Pancreatic Neuroendocrine Tumors: Slow-Growing and Often Curable

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By Pamela L. Kunz MD, Associate Professor of Medicine, Yale School of Medicine HealthDay reporter


MONDAY June 19, 2023, (HealthDay News). Pancreatic Cancer is a deadly disease that is usually aggressive and caught late. However, there is a type of pancreatic carcinoma that is much more treatable.

Unlike adenocarcinomas (the most aggressive and fatal type of pancreatic tumor), pancreatic neuroendocrine tumours (NETs), which are slow-growing, can be treated by surgery alone. These less aggressive tumors, though rare in terms of incidence (the number diagnosed each year), are more common than both pancreatic and stomach adenocarcinomas combined (the total number of people alive at any given time). Pancreatic NETs are a greater public health issue than previously thought.

What is pancreatic Cancer?

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The pancreas, a large gland located in the abdomen behind the stomach, is responsible for producing digestive enzymes and hormones that control blood sugar levels. The pancreas is responsible for producing digestive enzymes as well as hormones which control blood sugar. When cells in the pancreas multiply uncontrollably, they can develop into cancer. Pancreatic cancer may originate from exocrine (the cells which make digestive enzymes) and endocrine (the hormone-producing) cells.

Types of pancreatic cancer

Adenocarcinoma is the most common pancreatic carcinoma (90%) that arises from exocrine pancreatic cells. The remaining 10% is made up of rare subtypes, including cancers that are derived from endocrine pancreatic cells.

Pancreatic cancer is a multi-subtype disease with many different symptoms, risk factors and treatment options. Pancreatic NETs have a much better overall prognosis than adenocarcinomas because they are slow-growing.

Patients with metastatic pancreatic cancer NETs have a high cure rate and can live with the disease for years. Physicians use several features of pancreatic NETs to customize treatment, including stage, grade, and differentiation (markers for cancer cell division and aggression), hormones released by the cancer, as well as the presence or absence of somatostatin-receptors (a special mark on the surface of NET cells).

Pancreatic cancer symptoms

Pancreatic cancer is not screened. The symptoms are non-specific, and include fatigue, weight gain, nausea, vomiting and pain. They can also be accompanied by jaundice, or a yellowing of the skin. Some pancreatic neuroendocrine tumors (NETs) also produce hormones, which can cause specific symptoms.

What causes pancreatic NETs?

Most pancreatic NETs are not known to be genetic. A small number of patients are genetically predisposed. Genetic testing may be advised for certain patients. Other risk factors are not known for pancreatic NETs.

Treatment of pancreatic NETs

Treatment for pancreatic cancer NETs can include surgery, somatostatin analogs (a hormonal treatment), chemotherapy and targeted therapies. Peptide receptor radionuclide treatment (a targeted radiation) is also an option. Multidisciplinary teams, such as those that I work with at Yale Cancer Center and Smilow Cancer Hospital, in New Haven, Conn., are the best way to determine what treatment is most appropriate for each patient. These teams are made up of many specialists who all play a part in the treatment of patients with pancreatic cancer NETs. They include medical oncologists as well as surgical oncologists.