European Physician Exchange Summary

European Physician Exchange: Dr. Dan Granberg's Visit to Denver

A generous donor provided funds for the "European Physician Exchange" so that Dr. Kjell Oberg and Dr. Dan Granberg could complete the "exchange" begun when Dr. Eric Liu, Healing NET Chief Medical Advisor, spent several months in Uppsala, Sweden, studying with them. Dr. Oberg visited Denver in 2016, and right after the 2018 Healing NET Summit, Dr. Granberg joined Dr. Liu at his Denver clinic to jointly review a number of cases. Over 30 patients participated in each clinic with an emphasis on the LungNET patient and caregivers.

Dr. Granberg commented on such an opportunity: "I always think that it is valuable to meet people from other countries and other cultures, learning from each other." Perhaps because they had previously worked together, the two doctors generally experienced great consensus regarding what approach to take with each patient. There are significant differences, however, in the context for their work. As Dr. Granberg noted, "The healthcare system is different in Sweden compared to the US. In Sweden, the vast majority of the patients are seen within the public health care, while in the US most of the health care is private, financed by insurance companies and/or by the patients themselves. It cannot be excluded that this may have an impact on the differences in therapy." Some differences Dr. Granberg noticed in therapeutic approach are that surgery is more likely to be used in Denver, including removal of metastases to the liver; that radioembolization is more often used than bland embolization in Uppsala; and that in Uppsala they use more Streptozotocin-based chemotherapy in patients with metastatic pancreatic NETs.

For his part, Dr. Liu found that the treatments and diagnostics here in the U.S. had caught up to our European counterparts, which is a great opportunity for patients here in America. “With the approval of Gallium scans (NETSPOT®), PRRT (Lutathera®), and telotristat (Xermelo™). we now have a full complement of therapies to help our neuroendocrine patients here in the United States. I am always learning from our European colleagues, but I also hope to teach them that surgery can be more widely used,” Dr. Liu stated. He added his gratitude for our donors: “It’s only through the generous support of donors to the Healing NET Foundation that we have the opportunity for this kind of exchange, which benefits patients on both sides of the Atlantic. This is one of many projects that the The Healing NET Foundation is working on to benefit patients through education, awareness, and collaboration.”

Dr. Granberg headed back to Sweden grateful for the "exciting experience seeing patients together in the clinic" and ready to make modifications to the exam rooms in Uppsala. He found the arrangement of the space in Denver practical as it allowed him to comfortably view both the computer and his patient at the same time. Fostering the collaboration of physicians focused on advancing the care of people with NET cancer is an ongoing priority of The Healing NET Foundation.