Heidi is a 62-year-old female diagnosed with stage IV, grade 2 gastroenteric-pancreatic neuroendocrine tumor of unspecified site (C7A.8) and carcinoid syndrome (E34.0) with mass effect on distal common. Heidi was previously treated with creon, octreotide, and sandostatin, which has inadequately controlled her carcinoid syndrome. Over the past six months Heidi and been having diarrhea 3-7 times a day, accompanied by urgency and abdominal cramping. She cannot gain any weight back despite increasing appetite. Her symptoms are worsening and she is feeling feeble and debilitated. Xermelo is the only oral treatment for carcinoid syndrome, diarrhea; in which Heidi is currently suffering from. Xermelo is Heidi’s best treatment option at this
