The web around patients with neuroendocrine tumors: novel ways to inform, support and treat

Bouma, G., 2019, [Groningen]: Rijksuniversiteit Groningen. 165 p.

Research output: ThesisThesis fully internal (DIV)

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  • Title and contents

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  • Chapter 1

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  • Chapter 2

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  • Chapter 3

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  • Chapter 4

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  • Chapter 5

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  • Chapter 6

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  • Chapter 7

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  • Chapter 8

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  • Chapter 9

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  • Chapter 10

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  • Complete thesis

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  • Propositions

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Neuroendocrine tumors (NETs) are a rare and heterogeneous group of tumors. Patients can experience various symptoms including symptoms due to release of bioactive substances by the tumor and side effects of the treatment. In this thesis, we assessed novel ways of informing, supporting and treating patients with a NET.
NET patients experience a lower health-related quality of life (QoL) than the general population. Being properly informed results in a better QoL in patients with cancer. We therefore developed a web-based system to inform and support patients with a NET. Use of this web-based system did not improve distress, perceived information provision and QoL. However, patients had a positive opinion about the use of this system. We also demonstrated that the use of video-consultation during follow-up care of patients with a clinical stable NET is feasible and well received by the patients.
NET patients often experience vitamin deficiencies including niacin (vitamin B3) deficiency due to serotonin overproduction. We showed that oral niacin supplementation resulted in most patients with niacin-deficiency in a normalized vitamin B3 status.
In the search of new drug targets, we studied the tumor microenvironment of NETs. NETs were found to have a cold immune microenvironment. We suggest that this is at least partly the result of expression of two enzymes, namely indoleamine 2,3-dioxygenase and/or tryptophan 2,3-dioxygenase, and the presence of cancer-associated fibroblasts. These findings can be used in future investigations for new treatment modalities, such as immunotherapy.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Award date13-Nov-2019
Place of Publication[Groningen]
Print ISBNs978-94-034-2074-5
Electronic ISBNs978-94-034-2070-7
Publication statusPublished - 2019

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