutritional issues faced by patients with GEP NETs and help inform the development of screening tools and clinical practice guidelines.

DERR1-10.2196/11228

• diet
• diet, food, and nutrition
• malnutrition
• neuroendocrine tumor
• niacin
• patient experience
• signs and symptoms
• vitamins

• clinical practice
• gastroenteropancreatic neuroendocrine tumors
• health-related quality of life
• peptide receptor radionuclide therapy
• routine monitoring

To compare health-related quality of life (HRQoL), anxiety, depression, and impulsivity scores in patients with and without carcinoid syndrome (CS), and correlated them with serum 5-hydroxyindoleacetic acid (5-HIAA) levels.

Patients with advanced gastroenteropancreatic neuroendocrine tumours (GEPNET), with and without CS completed HRQoL QLQ-C30 and QLQ-GI.NET21, Hospital Anxiety and Depression Scale (HADS) and Barratt Impulsivity Scale (BIS) questionnaires. Two-sample Wilcoxon test was applied to assess differences in serum 5-HIAA levels, two-sample Mann-Whitney U test for HRQoL and BIS, and proportion test for HADS, between those with and without CS.

Fifty patients were included; 25 each with and without CS. Median 5-HIAA in patients with and without CS was 367nmol/L and 86nmol/L, respectively (P = 0.003). Scores related to endocrine symptoms were significantly higher amongst patients with CS (P = 0.04) and scores for disease-related worries approached significance in the group without CS, but no other statistically-significant differences were reported between patients with and without CS in responses on QLQ-C30 or QLQ-GI.NET21. Fifteen patients (26%) scored ≥ 8/21 on anxiety scale, and 6 (12%) scored ≥ 8/21 on depression scale. There was no difference in median 5-HIAA between those scoring < or ≥ 8/21 on anxiety scale (P = 0.53). There were no statistically significant differences between groups in first or second-order factors (BIS) or total sum (P = 0.23).

Excepting endocrine symptoms, there were no significant differences in HRQoL, anxiety, depression or impulsivity between patients with advanced GEPNET, with or without CS. Over one quarter of patients had high anxiety scores, unrelated to peripheral serotonin metabolism.

• Gastroenteropancreatic neuroendocrine tumours
• Carcinoid syndrome
• Quality of life
• Anxiety
• Depression
• Impulsivity

• Aged
• Anxiety/blood
• Anxiety/epidemiology
• Anxiety/psychology
• Biomarkers/blood
• Chromogranin A/blood
• Depression/blood
• Depression/epidemiology
• Depression/psychology
• Female
• Humans
• Hydroxyindoleacetic Acid/blood
• Hydroxyindoleacetic Acid/metabolism
• Impulsive Behavior
• Intestinal Neoplasms/blood
• Intestinal Neoplasms/pathology
• Intestinal Neoplasms/psychology
• Male
• Malignant Carcinoid Syndrome/blood
• Malignant Carcinoid Syndrome/pathology
• Malignant Carcinoid Syndrome/psychology
• Middle Aged
• Neuroendocrine Tumors/blood
• Neuroendocrine Tumors/pathology
• Neuroendocrine Tumors/psychology
• Pancreatic Neoplasms/blood
• Pancreatic Neoplasms/pathology
• Pancreatic Neoplasms/psychology
• Patient Health Questionnaire
• Prevalence
• Quality of Life
• Serotonin/metabolism
• Stomach Neoplasms/blood
• Stomach Neoplasms/pathology
• Stomach Neoplasms/psychology

• 5-Hydroxyindoleacetic acid
• Carcinoid syndrome
• Chromogranin A
• Depression
• Diarrhea
• Health-related quality of life
• Small intestine neuroendocrine tumor

