by Neuroendocrine tumors can arise in many areas of the body. While some are benign, others are cancerous or malignant. The treatment approach depends on the specific type and stage of the disease. Here are the various treatment options available:
Surgery
Surgery is often the primary treatment for neuroendocrine tumors that have not spread. The goal is to remove as much of the tumor as possible. For localized neuroendocrine tumors in the gastrointestinal tract or pancreas, surgery may involve removing the tumor and some surrounding healthy tissue. If the cancer has spread to the liver, surgery may involve removing the primary tumor and some or all liver tumors. Surgery aims to delay tumor growth and disease progression. It can potentially cure early-stage disease while also allowing doctors to determine the exact type and stage of cancer.
somatostatin analogs
Somatostatin analogs are medications similar to somatostatin, a hormone produced in the body that inhibits the secretion of other hormones. Common somatostatin analogs used for neuroendocrine tumors include octreotide and lanreotide. They work by binding to somatostatin receptors on tumor cells and reducing the production of hormones secreted by the tumor. This helps relieve symptoms caused by excess hormone production such as diarrhea and flushing. Somatostatin analogs may also slow tumor growth for some patients. They are often given before surgery to shrink tumors. They are also frequently used long-term for palliative care.
Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy neuroendocrine tumor cells. It may be considered for Neuroendocrine Tumor Treatment that have spread widely or are not controlled by surgery or other treatments. Common chemotherapy drugs include 5-fluorouracil, dacarbazine, streptozocin, and temozolomide. Chemotherapy is usually given in cycles with rest periods in between. Side effects depend on the drugs used but can include nausea, vomiting, hair loss, and more. Chemotherapy is not very effective for low-grade neuroendocrine tumors but can provide benefits for some high-grade tumors.
Radiofrequency ablation
Radiofrequency ablation uses high-frequency sound waves to heat and destroy isolated neuroendocrine tumor lesions, usually in the liver. It minimally invasive by using imaging guidance to insert a needle electrode into each tumor. An electric current then heats the tip of the electrode to almost 100°C to coagulate the tumor tissue. Radiofrequency ablation aims to control liver tumors in patients who cannot have surgery or when surgical removal of all lesions is not possible. It offers an alternative to surgery with less pain, scarring, and recovery time. Multiple treatments may be needed to target all tumors.
Targeted radionuclide therapy
This treatment involves attaching radioactive molecules to somatostatin analogs that can track down and bind to neuroendocrine tumor cells expressing somatostatin receptors. Common radiolabeled somatostatin analogs include lutetium-177 dotatate and yttrium-90 dotatate. After intravenous injection, the radioactive drugs travel through the bloodstream and accumulate in somatostatin receptor-positive tumors to destroy them from the inside out through beta radiation. This outpatient treatment is well-tolerated with fewer side effects than chemotherapy. It benefits patients who have progressed after other treatments or when other options are not suitable.
Proton beam therapy
Proton beam therapy is a type of external beam radiation therapy that uses protons rather than x-rays to precisely target tumors, especially those near sensitive areas. In neuroendocrine cancer, proton therapy may benefit patients with tumors located near critical structures such as the optic nerves or brainstem. It better spares surrounding healthy tissue compared to traditional photon radiation. Proton therapy is delivered on an outpatient basis, though it requires visiting a facility with a particle accelerator. Potential side effects can include fatigue, skin irritation in treated areas, and long-term risks like second cancers.
Clinical trials
Clinical trials study new and improved treatments for neuroendocrine tumors by testing them in patients. Participating in a trial voluntarily offers access to promising new therapies not otherwise available. Many trials explore targeted therapies designed to block specific pathways involved in tumor growth. Other trials combine standard treatments in novel ways or at different doses and intervals. Comprehensive cancer centers actively enroll patients in trials to advance care. Clinical trials provide potential benefits while also helping expand medical knowledge about these rare cancers.
Neuroendocrine tumors require coordinated treatment approaches tailored to each patient’s individual circumstances. Treatment planning and management ideally occurs at centers experienced in these complex cancers. A multidisciplinary team of experts works closely with patients to understand all options and guide treatment decisions based on the latest research. Outcomes have steadily improved due to a growing repertoire of both standard and cutting-edge therapies, providing hope for patients living with these challenging malignancies. Ongoing research aims to develop even more effective options.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
