Neuroendocrine tumour

Neuroendocrine tumours can be either benign or malignant and can occur anywhere in the body, including the lungs, appendix, small intestine, rectum and pancreas. However, they are a rare type of cancer and account for less than 1% of the total cases. That’s why most patients often struggle to get a timely diagnosis and access to appropriate care and support.

Symptoms:

In the early stages, neuroendocrine tumours don't cause any symptoms. While most neuroendocrine tumours don't release enough hormones to cause any symptoms, some can produce excess hormones to cause symptoms. Common symptoms of neuroendocrine tumours can include:

• Lump under the skin
• Pain and fatigue
• Sudden weight loss
• Skin flushing and rash
• Chronic diarrhoea
• Frequent urination
• Excessive thirst
• Dizziness and shakiness

If anyone has any persistent signs and symptoms of neuroendocrine tumours, they must consult with the doctor immediately.

Causes:

Neuroendocrine tumours are caused by mutations in the cell DNA. These mutations cause these specialized cells to grow and form a mass of cancerous cells. While the exact cause of cell mutations are unknown, people who inherit genetic syndromes are more prone to this cancer.

Risk factors:

While the risk of neuroendocrine tumours is higher in people who inherit genetic syndromes, other factors that can also increase the risk, including:

• Ageing
• Smoking
• Immunity disorders
• Family history
• Gastrointestinal conditions such as atrophic gastritis or pernicious anaemia
• Multiple endocrine neoplasias, type 1 (MEN 1), type 2 (MEN 2)
• Von Hippel-Lindau disease
• Tuberous sclerosis
• Neurofibromatosis

Diagnosis:

The tests for neuroendocrine tumours may depend on the severity of the symptoms. For further diagnosis, our doctors will evaluate the patient’s symptoms, medical history and perform several tests, including:

• Physical exam to check for swollen lymph nodes or signs of excess hormone production.
• Blood tests to look for excess hormones that are sometimes produced by neuroendocrine tumours.
• Imaging tests, such as ultrasound, CT and MRI, to identify the tumour and to see how far it has spread.
• Biopsy to remove a sample of cells and test it for cancer. Depending on the cancer position, our doctor will insert a long, thin tube through the lungs (bronchoscopy), your oesophagus (endoscopy) or the rectum (colonoscopy) to collect the cells.

Treatment:

Treatment options for neuroendocrine tumour depend on their type, size and location. Based on the diagnosis, our doctors develop the most effective treatment plan to remove cancer and reduce the chance of recurrence. While surgery is the most common treatment, other treatments can also be used to improve the outcome. These treatments might include:

Surgery:

Surgery is performed to remove the tumour through open surgery or minimally invasive surgery. Our surgeons will remove the tumour along with the surrounding tissues to leave no traces of cancer in the body. If removing the whole tumour is not viable, Debulking surgery is performed to remove as much cancer as possible.

• Peptide receptor radionuclide therapy (PRRT) allows radiation to be delivered directly to the tumour. It uses a combination of a drug that targets cancer cells with a small amount of radioactive substance.

Chemotherapy:

In chemotherapy, our doctors will use a group of drugs to stop cancer from spreading. Cancer cells absorb the drugs faster than normal cells, thus slowing their growth. These drugs can be delivered through a vein or a catheter, depending on the stage of cancer.

Radiation therapy:

Our surgeon will use controlled radiation to damage or destroy the DNA of cancer cells. Our radiation oncologist will use a machine to direct the energy beams on the cancer cells. It can be used in combination with chemotherapy if surgery isn’t an option.