I’ve had more than my share of exposure to the U.S. healthcare industry over the last several months. That and other dramatics that people call life explain my disappearance from these pages since February.
About two years after being diagnosed with carcinoid tumors, in what we later learned was an already very advanced stage, my father passed away this past April 1. Things began to more rapidly go downhill in mid-February, and with that, the family pulled out all the stops in support, including lengthy hospital visits.
This is a close relative of the cancer that Steve Jobs succumbed to. In his case, what is still commonly reported as “pancreatic cancer” and/or “liver cancer” would be more accurately described as carcinoid tumors in his pancreas, and his liver, and probably elsewhere within his abdomen. We all remember Jobs’ disturbingly gaunt look of extreme weight loss – I watched the same thing happen with my dad. It is a cruel disease.
To further complicate matters, exactly one year ago, and one year into my dad’s situation, I found myself calling 9-1-1 at 1 a.m. with severe abdominal pain. About 16 hours later, I awoke from a surgery to learn I had lost 14 inches of small intestine containing nine carcinoid tumors (I would later learn that I likely had these tumors for as long as ten years, and in my dad’s case, twenty), the biggest of which had caused a total obstruction.
Although Theodor Langhans (1839–1915) was the first to describe the histology of a carcinoid tumor in 1867 [ 1 ], it is generally Otto Lubarsch (1860–1933) who is credited with the first report of two patients with ileal carcinoid tumors discovered at autopsy, in 1888 [ 2 , 3 ]. In 1907, Siegfried Obendorfer (1876–1944), a German pathologist at the University of Munich, coined the term karzinoide, or “carcinoma-like,” to describe the unique feature of behaving like a benign tumor despite resembling a carcinoma microscopically [ 4 ]. Recognition of the endocrine-related properties of carcinoid tumors did not occur until much later. In 1948, Rapport and colleagues isolated and named serotonin (5-hydroxytryptamine), initially identified as a vasoconstrictor substance in the serum [ 5 ]; by 1952, it was determined that the origin of this amine was the Kulchitsky cell [ 6 ]. Just 1 year later, Lembeck identified serotonin in an ileal carcinoid and confirmed it as the major hormone responsible for carcinoid syndrome [ 7 ].