“…We must reject the sophistry of manageable toxicity and think carefully about the iatrogenic burdens we place on patients, especially those for whom we have the privilege to offer longitudinal care in the setting of germline tumor syndromes like MEN1. 1,10,11,15,32,36,65 (A) General flowchart, (B) parathyroid gland management, (C) duodenopancreatic neuroendocrine tumor (dpNET) management, and (D) pituitary adenoma (PA) management are illustrated. CgA indicates chromogranin A; CT, computed tomography; DXA, dual energy x-ray absorptiometry; EGD, esophagogastroduodenoscopy; EUS, endoscopic ultrasound; IGF-1, insulin-like growth factor-1; iPTH, intact parathyroid hormone; MRI, magnetic resonance imaging; NET, neuroendocrine tumor; PHPT, primary hyperparathyroidism; PP, pancreatic polypeptide; PPI, proton pump inhibitor; VIP, vasoactive intestinal peptide.…”