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Treatment Options for Pancreatic Neuroendocrine Tumors

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.

Gastrinoma

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Treatment of gastrinoma may include supportive care and the following:

  • For symptoms caused by too much stomach acid, treatment may be a drug that decreases the amount of acid made by the stomach.
  • For a single tumor in the head of the pancreas:
    • Surgery to remove the tumor.
    • Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid.
    • Surgery to remove the whole stomach (rare).
  • For a single tumor in the body or tail of the pancreas, treatment is usually surgery to remove the body or tail of the pancreas.
  • For several tumors in the pancreas, treatment is usually surgery to remove the body or tail of the pancreas. If tumor remains after surgery, treatment may include either:
    • Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid; or
    • Surgery to remove the whole stomach (rare).
  • For one or more tumors in the duodenum (the part of the small intestine that connects to the stomach), treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct).
  • If no tumor is found, treatment may include the following:
    • Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid.
    • Surgery to remove the whole stomach (rare).
  • If the cancer has spread to the liver, treatment may include:
    • Surgery to remove part or all of the liver.
    • Radiofrequency ablation or cryosurgical ablation.
    • Chemoembolization.
  • If cancer has spread to other parts of the body or does not get better with surgery or drugs to decrease stomach acid, treatment may include:
  • If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include:
    • Hepatic arterial occlusion, with or without systemic chemotherapy.
    • Chemoembolization, with or without systemic chemotherapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with gastrinoma. 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 clinical trials is available from the NCI Web site.

Insulinoma

Treatment of insulinoma may include the following:

  • For one small tumor in the head or tail of the pancreas, treatment is usually surgery to remove the tumor.
  • For one large tumor in the head of the pancreas that cannot be removed by surgery, treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct).
  • For one large tumor in the body or tail of the pancreas, treatment is usually a distal pancreatectomy (surgery to remove the body and tail of the pancreas).
  • For more than one tumor in the pancreas, treatment is usually surgery to remove any tumors in the head of the pancreas and the body and tail of the pancreas.
  • For tumors that have spread to lymph nodes or other parts of the body, treatment may include the following:
    • Surgery to remove the tumor.
    • Radiofrequency ablation or cryosurgical ablation, if the tumor cannot be removed by surgery.
  • For tumors that cannot be removed by surgery, treatment may include the following:
    • Combination chemotherapy.
    • Palliative drug therapy to decrease the amount of insulin made by the pancreas.
    • Hormone therapy.
    • Radiofrequency ablation or cryosurgical ablation.
  • If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include:
    • Hepatic arterial occlusion, with or without systemic chemotherapy.
    • Chemoembolization, with or without systemic chemotherapy.
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