Neuroendocrine Cancer

Neuroendocrine Cancer starts in cells of the neuroendocrine system. This system is a network of cells throughout the body that have a structure similar to neurons (nerve cells) and produce hormones like endocrine cells.

In its early stage, a NET often causes no symptoms and may only be detected during an unrelated x-ray or surgery for another condition. If a person presents neuroendocrine cancer symptoms, they may be associated with the size and-or location of the tumor or with the release of hormones, such as carcinoid syndrome. These are the following symptoms of Neuroendocrine cancer:

  • Fatigue
  • Loss of appetite 
  • Unexplained weight loss
  • Persistent pain in a specific area
  • Thickening or a lump in any part of the body 
  • Nausea or vomiting 
  • A cough or hoarseness that does not go away
  • Changes in bowel or bladder habits 
  • Jaundice, which is the yellowing of the skin and white of the eyes
  • Unusual bleeding and discharge
  • Diarrhea 
  • Facial flushing, usually without sweating
  • Hyperglycemia 
  • Ulcer disease
  • Skin rash 
  • Increased thirst
  • Dizziness
  • Shakiness
  • Confusion
  • Anxiety 

For More information visit: Cancer.net and Mayoclinic.org

Risk factors for Neuroendocrine cancer include:

  • Hereditary
  • Family history of cancer
  • Multiple endocrine neoplasia, type 1 (MEN 1)
  • Multiple endocrine neoplasia, type 2 (MEN 2)
  • Tuberous sclerosis
  • Neurofibromatosis type 1
  • Von Hippel-Lindau syndrome
  • Smoking
  • Diabetes
  • Chronic Atrophic Gastritis

For more information visit: Canadian Cancer Society, Mayoclinic.org, National Library of Medicine

One of the most important features of a NET is the grade it is assigned. We see 3 grades. Grade 1 is the slowest growing compared to the others; with grade 2, it is usually referred to as low grade. Survival times for patients can vary based on tumor grade and tumor stage (local, regional and distant) and primary location. Cases of NETs are most commonly seen in lung, small intestinal, rectal, pancreatic, stomach, appendiceal and colon cancer. (Carcinoid.org). These are the tests that may be completed to diagnose neuroendocrine cancer.

  • Physical examination
  • Urinalysis
  • Computed Tomography CT) scan
  • Magnetic Resonance Imaging (MRI)
  • Positron emission testing (PET) scan
  • Biopsy

You can find more information on neuroendocrine diagnosis and screening at Mayoclinic.org, Cleveland clinic, MD Anderson Cancer Centre 

NETs vary greatly in their size, location, symptoms and growth. Therefore the treatment in each case should be individualized to what is best for each individual. The treatment options can be categorized based upon primary tumor origin. Treatment options include:

  • Surgery, complete removal of all tumor tissue
  • Freezing probe (cryoablation)
  • Radiofrequency ablation (RFA)
  • Chemoembolization therapy 
  • Radioembolization therapy
  • Peptide Receptor radionuclide therapy (PRRT)
  • Capecitabine plus temozolomide (CAPTEM) 
  • Fluorouracil plus oxaliplatin (FOLFOX)
  • Immunotherapy with checkpoint inhibitors
  • External beam radiation therapy

For  more information visit : carcinoid.org

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Our vision is to invent the future of health care.

Our values are: excellence, collaboration, accountability, respect and engagement.

From our beginnings as a hospital for Canadian veterans, Sunnybrook has flourished into a fully affiliated teaching hospital of the University of Toronto, evolving to meet the needs of our growing community. Today, with 1.3 million patient visits each year, Sunnybrook has established itself across three campuses and is home to Canada's largest trauma centre. 

We are world leaders in the care of neuroendocrine tumours (NET). Our multidisciplinary clinic is the only one of its kind in Canada. Our integrated care model sees all specialists and treatment options under one roof.

Sunnybrook's groundbreaking research changes the way patients are treated around the world. Our over 200 scientists and clinician-scientists conduct more than $100 million of breakthrough research each year. Tomorrow, we will discover ways to treat the untreatable."

Visit them at Sunnybrook Health Science Centre

"The objectives of CNETS are:

To provide workshops and seminars on issues dealing with conditions associated with carcinoid and related neuroendocrine tumour diseases;

To establish support groups to provide support services for those affected by carcinoid and related neuroendocrine tumour diseases;

To increase awareness of and educate the public and health care professionals on carcinoid and related neuroendocrine tumours, their diagnosis, treatment and management; and to support cancer research by gifting funds to other registered charities or organizations that are otherwise qualified donees as defined in subsection 149.1(1) of the Income Tax Act.

The Carcinoid-NeuroEndocrine Tumour Society (CNETS) – Canada was formed in 2007 to assist the Canadian community, primarily patients, with this type of disease."

Visit them at Canadian Neuroendocrine Tumor Society (CNETS)