About this disease
What it is about
Risk factors are not known. Sometimes, however, neuroendocrine tumors are part of hereditary syndromes with tumors in multiple organs simultaneously. They are most common in the stomach, intestines or pancreas (GEP-NET tumors), followed by lungs and less frequently in the thyroid, adrenal glands or thymus. About 30 percent are active NETs that produce hormones and cause symptoms. The inactive NETs do not secrete hormones, which is why they are mostly asymptomatic and therefore often difficult to detect.
Types
In addition to the distinction between active, hormone-producing tumors and inactive tumors without hormone secretion (70%), neuroendocrine tumors can be divided into so-called well-differentiated and poorly differentiated tumors. In the case of well-differentiated tumors, the tumor tissue differs less from the original tissue. They usually grow slowly and the prognosis is better. On the other hand, the less differentiated tumors are more aggressive and more likely to form metastases.
Symptoms and consequences
Inactive tumors without hormone production may appear in the gastrointestinal tract by painful narrowing, bleeding or organ rupture. Sometimes they are also found by chance in connection with another examination (e.g. CT). Hormone-active tumors may result in cramping abdominal pain, diarrhea, shortness of breath, seizure-like facial flushing, palpitations, clustered peptic ulcers, or hypoglycemia, depending on the hormone release. Aggressive NET of the gastrointestinal tract most often form distant derivatives in the liver.
What we do for you
Examination and diagnosis
The variety of tumors and symptoms often make detection difficult. In addition to blood and urine tests, endoscopy, computed tomography (CT or PET-CT) or magnetic resonance imaging (MRI) can provide more information. In the course of these examinations, a tissue sample is also taken in order to be able to confirm the findings. The subsequent treatment is discussed jointly by specialists from different fields at the so-called tumor board.
Treatment
Often, neuroendocrine tumors and their offshoots in the body, the so-called metastases, must and can be surgically removed in one operation. Drugs such as somatostatin analogues (SSA) can be used to slow down hormone release and tumor growth. More effective than classical chemotherapies are, depending on the tumor, targeted therapies with drugs (mTOR inhibitors and tyrosine kinase inhibitors). In addition, so-called local ablative procedures or nuclear medicine therapies (with radioactively labeled substances) can be used as needed.