What are neuroendocrine tumours?

Written in association with: Dr Daniel Krell
Published: | Updated: 07/08/2024
Edited by: Conor Lynch

Neuroendocrine tumours (NETs) are a diverse group of malignancies that arise from neuroendocrine cells found throughout the body. These cells possess characteristics of both nerve cells and hormone-producing endocrine cells, enabling them to release hormones into the bloodstream in response to neuronal signals.

 

NETs can occur in various organs, including the gastrointestinal tract, pancreas, lungs, and thymus. Here to explain more about these tumours is revered medical oncologist, Dr Daniel Krell

What are neuroendocrine tumours?

Neuroendocrine tumours originate from neuroendocrine cells, which are involved in the regulation of physiological processes through hormone secretion. These tumors are generally classified into two main types: functional and non-functional. Functional NETs secrete hormones that can cause clinical syndromes, while non-functional NETs do not produce active hormones and often go undetected until they cause symptoms due to their size or location.

 

Symptoms and diagnosis

The symptoms of NETs vary widely based on their location and whether they are functional. Functional NETs can cause specific syndromes, such as carcinoid syndrome, which includes symptoms like flushing, diarrhoea, and wheezing, due to the release of serotonin. Non-functional NETs may cause vague symptoms such as abdominal pain, weight loss, or jaundice if they affect the liver.

 

The diagnosis of NETs typically involves a combination of imaging studies, biochemical tests, and histopathological examination. Techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans are commonly used for localisation and staging.

 

Treatment options

Treatment for neuroendocrine tumors depends on various factors, including the type, location, stage of the tumor, and whether it is functional. Surgery is often the primary treatment for localized tumors. In cases where the tumor has metastasised, other treatments such as somatostatin analogs, targeted therapies, chemotherapy, and peptide receptor radionuclide therapy (PRRT) may be utilised. Somatostatin analogs can help control hormone-related symptoms and slow tumor growth, while targeted therapies aim to inhibit specific pathways involved in tumor proliferation.

 

Prognosis and research

The prognosis for individuals with NETs varies widely. Factors such as tumor type, grade, stage, and response to treatment play crucial roles in determining outcomes. Generally, low-grade tumors tend to grow slowly and have a better prognosis, while high-grade tumors are more aggressive. Ongoing research in the field of NETs focuses on understanding the molecular mechanisms driving these tumors and developing new targeted treatments to improve patient outcomes.

By Dr Daniel Krell
Medical oncology

Dr Daniel Krell is a highly regarded oncology consultant. He specialises in gastrointestinal, colorectal, pancreatic, hepatic, and biliary duct cancers, as well as neuroendocrine tumours. He possesses extensive expertise in employing chemotherapy, targeted therapy, and immunotherapy. Dr Krell also oversees patients with cancer of an undisclosed origin and leads in a clinical capacity in this domain.

Within the Royal Free Trust, he collaborates as a member of the multidisciplinary team handling gastro-oesophageal and hepatobiliary cancer cases. Moreover, he serves as the clinical head for neuroendocrine tumour oncology at The Royal Free Hospital.

He underwent his oncology training at University College and the Royal Free Hospitals in London. In addition to his primary medical degree, he achieved a bachelor's degree in immunology and microbiology, alongside a DPhil in clinical medicine at the University of Oxford's Welcome Trust Centre for Human Genetics. The funding for his research came from Cancer Research UK and HCA. His study focused on constructing models to explore the influence of genetic mutations in genes controlling cellular metabolism on cancer development, with potential implications for the identification of novel therapeutic targets in this field.

Dr Krell continues to be actively involved in clinical research and trials aimed at discovering groundbreaking cancer therapies, with a specific focus on gastrointestinal, hepatobiliary, and neuroendocrine tumours. He has written several peer-reviewed papers and presented his findings at national and international conferences.

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