Pancreatic Cancer Health Center

Pancreatic Neuroendocrine Tumors

Symptoms of Pancreatic NETs

Nonfunctional pancreatic NETs typically don't cause symptoms until they spread or become large. These tumors are usually discovered at a later stage when a patient complains of abdominal discomfort and has a CT or MRI scan of the abdomen.

People with functional pancreatic NETs can have a variety of symptoms based on their type of tumor. Symptoms can include:

• Abdominal pain
• Changes in behavior, confusion
• Dizziness
• Diarrhea
• Gastroesophageal reflux (the backup of stomach acids into the esophagus)
• Headache
• Low or high blood sugar levels
• Abdominal pain
• Nausea
• Rapid heartbeat
• Unintentional weight gain or loss
• Gallstones

Treatments for Pancreatic NETs

Which treatment is used depends on whether the pancreatic NET is cancerous or noncancerous, how far it has spread, and whether it is functional or nonfunctional. 

Treatment for pancreatic neuroendocrine tumors that are nonfunctional usually involves surgery to remove the tumor. Types of surgery include:

• Enucleation removes the tumor only. This procedure can be used for pancreatic NETs that are noncancerous or have not spread.
• Whipple procedure removes the head of the pancreas, gallbladder, nearby lymph nodes, and part of the stomach, small intestine, and bile duct (how much is removed depends on the tumor and how far it has spread).
• Distal pancreatectomy removes the body and tail of the pancreas, and possibly the spleen.
• Total gastrectomy removes the entire stomach.
• Radiofrequency ablation uses a probe with high-energy radio waves to kill cancer cells.
• Cryosurgery freezes cancer cells to kill them.
• Parietal cell vagotomy cuts the nerves that signal stomach cells to produce acid.
• Liver resection removes the liver or part of the liver.

If the tumor is small and has not spread, surgery may be performed laparoscopically, with smaller incisions. Patients with pancreatic NETs may also receive chemotherapy.

Functional pancreatic NETs are usually found at an earlier stage because their symptoms alert the presence of a tumor sooner. Treatment for pancreatic NETs that are functional can involve surgery, which is tailored to the specific type of tumor. 

Patients may receive medicine to counteract the excess hormone produced by the tumor. For example, patients with gastrinomas may receive medications to reduce excess acid production in the stomach. People with insulinomas may receive the medication to control low blood sugar caused by excess insulin production.

Lifestyle changes may also help. Patients with insulinomas, for example, may need to eat more frequent meals to keep their blood sugar levels high enough.