Monday , March 20 2023

Neuroendocrine tumors – a disease with many faces


A common oncological illness has its own sign and color, something that some clubs see. Do you know what illness is behind the zebra mark? Those who want to know more about what zebras and neuroendocrine tumors (NET) have in common are invited to visit the Klaipėda University Hospital this Thursday.

Alvydas Cesus, head of Clinical Oncology Chemotherapy at the University Hospital of Klaipeda University Hospital, is still a little known oncology illness:

Explain what neuroendocrine tumors are.

– It is an oncology illness characterized by a disguised course. Its tumors can be both benign and malignant – hence the name of the disease: benign called tumors or benign tumors and malignant, aggressive forms – neuroendocrine cancer.

Compared with other cancers, neuroendocrine tumors are characterized by better progression of the disease and prognosis. But in order to extend the life expectancy of these patients and to improve the quality of life, we need to be well aware of the physiology, pathology, signs and course of neuroendocrine tumors. These tumors need to be diagnosed with accuracy, because then the patient will receive the best and most modern treatment.

Neuroendocrine tumors release a wide variety of biologically active substances that cause some changes in the body: some inhibit the production of hormone-released hormones (insulin, protein, adrenaline, glutamine), while others have no effect on growth or hormone formation.

These tumors become known in the early stages, but patients are often treated for other diseases: thyroid, diabetes or low blood sugar, adrenal insufficiency, and the like. It is rarely believed that this may be a neuroendocrine tumor.

– As I understand, these tumors are not easy to diagnose?

– It's really hard to diagnose. They have many different profiles, many possible scenarios, to mimic many other diseases.

Neuroendocrine tumors belong to a group of rare, heterogeneous tumors. Their prevalence is rather small – 2 cases were diagnosed at 100 thousand. of the population. They are only 0.5%. New Volumes Established Every year.

This is a rather rare condition, so an oncologist does not always believe he has been in contact with a neuroendocrine tumor. Therefore, it is necessary to have a lot of knowledge and not to forget such a possibility of diagnosis if the tumor can not be attributed to other known cases of illness.

The neuroendocrine system consists of neuroendocrine cells that spread throughout the body. This system includes two cellular features: it is similar to nerve cells (neurons) and endocrine cells that also produce hormones. For example, the pancreas produces insulin and the thyroid gland is growth hormone.

Therefore, neuroendocrine cells need not be found in any gland: thyroid, chest, pancreas or adrenal glands. Such a tumor can grow anywhere: in the lungs, brain, liver, stomach or intestine.

These tumors usually develop slowly and can function double (when triggered by various symptoms) and non-functional (usually people do not feel symptoms and the volume is detected, for example, during tests or surgery). Symptoms depend on the location of the tumor, the most common symptoms of gastrointestinal neuroendocrine tumors are severe diarrhea, facial flushing, hot flashes, bronchospasm, dyspnea, severe heart rhythm, loss of appetite and weight loss.

It may take some time from the onset of the disease and the appearance of the first symptoms to the diagnosis of the disease, as such symptoms are also common to other diseases. As mentioned above, patients often visit a number of doctors before reaching an oncologist for advice.

– Where do you identify more often neuroendocrine tumors?

– Approximately 70% All neuroendocrine tumors – benign and malignant – are detected in the digestive tract, the pancreas, and only 25% of these are in the lungs. But the latter are very rarely benign. You rarely see that such a volume is enough to get rid of it and everything is good.

Our goal is to determine the most accurate diagnosis of neuroendocrine tumors and to provide the most appropriate treatment. Most of the time, if the tumor is not widespread, it does not even require chemotherapy. Hormone products greatly help control the growth of the tumor and the release of hormones or biologically active substances, without compromising the quality of life of the patient and significantly prolonging the life span.

– Why is it important to determine the exact diagnosis?

– The patient may die if the exact diagnosis of neuroendocrine tumors has not been determined. Previous diagnostic options were more limited.

We now have genetic, molecular, biochemical, pathological laboratories at the Klaipėda University Hospital for Neuroendocrine Tumors, carry out nuclear diagnostic studies (somatostatin scintigraphy), MRI and computer tomography, and we have a team of endocrinologists with whom we work very closely.

Always carry out immunohistological, molecular and genetic tests (due to the MEN1 / 2 inheritance syndrome and we already have patients with even neuroendocrine tumors in several family members) to determine if there is a neuroendocrine tumor. If this diagnosis proves, the treatment tactics change completely.

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