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Neuroendocrine Tumors

Neuroendocrine Tumors

About Neuroendocrine Tumor

The neuroendocrine system is made up of nerve and gland cells. It makes hormones and releases them into the bloodstream which regulates the body. Neuro means nerve and endocrine means the cells of the endocrine system. Neuroendocrine cells are spread throughout the body organ such as bowel, lung, stomach and pancreas.

A neuroendocrine tumour (NETs) is a tumour of the neuroendocrine system. NETs often grow slowly, and it may be several years before symptoms appear and the tumour is diagnosed. NETs are classified according to where the cancer started in the body;

  • Carcinoid tumours(Lung)
  • Pancreatic NETs
  • Lung NETs
  • Small bowel NETs
  • Large bowel NETs
  • Appendiceal NETs
  • Gastric NETs

Risk factors:

The exact causes of NETs are unknown, however there are few factors that increase the cancer risk.

These include:

  • Genes: People who have a rare family syndrome (Multiple endocrine neoplasia type 1 (MEN 1) & Von Hippel-Lindau syndrome (VHL)) have a higher risk of developing NETs. About 30-60% of patients with MEN1 will develop a neuroendocrine tumor. About 11-17% of patients with VHL will develop a neuroendocrine/carcinoid tumor
  • Tobacco: Small cell lung cancer (SCLC), large cell neuroendocrine carcinoma (LCNEC) and neuroendocrine tumors are strongly associated with tobacco smoking
  • Family history: Some types of neuroendocrine tumours are more common in people with a family history of the disease or other types of cancer

Symptoms:

Signs and symptoms of Neuroendocrine tumour depend upon the type of neuroendocrine tumor (Organ involved). Some neuroendocrine tumours are non-functional and show no symptoms. Few of the common symptoms include:

  • Hyperglycemias (too much sugar in the blood) or Hypoglycaemia (very little sugar in the blood)
  • Diarrhoea and persistent pain in a specific area
  • Loss of appetite/ unexplained weight loss or weigh gain
  • Persistent cough and hoarseness
  • Thickening or lump in any part of the body
  • Changes in bowel or bladder habits
  • Jaundice (yellowing of the skin)
  • Unusual bleeding or discharge
  • Persistent fever or night sweats, Headache, Anxiety, Gastric ulcers etc.

Diagnosis:

  • Chromogranin A test: It is a blood test that helps to measure the amount of chromogranin A in the blood. Higher than normal amount of chromogranin A and normal amounts of hormones such as gastrin, insulin, and glucagon can be a sign of a non-functional pancreatic NET
  • Somatostatin receptor scintigraphy: It is a type of radionuclide scan that may be used to find small pancreatic NETs. A small amount of radioactive octreotide (a hormone that attaches to the tumors) is injected into a vein that travels through the blood. The radioactive octreotide attaches to the tumor and a special camera that detects radioactivity is used to show where the tumors are in the body
  • Other scan: Ultrasound scan, CT scan or MRI scan is done to find the extent and location of the cancer.
  • Biopsy: A biopsy is done by removing a small sample of tissue from the abnormal area and by examining under a microscope

Prevention:

At present there is no way to prevent the disease. There is a link between smoking and cancer and hence, smoking should be avoided.


Treatment:

Immunotherapy is effective in treating Neuroendocrine tumor with good results. Cancer healer therapy can be given along with chemotherapy without any interference with the treatment. Line of treatment varies as per the type of neuroendocrine tumor and it is decided by doctors after evaluating the case through the reports of the patient.

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