Neuroendocrine Tumors (NETs): Treatment Options

Getting the right treatment for your neuroendocrine tumor (NET) starts with a little fact-finding. The most important things to figure out are where the disease started and whether it has spread.

If your tumor is small and growing slowly, you may not need treatment. If you have to take action, surgery, drugs, and radiation are three options to destroy NETs and ease your symptoms.

A team of doctors works with you to create a treatment plan. It's OK to ask questions and get a second opinion if you're unsure about the recommendations they've made.

Surgery

Surgery is usually one of the first steps for treating NETs that have not spread or have spread only a little. Your doctor may remove the tumor and any affected lymph nodes nearby.

Your surgeon may remove more tissue if your cancer has spread from its original location. They may also use one of these techniques to stop it from growing more:

  • Radiation therapy, in which high-energy beams are used to kill cancer cells.
  • Embolization, where your doctor blocks a blood vessel to cut off a tumor's blood supply.
  • Cryoreductive surgery and ablation, in which your doctor uses intense cold or heat to treat cancer that has spread.

After surgery, you may have pain, fatigue, or feel weak for a few days.

Medications

Talk to your doctor if you have unusual symptoms like:

  • Redness on your face or neck
  • Stomach pain
  • Diarrhea
  • Shortness of breath

Your NET could be causing them. Doctors want to know whether you might have symptoms that show your tumor is making hormones. NETs in your pancreas can make insulin, for example.

You may need treatment with hormone therapy, which can control the release of hormones your tumor makes and help stabilize its growth. Somatostatin drugs like lanreotide and octreotide can ease symptoms caused by too many hormones.

You could need medicine to kill cancer cells that are still there after surgery, or to treat your NET if surgery isn't right for you.

If your doctor suggests chemotherapy, you'll get drugs that go through your whole body to kill cancer cells. Chemo may be taken as pills or through intravenous (IV) drips. You may have side effects like nausea or hair loss during your treatment.

Targeted treatments are newer drugs that attack the exact proteins or genes in your type of tumor. Imaging scans can help your doctor decide which ones you should use.

Biologic drugs can also be used to treat NETs. These meds boost your immune system -- your body's defense against germs -- to fight your cancer. They're also called immunotherapy.

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Radiation

This treatment uses energy waves like X-rays to destroy your cancer cells. Some people with NETs get traditional "external beam" radiation. You'll lie still while a machine aims radiation at the area of your tumor.

Doctors can also use a "smart bomb" drug that delivers radiation directly to your tumor.

You'll probably need a few treatments of any type of radiation to kill the tumor and cancer cells. Some side effects that you may get include fatigue, skin reactions at the site of your treatment, upset stomach, or loose bowel movements. They should go away soon after you're done getting radiation.

Nondrug Treatments

If you have a NET that makes hormones, you may need to change what you eat to ease or prevent symptoms. A nutritionist can come up with an eating plan for you, including which foods to avoid.

After you have surgery to remove some of your pancreas, for example, it can be hard to absorb the fats in food. This can cause diarrhea and make it hard to absorb some vitamins, like B12 or D, that you need for good health. Your nutritionist can come up with a plan to add some vitamins back in, as well as minerals like calcium to keep your bones strong.

Don't try high vitamin doses to treat your disease on your own. Too much of certain vitamins can be harmful. Instead, eat vitamin-rich foods.

While you get your treatment, don't neglect your mental and emotional health. NETs, like any cancer, may make you anxious or depressed. Meet with a therapist or join a support group to talk about your feelings. Meditation and other mind-body techniques may help you ease stress, too.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on May 01, 2020

Sources

SOURCES:

American Cancer Society: "Understanding Radiation Therapy."

Eugene Woltering, MD, neuroendocrine tumor program director, Ochsner Medical Center-Kenner, Kenner, LA.

Diane Reidy-Lagunes, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, New York City.

Jaffer Ajani, professor, department of gastrointestinal medical oncology, University of Texas MD Anderson Cancer Center, Houston.

Cancer Treatment Centers of America: "Neuroendocrine Tumors."

Moffitt Cancer Center: "Neuroendocrine Tumor Therapy."

American Society of Clinical Oncology: "Endocrine Tumor: Treatment Options."

American Association of Endocrine Surgeons: "Management of metastatic disease from neuroendocrine cancers."

Mayo Clinic: "Neuroendocrine Tumors."

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