Fedez, from the light rapper on rare cancers on the rise

They call them Net, neuroendocrine tumors. They are a “very heterogeneous” family of rare neoplasms “which usually remain in the shadows”, and which today end up in the spotlight in the story of the disease that rapper Fedez wanted to share on social networks. His diagnosis is shared by an increasing number of people: “In recent years we have been detecting more cases in all age groups and this is probably linked not to a real epidemiological increase, but to the ability we have developed to identify these diseases, with advances in technology in diagnostics and the use of endoscopy, on the one hand, and thanks to the greater knowledge we now have within the medical community, on the other. What were once identified as lesions or tumors generics now know each other better and have the greater ability to characterize them and to suspect their nature “, explains gastroenterologist Francesco Panzuto to Adnkronos Salute, researcher at Sapienza University of Rome, Sant’Andrea University Hospital – Enets Center of Excellence. The expert talks about the forms that affect the digestive system and explains that this increase in diagnoses “may appear even more pronounced in the younger groups”. And the Fedez case teaches us. “Because it is obvious – emphasizes Panzuto – that young people undergo screening tests and diagnostic checks without having particular risk factors, so it can happen that tests are carried out for trivial symptoms and sometimes an injury to the pancreas, intestine or stomach”. But the delay in diagnosis remains. It is calculated in “many months, if not years. But these are data that we extract from past experiences, which have a relative value – the specialist remarks – Today this gap is gradually being compensated thanks to the increase in knowledge. Many cases, however, continue to be get there already advanced, almost half are inoperable “, an important element for the purposes of treatment. “It happens because they are tumors that grow slowly – remembers Panzuto – they do not give major symptoms, they are not characterized by an evident clinic, apart from the forms that we call ‘functioning’, that is, they secrete substances that cause specific syndromes, but these are the 20- 30% of the total. 70-80% are cancers that do not accompany specific symptoms “. The overall incidence “still falls within the scope of rare diseases: we are about 3-5 cases per 100 thousand inhabitants – points out the expert – considering all the sites of the neuroendocrine tumor which can be located in all sites of the digestive system from the stomach to the rectum, the most frequent, from the small intestine to the pancreas “as in the case of Fedez.” Unfortunately, if for the purpose of early diagnosis there is no particular symptom that helps us “, Panzuto reiterates, these tumors often grow in silence. It must be said that, “if the surgery is radical and manages to remove all the tumor, and if the histology of the removed tumor is biologically favorable, there is a very good chance of a cure. Of course it is necessary for the patient to undergo for a long period to follow-up checks in a reference center, so that a relapse can be immediately diagnosed. Much, in any case, depends on the outcome of the histological examination because it will tell us what are the characteristics of the tumor and all this derives a risk profile for the patient who can be considered definitively cured, or equally cured, but with a more or less quantifiable risk of having a relapse in the future “. A crucial crossroads is at the beginning of the diagnosis, the specialist points out,” between a disease that is configured as ‘resectable’ surgically “, that is, radically eliminated with a scalpel,” or not. In the first case, surgery can be definitively curative, c as well as endoscopic removal if the tumor sites allow it “. In cases of advanced disease or in the presence of relapse, “there are several medical drug therapy options on which significant progress has been made in the last 10-15 years”.