EPISODE 17: KEY CONSIDERATIONS FOR NET SURGERY

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ABOUT THIS EPISODE

How do surgeons decide the type, extent, and approach of NET surgery? NET surgeon Dr. Alexandra Gangi of Cedars-Sinai answers 10 common questions about what to expect before, during, and after NET surgery. Gain insight on preparing for surgery and what is important for your surgeon to know about your recovery goals. Dr. Gangi’s comprehensive approach illustrates why surgeons are an integral part of your NET medical team.

MEET DR. ALEXANDRA GANGI

Dr. Alexandra Gangi is a board-certified surgical oncologist at Cedars-Sinai Medical Center in Los Angeles. Dr. Gangi completed a general surgical residency at Cedars-Sinai and completed her surgical oncology fellowship at the H. Lee Moffitt Cancer Center in Tampa, Florida.

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She currently serves as the director of the Gastrointestinal Tumor and Cancer Regional Therapies Programs with specialization in Pancreatic and GI Neuroendocrine tumors, Metastatic colorectal cancer, and Peritoneal Surface Malignancies. Her research focuses on understanding GEPNET heterogeneity between and within tumors subtypes and mechanisms of chemotherapy induced liver injury.

TOP 10 QUESTIONS

1. How do you decide if the tumors can and should be cut out? How does tumor location, tumor size, and amount of tumors factor into your decision?

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2. How do you decide if someone should have a laparoscopic surgery versus open surgery? What about robotic surgery?

3. How do you decide whether or not to remove the ileocecal valve?

4. What work up should NET patients have before surgery? Should all NET patients have an echo?

5. What is the risk of carcinoid crisis with a dental procedure, a biopsy, or with surgery? How do you manage this?

6. Should NET patients be on somatostatin analogs before surgery? What about after surgery? If so, when would you restart it?

7. When would you want someone on chemotherapy or PRRT to shrink a tumor before surgery? When might you want to do surgery first followed by another treatment?

8. When would you recommend imaging after NET surgery? What type of imaging would you order?

9. Why are there differing opinions from NET specialists, specifically about surgery and what treatment should be offered as the next option?

10. What questions would you recommend NET patients ask at their surgical consultation?

RESOURCES

READ

• LACNETS Resources on Surgery

• Blog Practical Tips for Patients Preparing for Surgery

• NET VITALS

• NET Intro

WATCH

"Surgery for NETs" - Alexandra Gangi, MD, Cedars-Sinai - 2020 LACNETS Virtual NET Conference (June 23, 2020)

"To Cut or Not to Cut? What Your NET Surgeon Wants You To Know" - Callisia Clarke, Medical College of Wisconsin - 2021 LACNETS Virtual NET Conference (June 19, 2021)

"NET Surgery: Making Decisions & Preparing for Surgery" - Callisia Clarke, MD, Medical College of Wisconsin - 2022 LACNETS Virtual NET Conference (June 18, 2022)

"Your Pathologist & Your Pathology Report" - Sue Chang, MD, City of Hope (March 27, 2020)

"Pathology" - Alberto Marchevsky, MD, Director of Pathology, Cedars-Sinai - 2019 LACNETS Conference (June 8, 2019)

LISTEN

The LACNETS Podcast Episode 3: Surgery for NETs >>

The LACNETS Podcast Episode 11: Pathology for NETs >>

DISCLAIMER

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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