In this episode, surgical oncologist Dr. Seth Concors of Emory’s Winship Cancer Institute discusses the role of the surgical oncologist within the multidisciplinary care team for neuroendocrine cancer. We explore what surgical oncologists do, why NET-specific experience matters, how surgical decisions are made, and what patients can expect during a surgical consultation. The conversation highlights coordination across care teams, common patient concerns, and the importance of informed decision-making and second opinions, offering practical guidance for patients and caregivers navigating surgical care in neuroendocrine cancer.

TOP TEN QUESTIONS

Understanding the Surgeon’s Role

1. What is a surgical oncologist, and what kind of training does that involve? How is a surgical oncologist similar to—or different from—other types of surgeons? Patients may hear the term “HPB surgeon.” What does that mean, and how can a patient tell if their surgeon is an HPB surgeon?

2. When a patient is looking for a surgeon, how can they find someone who is the “right fit” for them? How can patients know whether a surgeon has experience with the specific operation they may need—such as a Whipple procedure, liver surgery, or lung surgery? How important is it for a surgeon to be familiar with neuroendocrine tumors specifically?

3. What should patients expect at their first appointment with a surgical oncologist? What key information are you usually trying to communicate during that first visit? What questions do you encourage patients and caregivers to ask their surgeon?

4. How often should patients expect to see their surgical oncologist, and at what points in their care?

Surgical Decision-Making

5. How do you determine whether someone is a surgical candidate? What is the typical goal of surgery for neuroendocrine tumors?

6. If someone is not a surgical candidate initially, does that mean surgery is off the table forever? Are there treatments that can help make surgery possible in the future? How many NET surgeries can someone safely have over their lifetime?
Can major surgeries—such as extensive liver resections—affect eligibility for future treatment options?

Multidisciplinary and Coordinated Care

7. How do surgical oncologists work within a multidisciplinary care team for NET patients?
How do you collaborate with providers at different institutions, such as a local oncologist working with a NET specialty center?

8. What is your perspective on second opinions, specifically for neuroendocrine cancer?

9. Many patients worry about carcinoid crisis during surgery. How do you address and manage those concerns?

Preparing for Surgery

10. Patients often ask how they can best prepare—physically and emotionally—for surgery. What guidance do you typically offer?

BONUS: What research is currently being done involving neuroendocrine surgery?

ABOUT THE SPEAKER

Seth Concors, MD, is an academic surgical oncologist at Emory University and the Winship Cancer Institute, where he serves as Associate Program Director for both the General Surgery Residency and the Complex General Surgical Oncology Fellowship, and Director of the Surgical Oncology Research Fellowship. He leads Emory’s Peritoneal Surface Malignancy and Neuroendocrine Tumor surgical programs, with clinical and research interests focused on gastrointestinal neuroendocrine tumors, cytoreductive surgery/HIPEC, and survivorship outcomes. Dr. Concors is actively involved in national surgical societies, including SSO, SSAT, NANETS, ACS, and ECOG-ACRIN, and his work emphasizes multidisciplinary collaboration, prospective outcomes research, and surgical education. He is committed to advancing patient-centered cancer care while mentoring the next generatio

For more information, visit NCF.net.

ABOUT THIS EPISODE

Who is a genetic counselor, and who should see one? How do they fit into the neuroendocrine cancer care team? In this episode, Samantha Greenberg, PhD, MS, MPH, CGC, Director of the UT Southwestern Genetic Counseling Program, demystifies genetic counseling and testing for NET patients and their families. She explains what to expect before, during, and after a consultation—and how results can impact care, family members, and future planning.

TOP TEN QUESTIONS

Role & Training

1. What is a genetic counselor? What training is required? What’s your role in the care team?

Genetic Counseling & NETs

2. How are genetic counselors involved in NET care?

3. Who should get genetic testing? Do all NET patients need it?

• What if more than one family member has NET?
• Do you also see family members without a diagnosis?

4. How does one’s age play a role?

Testing Basics

5. Genetic vs. genomic vs. NGS—what are these terms?

• How do patients know they’re getting the right test?

6. Walk us through a genetic counseling consultation—before, during, after.

Results & Implications

7. What if the results are positive? How do you guide patients and families?

• What if the results are negative or inconclusive? How accurate are tests?

8. What is a “variant of unknown significance”?
9. Can environment or toxins cause hereditary mutations?

Practical Guidance

10. How can patients find the right genetic counselor? Do they need to be someone who specializes in neuroendocrine cancer?

ABOUT THE SPEAKER

Samantha Greenberg, PhD, MS, MPH, CGC

Pronouns: she/her series

Director, UT Southwestern Genetic Counseling Program

Assistant Professor

School of Health Professions

Samantha Greenberg is the founding program director of the UT Southwestern Genetic Counseling Training Program. She received her Master of Science degree in genetic counseling and public health from the University of Michigan after teaching middle school science with Teach For America in Tulsa, Oklahoma. She recently completed her Ph.D. at the University of Utah. As a cancer genetic counselor, Greenberg has provided clinical care across a variety of indications and facilitated the development of multidisciplinary teams and genetics clinics for patients with prostate cancer, von Hippel-Lindau syndrome, and paraganglioma/pheochromocytoma. She is the co-director of the paraganglioma program at UT Southwestern, which recently received a Center of Excellence designation from Pheo Para Alliance. Her passion for raising awareness on the genetics of neuroendocrine tumors stems from working with patients and a curiosity for how to optimize identification of patients with hereditary risk.

For more information, visit NCF.net/podcast/52

For more information, visit NCF.net.

ABOUT THIS EPISODE

In this special annual episode, OHSU medical oncologist Dr. Guillaume (“Will”) Pegna joins us once again to break down the highlights from the 2025 North American Neuroendocrine Tumor Society (NANETS) Multidisciplinary NET Medical Symposium. He walks us through the latest clinical trial results and emerging research—covering PRRT, non-PRRT therapies, liver-directed treatments, and new biomarkers—and explains what these updates mean for the NET patient and caregiver community.

ABOUT DR. PEGNA

Dr. Pegna is a medical oncologist who specializes in the care of adults with neuroendocrine tumors (NETs). He is additionally interested and experienced in the management of rare tumors, including pheochromocytomas, paragangliomas and adrenocortical carcinomas as well as other gastrointestinal cancers.

Dr. Pegna is actively involved with clinical trials and cancer research to improve survival and quality of life for cancer patients and to better understand the biology of these diseases. He specializes in the use of chemotherapy, immunotherapy and multidisciplinary approaches to cancer care. Dr. Pegna finds it rewarding to help patients understand their disease, providing treatment options based on each individual patient, and supporting them through their treatment journeys.

Visit NCF.net/podcast/51 for more information

For more information, visit NCF.net.