Is there a difference between Neuroendocrine tumors and Cancer?

Neuroendocrine tumors (NETs) have been featured in the news quite frequently in recent times. This is partly due to various celebrities being diagnosed and sometimes succumbing to this disease. People like Steve Jobs, Aretha Franklin, and the actor Irrfan Khan are closer to home. The natural tendency is to assume that this disease is primarily related to the brain. Not many realize that this is mainly an abdominal disease that tends to mimic cancer. Although it is a rare tumor, the incidence seems to be increasing, even in our country.

NETs mainly affect the abdominal organs such as the pancreas, intestine, appendix, stomach, and other organs. It can also affect the lungs and other organs as well. Many NETs are detected unexpectedly at regular check-ups or while investigating for something else.

The good news is that most NETs do not behave like typical cancers. The low-grade NETs (grades 1 and 2) are slow-growing tumors with high cure rates. There are also many treatment options that patients well tolerate. Some NETs are functional, which means the cancer secretes hormones into the bloodstream, causing symptoms related to those hormones. For example, if insulin is secreted, the blood sugar tends to get extremely low, causing giddiness. Unfortunately, high-grade NETs (grade 3) tend to behave like cancers and generally require chemotherapy.

NETs usually require a special PET scan called a 68-gallium PET scan or a DOTA-TOC scan. This helps to identify the tumor and its spread. The treatment is generally surgical. Other options like targeted therapy, long-acting octreotide, and peptide therapy are also effective.

To summarize, NETs are a relatively rare group of tumors that are usually ‘well-behaved,’ with numerous treatment options, the primary modality being surgery.