Neuroendocrine Tumor Treatment

Neuroendocrine tumors (NETs) are a rare type of tumor that can occur throughout the body. They develop from neuroendocrine cells, which have traits similar to both nerve cells and hormone-producing endocrine cells. These tumors most commonly form in the gastrointestinal tract, pancreas, and lungs.

What Are Neuroendocrine Tumors?

Neuroendocrine tumors (NETs) are growths that arise from neuroendocrine cells found in organs such as the stomach, intestines, pancreas, and lungs. They can be benign or malignant and may produce hormones (functional) or not (non-functional). NETs can grow slowly or aggressively, depending on their grade and location.

Types of NETs:

Carcinoid Tumors – Often found in the digestive tract or lungs
Pancreatic NETs – Includes insulinomas, gastrinomas, glucagonomas
Small-cell lung cancer (SCLC) – A high-grade aggressive NET
Medullary thyroid carcinoma
Adrenal gland NETs (pheochromocytomas)

Symptoms of Neuroendocrine Tumors

Symptoms vary based on the tumor’s location and whether it is functional or non-functional.

Common symptoms include:

Flushing
Diarrhea
Wheezing
Rapid heartbeat
Unexplained weight loss
Fatigue
Pain or a lump in the abdomen
Changes in blood sugar (from insulinomas)
Ulcers (from gastrinomas)

Functional tumors often cause symptoms related to hormone overproduction, while non-functional tumors may not be discovered until they grow large.

What Causes Neuroendocrine Tumors?

The exact cause is unknown, but risk factors include:

Genetic syndromes such as MEN1 (multiple endocrine neoplasia type 1)
Family history of NETs
Chronic atrophic gastritis
Smoking
Previous radiation exposure

How Are Neuroendocrine Tumors Diagnosed?

Diagnosis includes:

Blood tests – Check hormone levels (chromogranin A, serotonin, etc.)
Urine tests – Measure hormone byproducts (e.g., 5-HIAA)
Imaging – CT scan, MRI, PET scan, and octreotide scan
Endoscopy/colonoscopy – If the tumor is in the GI tract
Biopsy – Confirms tumor type and grade

Procedure

Treatment Options for Neuroendocrine Tumors

Treatment depends on tumor size, location, spread, hormone production, and patient health. Common options include:

1. Surgery

Removal of localized tumors is often the first-line treatment.
Debulking may be done for large or metastatic tumors.

2. Medications

Somatostatin analogs (Octreotide, Lanreotide) – Control symptoms and may slow tumor growth.
Targeted therapy (Everolimus, Sunitinib) – Blocks tumor growth pathways.
Chemotherapy – For high-grade or aggressive NETs.

3. Radiation Therapy

Peptide receptor radionuclide therapy (PRRT): Uses radioactive drugs that bind to tumor cells and destroy them.
External beam radiation – In select cases for localized tumors.

4. Liver-directed Therapy

For metastases in the liver: embolization, chemoembolization, or radioembolization.

5. Immunotherapy

Still under investigation for certain aggressive NETs.

Factors That Can Affect Neuroendocrine Tumor Treatment Cost in India

Type and stage of NET
Hospital and location
Doctor’s expertise
Type of treatment used (surgery, PRRT, chemotherapy, etc.)
Duration of hospital stay
Diagnostic and follow-up tests
Medications required

India offers high-quality treatment at lower cost compared to Western countries. Experienced oncologists and advanced nuclear medicine facilities make it a preferred destination.

Suggestions

NETs often grow slowly, but early diagnosis and targeted treatment significantly improve prognosis.
Regular follow-up is essential to monitor recurrence or progression.
Hormonal symptom management is key to quality of life.

The Most Important Frequently Asked Questions

Q: Are neuroendocrine tumors curable?
A: Many NETs can be cured if detected early and completely removed by surgery. Advanced cases are managed with long-term therapies.

Q: How fast do neuroendocrine tumors grow?
A: Some grow slowly over years; others are aggressive. Growth depends on the tumor grade.

Q: Is chemotherapy effective for NETs?
A: It is useful for aggressive or high-grade NETs but not always for slow-growing ones.

Q: What is PRRT therapy?
A: A targeted radiation therapy that delivers radioactive particles to tumor cells using somatostatin analogs.

Q: Can NETs come back after treatment?
A: Yes, NETs can recur. Regular monitoring with imaging and blood tests is necessary.

Q: What is the survival rate for NET patients?
A: It varies by type and stage. Many low-grade NET patients live for many years.

Q: Do neuroendocrine tumors spread?
A: Yes, especially to the liver, bones, and lymph nodes. Metastatic NETs require systemic treatment.

Q: Are all NETs cancerous?
A: No, some are benign or very slow-growing, but all should be evaluated and monitored carefully.