The table below shows the various treatments for NETs that are available. Always consult your doctor to discuss and determine the most appropriate treatment options for you.
Surgery is usually the first choice for treatment if imaging scans show that the primary tumor is contained in one area (localized) or there has been only limited spread within an organ of the body. If it is possible to remove the tumor completely with surgery, then no other treatment may be necessary.
Even if the primary tumor has spread (metastasized), surgery may still be possible to remove part of the tumor and any other secondary tumors. This is often referred to as tumor debulking.
Radiation therapy uses high-energy particles or waves, such as X-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells.
Before radiotherapy can be given, imaging scans will be performed to determine the precise location of the tumors.
Radiation therapy aims to give the highest chance of curing or shrinking the cancer, and the lowest doses to surrounding healthy cells to avoid treatment side effects. Other names for radiation therapy are radiotherapy, irradiation, or X-ray therapy.
Intra-operative radiation therapy (IORT) is a precise way to deliver radiation therapy during surgery. During surgery, radiation is applied directly to the area where the tumor has been removed. This may help to remove any microscopic tumor cells and potentially reduce the chance that a tumor could grow back. A single treatment may be enough in some cases, although some patients may still need additional external beam radiotherapy for a short while after surgery.
Chemotherapy involves the use of anti-cancer (cytotoxic) drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide.
The type of chemotherapy that you are given will depend on where in the body the NETs started. For example, some people may receive chemotherapy to treat NETs in the pancreas (pancreatic NETs) or lungs (bronchial NETs). Chemotherapy can be used alone to treat NETs, or together with other treatments and procedures overviewed in this section.
Targeted cancer therapies are drugs or other substances that can block the growth, development, and spread of cancer by interfering with specific molecules and signaling pathways involved in carcinogenesis (the process by which normal cells become cancer cells), tumor vasculature, and tumor growth.
These treatments are also known as molecularly targeted therapies. They are used to treat specific types of neuroendocrine cancer by targeting the biological differences between cancer cells and normal cells.
Some molecularly targeted therapies can fight tumor cells while potentially causing less harm to the healthy cells. Targeted cancer therapies may be prescribed to some people with NETs, most of them having first received somatostatin analog medications.
Somatostatin analogs are medications that copy the action of somatostatin. Somatostatin is a hormone, a chemical messenger that is naturally produced in the body. It can stop the overproduction of other hormones that cause symptoms such as diarrhea, flushing, and wheezing.
Somatostatin analogs can provide therapy for both symptom management and control of symptomatic and asymptomatic tumors. They can help reduce symptoms by stopping the body from making too many hormones. They may also control the growth of certain types of NETs.
Interferon is a naturally occurring substance that is produced by the body’s immune system during an illness, such as a viral infection like influenza. Interferon is sometimes called biologic therapy or immunotherapy and is used to treat some people with NETs.
Sometimes interferon is taken on its own as a medication for NETs. However, it is often taken as part of a combination therapy with somatostatin analogs. Interferon may not be a suitable therapy for everyone with NETs.
Targeted radionuclide therapy is also called peptide receptor radionuclide therapy (PRRT) or hormone-delivered radiotherapy. PRRT is based on using radioactive substances (radionuclides) to target receptors on the tumor cells’ surface.
In this type of treatment for NETs, radionuclides are chemically combined with hormones (somatostatin analogs). When this combination treatment is injected into the body, it will aim for the surface of the neuroendocrine tumor cells and deliver a targeted radiation dose to help prevent further tumor growth or even destroy the tumor.
Other treatment options are currently being studied in clinical trials and may become available in the future. It’s important to understand these treatments have not been approved by the FDA, and there is a possibility they may never be approved or available in the US.
Access the latest trials at clinicaltrials.gov. Remember to talk to your doctor about any questions you may have.