Neuroendocrine Tumour Treatment in Delhi, India

From the different types of neuroendocrine tumours, few types grow slowly while others grow aggressively and spread to other body parts.

Following are the various types of NETs:

Carcinoid tumour: Carcinoid tumours, a slow-growing tumour, are NETs that mainly arise in the digestive tract, appendix lungs, or thymus. However, it can also develop in the lymph nodes, bone, brain, or skin. It often doesn't cause signs and symptoms in its early stage.

Pancreatic neuroendocrine tumour (pNET): Pancreatic neuroendocrine tumours (pNET) can develop in hormone-producing cells of the pancreas. Also known as islet cell cancers, these are very rare.

Neuroendocrine tumour symptoms may not always be visible at first. The visibility of the symptoms depends on the location of the tumour and the extent of the hormones produced. Neuroendocrine tumour symptoms include:

• Pain in abdomen
• Weakness and tiredness
• Loss of appetite
• Weight loss without reason
• Headache
• Nausea and vomiting
• Fever
• High blood pressure
• Swelling in feet and ankles
• Jaundice
• Anxiety
• Coughing and hoarseness in the throat

If a neuroendocrine tumour produces excess hormones, the symptoms may include:

1. Skin flushing
2. Diarrhoea
3. Increased thirst
4. Dizziness
5. Frequent urination
6. Skin rash

Consult a doctor if any of the given signs and symptoms are persistent.

The exact cause of the neuroendocrine tumour remains unknown. However, neuroendocrine cells have similar traits of no sense and hormone-producing cells. A tumour develops in neuroendocrine cells when the DNA in the cell changes. The changes cause the cells to multiply faster and form a tumour.

Factors that may increase the risk for NETs include:

Inherited Syndromes: Inherited syndromes such as MEN1, MEN2, von Hippel-Lindau syndrome, neurofibromatosis are associated with various types of NETs.

Medical Conditions: People with serious medical conditions such as stomach damage or a low level of acid production in the stomach due to prolonged antacid/stomach acid reducing medicines increase the risk of NETs.

Different tests are conducted to examine the type of tumour and its location in the body. The doctor may ask about symptoms or any previous health problems. Functional NETs produce symptoms due to excess hormones that can be diagnosed easily. Non-functional NETs may not cause specific symptoms, which makes diagnosis difficult. Test conducted to identify the tumour may include:

Physical Exam: The doctor would examine the body to analyse the signs and symptoms. For example, abdominal pain or the presence of swollen lymph nodes suggest a tumour (producing excess hormones).

Tests: Blood and urine tests may be recommended to check the number of hormones produced by neuroendocrine cells.

Biopsy: A biopsy is a method of collecting sample tissue from the affected area to examine under a microscope to identify the type of tumour. Anaesthesia may be given to make the procedure comfortable.

Imaging Tests: Imaging tests such as ultrasound, CT scan, MRI, and X-ray are recommended that help to identify the type of tumour and its spread to other body parts.

The treatment for tumours depends on the type, size and location. The different treatment methods available for neuroendocrine tumours include:

Surgery: Surgery is a widely and common treatment used to remove the tumour. In this treatment, the tumour is removed (partially or entirely) with surrounding healthy tissue to prevent the spread of tumour cells.

Targeted Drug Therapy: Drug therapy treatment focuses on the specific abnormality in the tumour cells. Drugs are given to block this abnormality that kills the tumour cells. Depending on the size of the tumour, drug therapy may be combined with radiation therapy or chemotherapy.

Peptide Receptor Radionuclide Therapy: PRRT is an effective and molecular targeted treatment for NETs. This treatment uses drugs and other substances to attack tumour cells, reducing harm to surrounding healthy tissue. It delivers high doses of radiation to tumour cells in the body to destroy and slow their growth.

Chemotherapy: Chemotherapy treatment uses chemical drugs to kill the tumour cells and stop them from spreading. The drug can be given as a pill or injected through the vein. Chemotherapy can cause side effects such as vomiting, hair loss, fatigue, and nausea. It is recommended if there is a risk of tumour recurrence or used when the tumour can't be removed with surgery.

Medications: If the tumour releases excess hormones, medications can be given to control excess hormones.

Radiation Therapy: Radiation therapy is a treatment that uses powerful radiation waves directed straight towards the tumour to kill the tumour cells. This treatment is usually not needed for these tumours recommended when other treatments are unsuccessful.

• Quit smoking
• Limit alcohol intake