Since neuroendocrine tumors (NETs) are rare, finding a care team with experience treating them is especially important. At MD Anderson, we have physicians who specialize in treating neuroendocrine tumors. This gives them incredible experience when designing treatment plans for patients diagnosed with a NET.
Many of these doctors also conduct research in NETs and are working to develop new treatments for these tumors. As a result, MD Anderson has a large number of clinical trials for NET patients. These offer new treatments that may not be available anywhere else.
NET treatment plans
Regardless of location, the preferred treatment for most NETs is surgery to remove the entire tumor. This may cure the patient.
Most surgeries meant to cure NETs are performed on patients whose disease has not metastasized, or spread. In some cases, though, patients whose disease has metastasized can be effectively cured by surgery that removes the primary tumor and the metastases.
For the vast majority of patients, it is not possible to remove the entire tumor through surgery. This may be because it is located in a spot that is hard to reach surgically or because it has spread in such a way that the metastases cannot be removed. In these cases, doctors may still perform surgery to remove part of the tumor. This can help relieve symptoms.
If all of the patient’s tumors cannot be removed through surgery, a complete cure is not possible. Instead, the disease is managed through treatments designed to slow or stop its progression.
The treatments and treatment plans for a NET depend on many factors. These include the location of the tumor, whether it is functional or non-functional, and how advanced the disease is.
Since NETs can be slow growing, doctors may recommend active surveillance. With this approach, the patient undergoes regular tests, including blood, urine and imaging exams, to see if the tumor is growing. No treatments are given unless and until the disease progresses. This is a popular approach for older patients who might find surgery or other therapies difficult to bear.
Many neuroendocrine tumors can be removed with surgery, especially if they are diagnosed before they have metastasized, or spread beyond the main tumor and nearby lymph nodes. If the surgeon cannot remove the entire tumor, only part of it may be removed in order to help treat a patient’s tumor-related symptoms.
The patient’s surgical options will depend on the tumor’s location. The procedures are essentially identical to surgeries for other types of tumors at that site. For example, if a patient has lung cancer, the surgery to treat that tumor is the same, regardless if it is a neuroendocrine tumor or not. To see the surgical options for neuroendocrine tumors at a particular site, learn more about that specific cancer.
Chemotherapy works by killing fast-growing cells, including cancer cells. Learn more about chemotherapy.
Traditional chemotherapy works by killing cells that multiply quickly, whether normal or cancerous. Targeted therapy, also called precision medicine, is different. It works by stopping or slowing the growth or spread of cancer.
This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves.
Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them. Learn more about targeted therapy.
Radiation therapy uses focused beams of energy to destroy cancer cells. There are several ways doctors can deliver this radiation to the tumor. Learn more about radiation therapy.
Peptide radionuclide therapy
Peptide radionuclide therapy is a method of delivering cancer-killing radiation to a tumor. Instead of using a beam of energy, a radioactive chemical is combined with another chemical that attaches to cancer cells. The patient receives this combined liquid through an IV.
Somostatin analogs are drugs that slow tumor growth and help relieve cancer symptoms. While they were initially used only for functional NETs (NETs that produce hormones) more recent studies show they can work on non-functional NETs as well.
When NETs metastasize, or spread beyond their primary location, they often move to the liver. Liver directed therapies use a catheter sent through an artery to deliver treatments directly to the metastasis. Treatments include chemotherapy and the use of radioactive beads that can kill cancer cells. Doctors also can use the catheter to heat and kill blood vessels that feed the tumor.
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