Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Cellular Classification of Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
Table 1. Endocrine Tumors of the PancreasIslet CellsSecreted Active AgentTumor and SyndromeACTH = adrenocorticotropin; MSH = melanocyte-stimulating hormone; VIP = vasoactive intestinal peptide; WDHA = watery diarrhea, hypokalemia, and achlorhydria; 5-HT = serotonin.AlphaGlucagonGlucagonoma (diabetes, dermatitis)BetaInsulinInsulinoma (hypoglycemia)DeltaSomatostatinSomatostatinoma (mild diabetes); diarrhea/steatorrhea; gallstonesDGastrinGastrinoma (peptic ulcer disease)A -> DVIP and/or other undefined mediatorsWDHA5-HTACTHMSHCarcinoidCushing syndromeHyperpigmentationInteracinar CellsSecreted Active AgentTumor and SyndromeFPancreatic polypeptideMultiple hormonal syndromesEC5-HTCarcinoid
Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (06 / 29 / 2012)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Pancreatic Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Recurrent Pancreatic Cancer
Recurrent pancreatic cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the pancreas or in other parts of the body.
Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Patient Information [NCI] - Get More Information From NCI
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Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Miscellaneous Islet Cell Tumors
VIPomaImmediate fluid resuscitation is often necessary to correct the electrolyte and fluid problems that occur as a result of the watery diarrhea, hypokalemia, and achlorhydria that patients experience. Somatostatin analogs are also used to ameliorate the large fluid and electrolyte losses. Once patients are stabilized, excision of the primary tumor and regional nodes is the first line of therapy for clinically localized disease. In the case of locally advanced or metastatic disease, where curative resection is not possible, debulking and removal of gross disease, including metastases, should be considered to alleviate the characteristic manifestations of VIP overproduction. (Refer to the Treatment Option Overview section of this summary for information about the remaining principles of therapy.)SomatostatinomaComplete excision is the therapy of choice, if technically possible. However, metastases often preclude curative resection, and palliative debulking can be considered to
Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Patient Information [NCI] - General Information About Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas.The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine. Anatomy of the pancreas. The pancreas has three areas: head, body, and tail. It is found in the abdomen near the stomach, intestines, and other organs. There are two kinds of cells in the pancreas:Endocrine pancreas cells make several kinds of hormones (chemicals that control the actions of certain cells or organs in the body), such as insulin to control blood sugar. They cluster together in many small groups (islets) throughout the pancreas. Endocrine pancreas cells are also called islet cells or islets of Langerhans. Exocrine pancreas cells make enzymes that are released into the small intestine to help the
Pancreatic Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Treatment Options by Stage
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.Stages I and II Pancreatic CancerTreatment of stage I and stage II pancreatic cancer may include the following:Surgery.Surgery followed by chemotherapy.Surgery followed by chemoradiation.A clinical trial of combination chemotherapy.A clinical trial of chemotherapy and targeted therapy, with or without chemoradiation.A clinical trial of chemotherapy and/or radiation therapy before surgery.Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I pancreatic cancer and stage II pancreatic cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about
Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Glucagonoma
As with the other pancreatic neuroendocrine tumors, the mainstay of therapy is surgical resection, and extended survival is possible even when the disease is metastatic. Resection of metastases is also a consideration when feasible.Standard treatment options:Single small lesion in head or tail of pancreas:[1,2,3,4]Enucleation, if feasible.Large lesion in the head of the pancreas that is not amenable to enucleation:[1,2,3,4]Pancreaticoduodenectomy.Single large lesion in body/tail:[1,2,3,4]Distal pancreatectomy.Multiple lesions:[1,2,3,4]Enucleation, if feasible.Resect body and tail otherwise.Metastatic disease: lymph nodes or distant sites:[5,6,7,8,9,10,11,12]Resect when possible.Consider radiofrequency or cryosurgical ablation, if not resectable. Unresectable disease:[13,14,15,16,17,18,19,20,21,22]Combination chemotherapy.Somatostatin analogue therapy. Necrotizing erythema of glucagonoma may be relieved in 24 hours with somatostatin analogue, with nearly complete disappearance
Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®): Treatment - Patient Information [NCI] - Recurrent Pancreatic Neuroendocrine Tumors
Recurrent pancreatic neuroendocrine tumors (NETs) are tumors that have recurred (come back) after being treated. The tumors may come back in the pancreas or in other parts of the body.
Pancreatic Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Stages of Pancreatic Cancer
Tests and procedures to stage pancreatic cancer are usually done at the same time as diagnosis. The process used to find out if cancer has spread within the pancreas or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage of the disease in order to plan treatment. The results of some of the tests used to diagnose pancreatic cancer are often also used to stage the disease. See the General Information section for more information.There are three ways that cancer spreads in the body.The three ways that cancer spreads in the body are:Through tissue. Cancer invades the surrounding normal tissue.Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.When cancer cells break away from the primary