Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells.

Neuroendocrine tumors are rare and can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas.

There are many types of neuroendocrine tumors. Some grow slowly and some grow very quickly. Some neuroendocrine tumors produce excess hormones (functional neuroendocrine tumors). Others don’t release hormones or don’t release enough to cause symptoms (nonfunctional neuroendocrine tumors).

Diagnosis and treatment of neuroendocrine tumors depend on the type of tumor, its location, whether it produces excess hormones, how aggressive it is and whether it has spread to other parts of the body.

Types

1. Adrenal cancer
2. Carcinoid tumors
3. Merkel cell carcinoma
4. Pancreatic neuroendocrine tumors
5. Paraganglioma
6. Pheochromocytoma

Symptoms

Neuroendocrine tumors don’t always cause signs and symptoms at first. The symptoms you might experience depend on the location of your tumor and whether it produces excess hormones.

In general, neuroendocrine tumor signs and symptoms might include:

• Pain from a growing tumor
• A growing lump you can feel under the skin
• Feeling unusually tired
• Losing weight without trying

Neuroendocrine tumors that produce excess hormones (functional tumors) might cause:

• Skin flushing
• Diarrhea
• Frequent urination
• Increased thirst
• Dizziness
• Shakiness
• Skin rash

Causes

The exact cause of neuroendocrine tumors isn’t known. These cancers begin in neuroendocrine cells that have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine cells are found throughout your body.

Neuroendocrine tumors begin when neuroendocrine cells develop changes (mutations) in their DNA. The DNA inside a cell contains the instructions that tell the cell what to do. The changes tell the neuroendocrine cells to multiply rapidly and form a tumor.

Some neuroendocrine tumors grow very slowly. Others are aggressive cancers that invade and destroy normal body tissue or spread (metastasize) to other parts of the body.

Risk factors

The risk of neuroendocrine tumors is higher in people who inherit genetic syndromes that increase the risk of cancer. Examples include:

• Multiple endocrine neoplasia, type 1 (MEN 1)
• Multiple endocrine neoplasia, type 2 (MEN 2)
• Von Hippel-Lindau disease
• Tuberous sclerosis
• Neurofibromatosis

Diagnosis

The tests and procedures you might undergo to diagnose a neuroendocrine tumor will depend on where your tumor is located in your body. In general, tests might include:

• Physical exam. Your doctor may examine your body to better understand your signs and symptoms. He or she may feel for swollen lymph nodes or look for signs that a tumor is producing excess hormones.
• Tests to look for excess hormones. Your doctor may recommend testing your blood or your urine for signs of excess hormones that are sometimes produced by neuroendocrine tumors.
• Imaging tests. You might undergo imaging tests, such as ultrasound, CT and MRI, to create pictures of your tumor. For neuroendocrine tumors, pictures are sometimes created using positron emission tomography (PET) with a radioactive tracer that’s injected into a vein.
• Procedures to remove a sample of cells for testing (biopsy). To collect the cells, the doctor might insert a long, thin tube with a light and a camera on the end into your lungs (bronchoscopy), your esophagus (endoscopy) or your rectum (colonoscopy), depending on your situation. Sometimes, collecting a tissue sample requires surgery.

If there’s a risk that your neuroendocrine tumor may have spread to other parts of your body, you might have additional tests to determine the extent of the cancer.

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