Going concern assumption = a business is expected to function as if it will continue to operate indefinitely. It should be able to remain active without the need to close and sell everything. The business owner determines whether the business is able to continue in the foreseeable future. This affects the accounting methods used by the business. I (very) briefly cover this idea in one lecture of one class.

For some reason this concept came to mind during my appointment with the NET specialist. First – what I heard from the NET specialist:

• The monthly shots are doing what is hoped for, they are keeping the tumors from growing.  What I learned is this medication typically only works for a year or two before a new treatment is needed. That will be determined by the activity seen in the scans. I could be lucky and have the medication work longer than the norm.
• There are other treatments available, but not yet, since the shots are working.  They will probably have more side effects.  Some of these may require treatment at a different facility, if my current oncologist doesn’t provide it. At least I have options?
• I am not a candidate for clinical trials due to my ‘recent’ breast cancer.  I might be in a couple more years, further out from that first cancer.
• The tumors they watch on the scans are only the places where they are large enough to show up. There are other spots not big enough to pick up the contrast, seen at the time of surgery.  She mentioned these as being a potential problem.  The extent and location of these could be what cause issues in my GI tract at some point.
• The outlook for my future is not as rosy as I was thinking.  I was planning on a few decades but it sounded to me like that is unlikely based on norms.  Nothing is imminent but this will continue to progress, the goal is to keep it as slow as possible.  I am really hoping my abnormalness is an asset here.
• For now I plan to stay with my current oncologist and only plan to see the NET specialist as needed. 

So now what? I didn’t ask directly how much time I have left – even with her expertise this form of cancer is so hard to predict. I also didn’t really want to hear an answer. But I did ask about how safe is it to make plans for the future, like trips. She said go ahead and plan, and have a backup plan for making cancellations, but don’t stop planning things.

This triggered the going concern principle idea in my head. Before this surgery and diagnosis, I was all in for continuing with life ‘indefinitely’ (or at least lots and lots more years). That idea is no longer valid but I need to find a way to expect to keep going, whether or not I do. I need to figure out how to get past the fear of what’s to come. I am terrified of what may come my way because of the disease progression. I am sad and scared for so many reasons. Right now I am doing all I can to remain as healthy as I can. It’s more of a preemptive strike but that’s all I have to hang on to.

FYI – NETs (neuroendocrine tumors) information:

• NETs are an uncommon cancer type forming in neuroendocrine cells. These cells are part of many organs (e.g. GI tract, liver, lungs, ovaries…to name a few) and carry messages from the nervous system to the endocrine system. The endocrine system controls body functions by making and releasing hormones in response to these signals. (This has been your brief anatomy & physiology lesson)
• Over 90% of NETs patients are mis-diagnosed and treated for incorrect diseases, usually things like Irritable Bowel Syndrome (IBS), Crohn’s Disease, gastritis or anxiety (like me!)
• Correct diagnosis can take up to 5 years from the time symptoms start (like me!)
• Many physicians are not aware of NETs or treat them as benign and unable to metastasize. Over 50% of patients have metastasis = spreading at diagnosis (like me!)