Neuroendocrine tumors (NET) have long been considered a rare pathology, and, accordingly, little attention was paid to it both in the process of specialist training and in the differential diagnostic research. However, the increase in the incidence of NETs observed in recent years forces many researchers and clinicians to reconsider the approach to them.
Treatment options for neuroendocrine tumors (NETs)
Treatment should be aimed at the eradication of the tumor. The treatment scheme depends on the type of NET, its stage, the degree of differentiation, the functional activity of the tumor, the degree of liver damage by metastases, and the general health condition of the patient.
A multidisciplinary approach is of particular importance in the treatment of neuroendocrine tumors. The main method of treatment is surgical. Radiation therapy and chemotherapy, targeted and symptomatic therapy can also be used.
Surgery
At the early stages, surgical intervention is enough to get rid of the disease. Unfortunately, due to the late detection of a tumor, it is often impossible, since the disease is diagnosed already at the stage of metastasizing. However, even for patients with metastases, sometimes it is advisable to have surgical treatment in order to reduce the tumor size. In such cases, cytoreductive surgery is performed.
As for palliative surgery, most doctors believe that it should be performed only if at least 90% of the tumor mass can be removed. Nevertheless, there are reports that resection of a smaller tumor volume improves long-term results. If it is impossible to remove the tumor and metastases completely, drug treatment is used to control symptoms, stop or inhibit tumor growth.
Chemotherapy for neuroendocrine tumors
Chemotherapy for neuroendocrine tumors is effective in poorly differentiated NETs and is used as first-line therapy. For the treatment of poorly differentiated NETs, cytotoxic chemotherapy is used.
For highly differentiated NETs, chemotherapy should only be used if other methods have failed. Platinum-based regimens are standard treatment in this case.
Drug therapy
Synthetic analogs of somatostatin play a key role in the treatment of metastatic NETs. Their action is aimed at eliminating functional symptoms and reducing the spread of cancer cells.
Most NETs have somatostatin receptors on their surface. Inhibition of somatostatin receptors leads to a decrease in the secretion of biologically active substances and suppression of the malignant process.
Currently, long-acting synthetic analogs of somatostatin with high affinity are widely used. They have similar pharmacological effects but act much longer. Long-acting synthetic analogs of somatostatin suppress the secretion of growth hormone (somatotropin), insulin, glucagon, gastrin, and serotonin.
Often, patients with NET require lifelong use of such drugs.
Peptide receptor radionuclide therapy
Peptide receptor radionuclide therapy is used in the treatment of patients with metastatic NETs that are not subject to surgical removal, as well as those progressing despite drug therapy. By binding to somatostatin receptors, a radioactive peptide finds and recognizes the tumor, suppresses hormone secretion, and has an anti-spreading effect.
Even though peptide receptor radionuclide therapy has been used in medical practice for more than 15 years as a treatment method for NETs, the information on long-term results is somewhat limited.
Recently, a study that lasted more than a decade has revealed the statistics on the response for the treatment method. In 80% of cases, peptide receptor radionuclide therapy successfully treats neuroendocrine tumors with a further high survival rate.
Undergoing treatment of neuroendocrine tumors during the lockdown
To undergo treatment of neuroendocrine tumors abroad, you don’t need to spend hours researching whether it is actually possible during the lockdown situation.
It is possible. But it can be easier with some assistance along the way.
Booking Health supports patients all over the globe, helping them to receive quality treatment abroad while making it as comfortable as possible. Booking Health negotiates with a hospital of your choice, resolves all possible issues with getting a visa during the lockdown, offers the services of a personal interpreter if needed, and does anything related to the treatment organization for you.
To get the information on how you can start treatment of neuroendocrine tumors, contact Booking Health by leaving a request on the webpage.