• Adult
• Aged
• Aged, 80 and over
• Female
• Finland/epidemiology
• Health Status
• Humans
• Intestinal Neoplasms/epidemiology
• Intestinal Neoplasms/pathology
• Intestinal Neoplasms/therapy
• Intestine, Small/pathology
• Male
• Middle Aged
• Neuroendocrine Tumors/epidemiology
• Neuroendocrine Tumors/pathology
• Neuroendocrine Tumors/therapy
• Quality of Life
• Surveys and Questionnaires

• anxiety
• carcinoid syndrome
• carcinoid tumor
• depression
• neuroendocrine tumor
• selective serotonin reuptake inhibitor (SSRI)
• serotonergic medication

• Gastroenteropancreatic neuroendocrine tumours
• Health-related quality of life
• Methodological quality
• Patient-reported outcomes
• Systematic review

• Disease-Free Survival
• Health Status
• Humans
• Intestinal Neoplasms/psychology
• Neuroendocrine Tumors/psychology
• Outcome Assessment, Health Care
• Pancreatic Neoplasms/psychology
• Quality of Life/psychology
• Quality-Adjusted Life Years
• Stomach Neoplasms/psychology

• Austrian Science Fund

• Diarrhoea
• Neuroendocrine tumour

• Chemotherapy
• Gastroenteropancreatic neuroendocrine tumors (GEP-NETs)
• Health-related quality of life (HRQoL)
• Locoregional therapy
• Peptide receptor radionuclide therapy (PRRT)
• Quality of life (QoL)
• Questionnaires
• Somatostatin analogs (SSA)
• Surgery
• Targeted therapy

• health technology assessment
• neuroendocrine
• quality of life
• resource utilisation

• Health Care Costs
• Health Services/economics
• Health Services/statistics & numerical data
• Humans
• Neuroendocrine Tumors/economics
• Neuroendocrine Tumors/pathology
• Neuroendocrine Tumors/psychology
• Quality of Life

• angiogenesis
• biomarker
• quality of life
• survival
• targeted therapy

The purpose of the study was to evaluate changes in general self-efficacy, health related quality of life (HRQoL), and stress among patients with neuroendocrine tumors (NET) following a multidisciplinary educational intervention. Forty-one patients were enrolled in this exploratory pilot study. A total of 37 patients completed the full 26-week intervention based on the principles of self-efficacy. General self-efficacy was measured by the General Self-Efficacy Scale, HRQoL was measured with the SF-36, and stress was measured with the Impact of Event Scale. Mixed effect models were used to evaluate changes in general self-efficacy, mental and physical components of HRQoL, and stress adjusting for demographic and clinical variables. Results showed significant improvements in patients' general self-efficacy (β = 0.71; P < 0.05), physical component scores of HRQoL (β = 3.09; P < 0.01), and stress (β = −2.10, P = 0.008). Findings suggest that patients with NET have the capacity to improve their ability to cope with their disease, problem-solve, improve their physical status, and reduce their stress following an educational intervention based on the principles of self-efficacy. These preliminary data provide a basis for future randomized controlled trials to test interventions to improve HRQoL for patients with NET.

Quality of life is an important end point in clinical trials, yet there are few quality of life questionnaires for neuroendocrine tumours.

This international multicentre validation study assesses the QLQ-GINET21 Quality of Life Questionnaire in 253 patients with gastrointestinal neuroendocrine tumours. All patients were requested to complete two quality of life questionnaires – the EORTC Core Quality of Life questionnaire (QLQ-C30) and the QLQ-GINET21 – at baseline, and at 3 and 6 months post-baseline; the psychometric properties of the questionnaire were then analysed.

Analysis of QLQ-GINET21 scales confirmed appropriate aggregation of the items, except for treatment-related symptoms, where weight gain showed low correlation with other questions in the scale; weight gain was therefore analysed as a single item. Internal consistency of scales using Cronbach's α coefficient was >0.7 for all parts of the QLQ-GINET21 at 6 months. Intraclass correlation was >0.85 for all scales. Discriminant validity was confirmed, with values <0.70 for all scales compared with each other.

