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Gastroenterologist and Neuroendocrinologist Dr. David C. Metz discusses important concepts in Gastric NET, Gastrinomas and Zollinger-Ellison Syndrome, including detection, treatments, associated risks and monitoring. He also lends valuable insight on ulcers, MEN and proton pump inhibitors.



After earning his MD from the University of the Witwatersrand's Medical School, Dr. Metz was a resident at both the Albert Einstein Medical Center and the Johannesburg General Hospital. He went on to complete fellowships at Georgetown University Hospital as well as the National Institutes of Health.

Arriving at Penn Medicine in 1993, David Metz, MD, held a variety of leadership roles within the Department of Gastroenterology, including Co-Directorship of the Neuroendocrine Tumor Center and Penn NET Treatment Program. Dr. Metz was previously a staff fellow at the National Institutes of Health, where he performed basic research in pancreatic acinar cell secretion and clinical research in Zollinger-Ellison syndrome. While at Penn Medicine, he served as Chair of the North American Neuroendocrine Tumor Society (NANETS), as a member of the Liaison Committee for Recertification of the American Board of Internal Medicine (American Gastroenterological Association representative), and on the Food and Drug Administration Gastrointestinal Drugs Advisory Committee, among other positions.

Dr. Metz's clinical interests at Penn included Zollinger-Ellison syndrome and other acid-peptic conditions, Helicobacter pylori infection, non-steroidal anti-inflammatory drug gastropathy and the diagnosis and management of patients with functional and non-functional neuroendocrine tumors of the pancreas and alimentary tract. An investigator for a series of prominent clinical trials in all of these areas, Dr. Metz has published more than 200 articles on topics of clinical interest and research. He retired in July 2021 after 28 years at Penn Medicine. 

In 2021 Dr. Metz received the NANETS Lifetime Achievement Award that honors an individual who, over the course of their career, has provided outstanding contributions to neuroendocrine disease management through research, clinical practice or educational initiatives, as well as exceptional leadership in NANETS and dedication to its mission.



1. What is Gastric NET? How is it found? What are the symptoms? How does it differ from “stomach cancer” or other types of NETs?​

2. How is Gastric NET treated and how is it monitored? 

3. What is a Gastrinoma? How and where is it found? Are Gastrinomas and Gastric NET the same thing?

4. How is a Gastrinoma treated?

5. How is a Gastrinoma monitored? ​

  • How often do you recommend Endoscopies or Gastrin level lab testing?

  • Does a high Gastrin level mean someone has a Gastrinoma or are there other causes? Can you have a high Gastrin level without having a gastrinoma? 

6. What is Zollinger-Ellison Syndrome? How is it found? What are the common symptoms from ZES/functioning Gastrinomas?

7. How is Zollinger-Ellison Syndrome treated? How is Zollinger-Ellison Syndrome monitored? Does ZES put you at risk for other conditions/complications?

8. What is a common Proton Pump Inhibitor dose for someone with ZES? Is there a danger in taking PPIs for a long time or in high doses? 

9. I’ve been told I have an ulcer? Am I at risk for cancer?

10. What are advances for gastric nets, gastrinomas or Z-E syndrome that we should be aware of or excited about?

*Bonus question: What last words of hope would you like to leave the NET community with?



Patient Story: Zollinger-Ellison Syndrome and Gastrinoma

Shaunie shares her experience living with Zollinger-Ellison syndrome and a functioning gastrinoma of the pancreas.




LACNETS Podcasts are created for educational purposes only and do not substitute for medical advice. The views shared in this Podcast are the personal opinions of the experts and do not necessarily reflect the views of LACNETS. Please contact your medical team with questions or concerns about your individual care or treatment.



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