Neuroendocrine Tumor Treatment

Neuroendocrine Tumor Treatment

If you’ve been diagnosed with a neuroendocrine tumor (NET), your doctor will recommend treatment based on the tumor’s size and location. Everyone’s NET is different; therefore the treatment your doctor recommends is specific to your situation. It is also important to make sure that carcinoid syndrome does not take a back seat in your treatment process. Share all your concerns and symptoms regarding carcinoid syndrome with your healthcare team. It is just as important to treat your carcinoid syndrome symptoms as it is to treat the tumor.


“I would like a treatment to control my symptoms and disease progression.”

Patient with carcinoid syndrome

Surgery

Surgery to remove the tumor is often the first step your doctor will recommend taking.

  • Endoscopic resection
    This technique is used when tumors are small. A thin instrument consisting of a light, a lens, and a surgical tool is inserted through the mouth and down through the digestive tract to the site of the tumor.
  • Hepatic artery embolization
    Achieved through laparoscopic surgery, this type of therapy can reduce the blood flow through the main artery to the liver. This can help kill cancer cells.
  • Cryosurgery or cryotherapy
    Achieved through laparoscopic surgery, this technique is used to freeze the tumor, destroying cancerous tissue.
  • Radiofrequency ablation (RFA)
    Achieved through laparoscopic surgery, this medical procedure sends high-frequency radio waves to the tumor with the goal of killing cancer cells.

All types of surgery have varying recovery times. In ideal cases, surgery only removes the tumor. If that’s not possible, healthy tissue around the tumor, lymph nodes, and all or part of an affected organ (such as a section of the intestinal tract) may need to be removed as well. When part of an organ is removed, that organ may not function as well. The effects of this depend on each particular surgery.

Discussion tips and conversation starters for you and your doctor:

  • What is the preparation and recovery time for surgery?
  • How will this impact my daily life and/or work?

Chemotherapy

An anticancer drug, or combination of drugs, is injected or taken by mouth. The drug travels throughout the body via the bloodstream. Carcinoid tumors don’t respond well to chemotherapy, or “chemo,” so it is not typically used unless the tumor has spread to other organs (from the intestines to the liver, for example).
In addition to attacking cancer cells, chemo can damage healthy cells, including the cells in your bone marrow that create blood.
Side effects: Nausea and vomiting; loss of appetite; hair loss; mouth sores; low blood count

Discussion tips and conversation starters for you and your doctor:

  • How effective is chemotherapy for my particular type of neuroendocrine tumor?
  • How will this impact my daily life and/or work?
  • Are there physical or outward side effects of chemotherapy I should be aware of?
  • Are there any risks to chemotherapy?

Radiation therapy

Radiation can damage cancer cells, either killing them outright or preventing them from dividing and spreading.

  • Peptide receptor radionuclide therapy (PRRT):
    A protein is combined with radioactive material, which is injected into the bloodstream. The protein, octreotide, is attracted to the cancer cells, binds to them to prevent serotonin release, and brings radioactive material with it. The radioactive material kills the cancer cells.
    Side effects: Nausea and vomiting (sometimes severe); low blood cell counts

Discussion tips and conversation starters for you and your doctor:

  • Is there a risk for secondary cancer with radiation therapy?
  • How long do I need to stay away from children and pregnant women?

Hormone therapy

Certain hormones can help slow tumor growth. Somatostatin analogues (SSAs) work similarly to the hormone somatostain produced by the body. SSAs are given through injection and are used to block the effect of hormones produced by NETs in your body.

  • Somatuline® (lanreotide)
    Somatuline is prescribed to help slow tumor growth if surgery has not been successful.
    Side effects: Abdominal pain; musculoskeletal pain; vomiting; headache; injection site reaction; high blood sugar; hypertension; gallstones

Discussion tips and conversation starters for you and your doctor:

  • Are there any risks associated with hormone therapy?
  • Will I need to be on any therapies in addition to this?

Biologic therapy

Biologics are treatments made from living organisms, sometimes produced in a laboratory.

  • Interferon alfa
    Interferon alfa is a type of protein called a cytokine. Cytokines help your immune cells communicate. Interferon alpha can help fight carcinoid tumors in two ways: directly, because it can stop cancer cells from dividing, and indirectly, by helping the immune system fight.
    Side effects: Flu-like symptoms; fatigue, drowsiness; low blood counts

Discussion tips and conversation starters for you and your doctor:

  • How effective is biologic therapy for treating NETs?
  • Is this the best option for my particular situation?

Targeted therapy

This form of treatment acts on the specific molecules that allow cancer cells to grow and spread, blocking cancer growth, unlike chemotherapy or radiation.

  • Afinitor®* (everolimus)
    Afinitor is used to treat carcinoid tumors, but it cannot be used in patients who have carcinoid syndrome.
    Side effects: Inflammation of the mouth; infections; rash; fatigue; diarrhea; edema; vomiting; nausea; fever; weakness; cough; headache; and decreased appetite

*Afinitor is a trademark of Novartis Pharmaceuticals Corporation.

Discussion tips and conversation starters for you and your doctor:

  • Will targeted therapy also help control my symptoms?
  • Are there any risks associated with this option?
 

See how carcinoid syndrome has affected those who suffer from it

Carcinoid Impact Survey Results