Neuroendocrine Cancer

What is a Neuroendocrine Tumor?

A Neuroendocrine tumor is a rare kind of tumor. Cancer is a condition in which cells of the body start dividing uncontrollably. Neuroendocrine tumors are special in the way that they can arise from multiple organs in the body. In addition, they behave in their own unique way that may be different from the organ of origin.

Common Sites of Neuroendocrine Tumor (Carcinoid):

Pancreas
Stomach and Intestines
Lungs

Besides these common sites, Neuroendocrine Tumors can uncommonly occur in many other organs.

Signs of NeuroendocrineTumor:

Signs of Neuroendocrine Tumors are dependant on a few factors. Some Neuroendocrine tumors produce hormones and patients have symptoms due to the excessive hormone production.

Some examples include:

Gastrinoma: Increase stomach acidity
Insulinomas: Produce excess Insulin and cause low blood sugar
VIPomas: Cause excessive loose stools
Glucagonomas: Skin rash and diabetes
Carcinoid Syndrome

These and other signs and symptoms may be caused by Neuroendocrine Tumoris due to the tumor mass pressing on surrounding structures:

Lung NETs cause cough, blood in sputum, breathlessness, chest pain, etc
Abdominal NETs cause abdominal pain, abdominal lumps, liver abnormalities, swelling of abdomen etc.

Tests for Neuroendocrine Tumors:

The following tests and procedures may be used:

Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Dotanoc Scan
Chromogranin and other cancer markers
Biopsy however is the definite method for diagnosis of Neuroendocrine Tumors. A biopsy involves taking a small piece of tumor using a needle and examining it under a microscope.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis and treatment options depend on the following:

The stage of the cancer (Grade Group, how much of the prostate is affected by the cancer, and whether the cancer has spread to other places in the body).
Grade of the tumor (Grade I, II or III)
Whether the cancer has just been diagnosed or has recurred (come back).

Treatment Options

There are different types of treatment for patients with Neuroendocrine Tumors.

Surgery
Radiation therapy
Peptide receptor radionuclide therapy (PRRT or Lutetium DOTATATE therapy)
Hormone therapy
Chemotherapy
Targeted therapy
New types of treatment are being tested in clinical trials.
Treatment for neuroendocrine tumors may cause side effects.
Follow-up tests may be needed.

Surgery

Patients in good health whose tumor is in only one part of the body may be treated with surgery to remove the tumor.

Radiation therapy:

Radiation therapy may be used in patients in whom tumor is localized but may not be easily operable.

Peptide Receptor RadionuclideTherapy (PRRT)

PRRT uses a radioactive substance to treat cancer that has spread to multiple parts of the body:
Lutetium – 177 DOTATATE therapy
Actinium – 225 DOTATATE therapy

Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream.

In patients with Neuroendocrine Tumour’s, hormone therapy in the form of long acting somatostatin receptor targeting drugs such as Sandostatin are used.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). Chemotherapy is generally used for high grade Neuroendocrine tumors.

Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.