Scores changed in accordance with alterations in performance status and in response to expected clinical changes after therapies. Mean scores were similar for pancreatic and other tumours.

The QLQ-GINET21 is a valid and responsive tool for assessing quality of life in the gut, pancreas and liver neuroendocrine tumours.

Background: The aim of this study is two-fold. The first part compares quality of life (QoL) data of prostate cancer patients with those of a representative and age-specific sample of the general population and analyzes the influence of cancer related as well as socio-demographic parameters on QoL. Secondly, differences in QoL depending on the experienced psychological distress will be shown both in prostate cancer patients and in the general population.

Material and Methods: A sample of 265 prostate cancer patients completed both the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale (HADS) during their stay in the hospital. A total HADS cut off score of 15 was used to indicate psychological distress and significant emotional concerns in patients and men of the general population. The results of the patients were compared with those of the general population (N=444).

Results: Prostate cancer patients reported significantly worse levels of social and emotional functioning as well as more symptoms like insomnia, constipation and diarrhea compared to the general population. Patients and men of the general population with a total HADS score ≥15 reported lower QoL in all sub-scales except for diarrhea in comparison to people without distress.

Discussion: Psychological distress is accompanied by lower QoL and therefore should be taken into consideration when QoL is assessed. Furthermore, clinicians should be trained by professionals to detect distress in their patients and to pay more attention to their emotional concerns, which are strongly associated with the patients’ well-being and QoL during their stay in hospital.

• cancer
• distress
• general population
• oncology
• prostate
• quality of life

AIM: To assess the patient-reported outcomes (PROs) of pancreatic neuroendocrine tumor (PNET) patients.

METHODS: Fifty-one consecutive patients (21 male, 30 female, 61.0 ± 10.3 years) with proven PNETs were studied. An SF-12 questionnaire capable of exploring the physical (PCS) and mental (MCS) aspects of daily life was used. Four questionnaires were also used [12 items General Health Questionnaire (GHQ-12) for non-psychotic psychiatric disorders, State Trait Anxiety Inventory (STAI) Y-1 and Y-2 for anxiety and BDI-II for depressive symptoms] to explore the psychological aspects of the disease. Forty-four sex- and age-matched Italian normative subjects were included and evaluated using the SF-12, STAI Y-1 and Y-2 questionnaires.

RESULTS: Seven patients refused to participate to the study; they were clinically similar to the 44 participants who agreed to complete the questionnaires. PNET patients had a PCS score (44.7 ± 11.0) were not significantly different from the norms (46.1 ± 9.9, P = 0.610), whereas the MCS score was significantly lower in patients (42.4 ± 13.0) as compared to the norms (48.2 ± 9.8, P = 0.036). GHQ-12 identified 11 patients (25.0%) as having non-psychotic psychiatric disorders. The STAI scores were similar in the patients and in the normative population. Finally, BDI-II identified eight patients (18.2%) with moderate depression and 9 (20.5%) with mild depression whereas 27 patients (61.4%) had no depression.

CONCLUSION: The PNET patients had a good physical but an impaired mental component of their quality of life; in addition, mild or moderate depressive symptoms are present in about 40% of PNET patients.

• Endocrine gland neoplasms
• Pancreatic neoplasms
• Somatostatin
• Quality of life
• Quality indicators
• Health care

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Neuroendocrine
• Female
• Health Status
• Humans
• Male
• Middle Aged
• Norway
• Quality of Life
• Surveys and Questionnaires

The aim was to investigate HRQoL and psychosocial function among patients with carcinoid tumours, longitudinally and prospectively, and to compare HRQoL among patients with carcinoid tumours to that of the Swedish general population. The aim was also to investigate the prevalence of distress during the first year after diagnosis.

