Naveed, my son, texted a photo of the famous Bollywood actor, Irfan Khan, two days ago and said, “this actor has died! RIP (crying emoji)”
I was shocked to hear it. Irfan Khan was so young, and such a good actor. What a loss!
Isha, my daughter, texted, “No really??? Oh my god he was such a cool person. I’m so sad.”
He had a neuroendocrine tumor, I sent them a paper to read on signs and symptoms of the neuroendocrine tumors.
Irfan khan was a world famous actor, who acted in soap operas before starring in dozens of Hindi-language films and crossover hits like Slumdog Millionaire. He died, in Mumbai, at age 54. According to NPR (National Public Radio), the actor died at the hospital after being admitted for a colon infection. He had also undergone treatment for a rare type of neuroendocrine cancer- although it didn’t specify what kind of a neuroendocrine tumor.
“Amma is here to take me!” – meaning my mom is here to take me – were his last words. His mother had passed away less than a week before his death.
Irfan khan was a wonderful actor. I have seen lots of Bollywood and Hollywood movies with him in them. Naturally talented, he poured himself into very different characters so effortlessly.
Khan won four Filmfare awards, the Bollywood equivalent of the Academy Awards. He played a police inspector in the 2008 British film Slumdog Millionaire, about a teenager from Mumbai’s slums who competes on the Indian version of the TV game show Who Wants to Be a Millionaire. Khan also starred in multiple Hollywood productions, including Life of Pi, Jurassic World, and The Amazing Spider-Man.
I am an Internist, and an Endocrinologist. I have taken care of several people with neuroendocrine tumors. In this blog, I will try to go over the neuroendocrine tumors to help readers learn a little about this rare condition.
Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells. A hormone is a chemical that is made in one part of our bodies, travels through the blood stream, and exerts its effects on other parts of the body. Insulin, for example, is a hormone produced in the pancreas which helps glucose enter inside of cells to generate energy. Dysregulation involving insulin leads to diabetes which constitutes approximately fifty percent of my Endocrine practice.
Neuroendocrine tumors are rare and can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas.
There are many types of neuroendocrine tumors. Some grow slowly while others grow very quickly. Some neuroendocrine tumors produce excess hormones. These tumors are called functional neuroendocrine tumors. Some neuroendocrine tumors either don’t release hormones or they don’t release enough to cause symptoms. These are known as nonfunctional neuroendocrine tumors.
Diagnosis and treatment of neuroendocrine tumors depend on the type of tumor, its location, whether it produces excess hormones, how aggressive it is, and whether it has spread to other parts of the body.
Some types of neuroendocrine tumors include Carcinoid tumors, pancreatic neuroendocrine tumors, pheochromocytomas and paragangliomas. Pheochromocytoma, for instance is a tumor of the adrenal gland that produces fight or flight hormones.
Neuroendocrine tumors don’t always cause signs and symptoms at first. The symptoms you might experience depend on the location of your tumor and whether it produces excess hormones. I took care of a patient who had a pheochromocytoma. He didn’t realize he had symptoms until the tumor was taken out. He then noticed the absence of palpitations and occasional headaches.
Sometimes, people live with symptoms for years without realizing that they are not normal feelings. In the case of Irfan Khan, I don’t know the specifics of his case, but it is easy to imagine the anxiety and stage fright that is very common in show business. These symptoms may have been deemed normal in his case. In general, neuroendocrine tumor signs and symptoms might include: Pain from a growing tumor, palpable lumps, feeling tired, and losing weight without trying. Neuroendocrine tumors that produce excess hormones can cause skin flushing, diarrhea, frequent urination, increased thirst, dizziness, shakiness, and skin rashes.
In 2016, my team published a case of Insulinoma in a 36 year old woman with Insulinoma (one kind of neuroendocrine tumor) in the journal Pancreas. This patient presented with frequent low blood sugars due to an insulin producing tumor. She felt better after having this tumor removed. This led to her losing weight, and her low blood sugars resolving.
The exact cause of neuroendocrine tumors isn’t known. These cancers begin in neuroendocrine cells that have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine cells are found throughout your body. Neuroendocrine tumors begin when neuroendocrine cells develop mutations in their DNA (deoxyribonucleic acid). Some neuroendocrine tumors grow very slowly. Others are aggressive cancers that invade and destroy normal body tissue or metastasize to other parts of the body.
The risk of neuroendocrine tumors is higher in people who inherit genetic syndromes that increase the risk of cancer. Some of these familial disorders are Multiple Endocrine Neoplasia Type 1 (MEN 1), Multiple Endocrine Neoplasia Type 2 (MEN 2), Von Hippel-Lindau disease, Tuberous Sclerosis, and Neurofibromatosis. With the genetic component involved, Irfan Khan’s family members should get checked out to see if they may be at risk.
There is a saying in medicine, “If you diagnose a rare disease, you are rarely correct.” But, rare diseases do happen to people and people do die from them. I do not mind at all if my patients like to use google to try to learn more about what is going on with them. In fact, some patients have really discovered rare diseases in themselves. There was one who thought she had giant cell arteritis and she had it. Another patient thought she had multiple myeloma – and she turned out to be correct. Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.
Hope you found this read informative. I will conclude this paper with one of Khan’s poems that he shared with his fans in 2018.
God speaks to each of us as he makes us,
then walks with us silently out of the night
These are the words we dimly hear:
You, sent out beyond your recall,
go to the limits of your longing
Flare up like a flame
and make big shadows I can move in
Let everything happen to you: beauty and terror
Just keep going. No feeling is final
Don’t let yourself lose me
Nearby is the country they call life
You will know it by its seriousness
Give me your hand!