Neuroendocrine cancers (also known as neuroendocrine neoplasms (NENs)) are a rare group of cancers that develop in cells of the neuroendocrine system. These cancers can develop in different parts of the body, such as the stomach, pancreas or lungs.
The neuroendocrine system is made up of nerve pathways and neuroendocrine cells, which are distributed throughout the body. These cells receive signals from the brain and, in response, produce and release hormones and similar substances that regulate essential bodily functions.
The term ‘neuro’ refers to nerve signalling and response, while ‘endocrine’ refers to the production and release of hormones.
Hormones and related substances are crucial for normal human development and growth. They also help with different bodily functions, such as breathing, digesting and sleeping. They also play a vital role in the body’s response to stress.
Neuroendocrine cells are found in almost all organs and endocrine glands, including the oesophagus, stomach, lungs, small and large bowel, pancreas, appendix and ovaries.
Neuroendocrine cancers don't always cause signs and symptoms at first. The symptoms you may experience depend on the tumour’s location and whether it produces excess hormones. Not all neuroendocrine cancers produce hormones.
Generally, the signs and symptoms might include:
- Mass effect from tumour affecting local structures causing symptoms, such as pain
- Unusual fatigue
- Unintentional weight loss
- Symptoms related to excess hormone production including diarrhoea, flushing or low blood sugar levels
There are various types of neuroendocrine cancer, typically named after the part of the body where they develop. However, they can be broadly categorised into two key groups:
- Neuroendocrine Tumours (NETs): These can be slow, moderate or fast-growing cancers. Although their cells are abnormal, they resemble normal neuroendocrine cells.
- Neuroendocrine Carcinomas (NECs): These are fast-growing cancers with cells that look very different to normal neuroendocrine cells.
It’s important to distinguish between neuroendocrine tumours (NETs) and neuroendocrine carcinomas (NECs), as they are very different, and their management is therefore different.
If you’re unsure which type you have, consult your doctor or specialist nurse.
Treatment for neuroendocrine cancers at CUH
The treatment you have depends on several factors, which include:
- the type and size of the cancer
- whether the cancer is producing hormones or not
- whether the neuroendocrine cancer is a ‘NET’ or a ‘NEC’
- where the cancer is located
- your general health
- whether the cancer has spread
A team of specialists at CUH will meet to discuss your condition and to make a recommendation about the best possible treatment for you.
You, along with your clinician, will then discuss your treatment recommendations at the clinic appointment and decide on the right treatment plan for you. Your clinician will explain the different treatment options and possible side effects.
The treatment for neuroendocrine cancers can include:
- surgery
- systemic therapy
- somatostatin analogues
- targeted therapy
- radiotherapy
Surgery is often the main treatment to remove neuroendocrine cancer. If surgery cannot completely remove the cancer, or if the cancer is large or has spread, other treatments may be offered to help manage your condition.
At times, you may require more than one treatment or a combination of different treatments to give the best chance of long-term cure. For some patients, treatment may be given with the aim of curing the cancer. For others, to help control the
cancer, prolong life and improve symptoms. Your clinical team will discuss with you what to expect.