At four assessments during the first year after diagnosis, HRQoL was measured by the EORTC QLQ-C30 3.0, anxiety and depression by the HADS, and prevalence, and worst aspects of distress by an interview guide. ANOVA was performed in order to study changes over time with regard to HRQoL, anxiety and depression. Comparisons regarding HRQoL between patients and the Swedish population were made by the use of one-sample t-tests and changes over time regarding the prevalence of distress was investigated by means of Cochran's Q.

High levels of physical-, emotional-, cognitive-, and social function and somewhat lower levels of role function and global quality of life were reported at all assessments. Role- and emotional function increased over time. Patients reported lower role function and global quality of life and more problems with fatigue and diarrhoea than the Swedish general population, at all assessments. Fatigue, limitations to work and pursue daily activities, and worry that the illness will get worse were among the most prevalent aspects at all assessments. At all assessments the majority reported worrying about the family's situation, the ability to care for the family, and worrying before the check-up.

It is concluded that HRQoL and psychosocial function among patients with carcinoid tumours remains stable during the first year, that the patients report a lower HRQoL than the Swedish general population, and that a majority of the patients report a number of aspects of emotional distress. In the clinical care, it should be considered that the majority of patients report not only fatigue and diarrhoea but also worries about their prognosis, their families, tests, and examinations. Efforts to reduce these worries should be made.

• Adult
• Aged
• Analysis of Variance
• Anxiety/epidemiology
• Anxiety/etiology
• Carcinoid Tumor/physiopathology
• Carcinoid Tumor/psychology
• Case-Control Studies
• Depression/epidemiology
• Depression/etiology
• Diarrhea/epidemiology
• Diarrhea/etiology
• Fatigue/epidemiology
• Fatigue/etiology
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Quality of Life/psychology
• Sickness Impact Profile
• Stress, Psychological/epidemiology
• Stress, Psychological/etiology
• Surveys and Questionnaires
• Sweden/epidemiology

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Female
• Gastrointestinal Neoplasms/psychology
• Humans
• Male
• Middle Aged
• Neuroendocrine Tumors/psychology
• Psychometrics
• Quality of Life
• Sensitivity and Specificity
• Surveys and Questionnaires/standards

• Adenocarcinoma/complications
• Adenocarcinoma/secondary
• Aged
• Antidepressive Agents, Second-Generation/adverse effects
• Antidepressive Agents, Second-Generation/therapeutic use
• Carcinoid Tumor/complications
• Carcinoid Tumor/secondary
• Citalopram/adverse effects
• Citalopram/therapeutic use
• Colonic Neoplasms/complications
• Colonic Neoplasms/secondary
• Depressive Disorder/drug therapy
• Diarrhea/chemically induced
• Female
• Humans
• Neoplasms, Unknown Primary/complications
• Selective Serotonin Reuptake Inhibitors/adverse effects
• Selective Serotonin Reuptake Inhibitors/therapeutic use

• Gastrointestinal Neoplasms/therapy
• Humans
• Neuroendocrine Tumors/therapy
• Pancreatic Neoplasms/therapy
• Quality of Life
• Rare Diseases

• Carcinoid Heart Disease/complications
• Carcinoid Tumor/complications
• Carcinoid Tumor/therapy
• Diarrhea/etiology
• Flushing/etiology
• Follow-Up Studies
• Humans
• Malignant Carcinoid Syndrome/complications
• Malignant Carcinoid Syndrome/therapy
• Mental Disorders/etiology
• Models, Biological
• Pellagra/etiology
• Respiratory Sounds/etiology
• Serotonin/metabolism
• Stomach Neoplasms/complications
• Stomach Neoplasms/therapy

• Adult
• Aged
• Family/psychology
• Genetic Diseases, Inborn/diagnosis
• Genetic Diseases, Inborn/genetics
• Genetic Diseases, Inborn/psychology
• Humans
• Male
• Mass Screening/psychology
• Middle Aged
• Office Visits
• Prostatic Neoplasms/diagnosis
• Prostatic Neoplasms/genetics
• Prostatic Neoplasms/psychology