Treatments

Neuroendocrine Tumours (NETs) are diverse and complex, and therefore the treatments given depend on several factors including type and grade of NET as not all tumours are the same.

Somatostatin Analogues

Patients with advanced or metastatic low or middle grade NETs will often commence monthly somatostatin analogue injections (Octreotide or Lanreotide) to control growth of tumours. In some cases, this can also help symptoms caused by hormonal secretion by the NET (but not all symptoms are due to hormones). These are administered by the homecare service after an initial injection by a CNS but can be also be occasionally undertaken in a GP practice.

Radionuclide therapy

PRRT (Peptide Receptor Radionuclide Therapy) is a targeted therapy used to inhibit tumour growth and reduce associated symptoms when there has been some progression after previous therapies. It is not suitable for every patient with a NET. Currently, this therapy is given in London, in four infusions over one year but there are plans to offer this service in South Wales. The patient information leaflet on PRRT can be found by clicking here.

For information on getting to the Royal Free Hospital in London for PRRT, please click here.

Surgery

If possible, surgery is performed with the intention of removing the tumour in the hope of a cure. Sometimes "debulking" surgery is performed in order to remove as much tumour as possible so that other treatments have less tumour to treat. Depending on where the tumours are, this could involve surgery in the bowel in a local hospital or specialised liver, pancreas or lung surgery in Cardiff or Swansea.

Chemotherapy and other systemic treatments

Patients with higher grade NETs or ‘poorly differentiated’ neuroendocrine carcinomas often need traditional oncology treatments such as chemotherapy or radiotherapy in Velindre or South West Wales Cancer Centres. Sunitinib or Everolimus are oral medications which are options in certain cases. 

For information on Chemotherapy, please visit this Velindre webpage.

Liver - directed therapy 

Liver embolisation, that is, cutting off the blood supply to tumours in the liver, is useful for a small group of patients with mainly liver disease. Ablation (radiofrequency or microwave) of a few small metastases in the liver is also useful in certain cases.

Other treatments 

Other medications may be needed to help symptoms and will be discussed with you by your clinical team.

For further information, please visit the Neuroendocrine Cancer UK website.