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Neuroendocrine tumour of pancreas treatment in Bangalore

What is a pancreatic neuroendocrine tumour

A pancreatic neuroendocrine tumour (PNET) is a rare type of tumour that develops in the pancreas, a gland located behind the stomach. Unlike more common pancreatic cancers, PNETs grow from specialised cells called neuroendocrine cells. These tumours can be non-cancerous (benign) or cancerous (malignant).

Think of neuroendocrine cells as messengers in your body that help regulate various functions, like digestion and hormone production. When these cells start to grow uncontrollably, they form a tumour. The symptoms of PNETs can vary depending on their size and location, but they may include abdominal pain, changes in bowel habits, weight loss, and fluctuations in blood sugar levels.

Neuroendocrine tumours of pancreas treatment in Bangalore

Symptoms of pancreatic neuroendocrine tumour

Abdominal pain

Pancreatic neuroendocrine tumours (PNETs) often cause abdominal pain, which can range from mild discomfort to severe, persistent pain. This pain typically arises due to the tumour pressing on nearby organs or nerves as it grows within the pancreas. Patients may describe the pain as dull, achy, or cramp-like, and it may radiate to the back or other areas of the abdomen. The intensity and frequency of the pain can vary depending on the size and location of the tumour. Seeking medical evaluation is crucial if you are experiencing persistent or worsening abdominal pain, as it may indicate underlying health concerns such as PNETs.

Changes in Bowel Habits:

Pancreatic neuroendocrine tumours (PNET) can disrupt bowel habits, leading to changes in digestion and stool consistency. Individuals may experience frequent diarrhoea or constipation, often accompanied by abdominal discomfort. These changes occur due to the tumour’s impact on the pancreas, which plays a crucial role in producing digestive enzymes and regulating bowel movements. Additionally, the tumour’s growth can affect nearby organs and disrupt their normal functions, further contributing to bowel irregularities.

 

weight loss

Pancreatic neuroendocrine tumours (PNETs) can cause weight loss due to various reasons. These tumours can disrupt the normal functioning of the pancreas, affecting the production of digestive enzymes and hormones involved in metabolism. As a result, the body may have difficulty properly digesting food and absorbing nutrients, leading to unintended weight loss. Additionally, certain types of PNETs can produce hormones that increase metabolism or cause changes in appetite, further contributing to weight loss. Thus, unexplained weight loss is often a concerning symptom associated with PNETs.

Fluctuations in Blood Sugar

Pancreatic neuroendocrine tumours (PNETs) can disrupt normal blood sugar levels, leading to fluctuations. These tumours may produce excess hormones, such as insulin or glucagon, which play crucial roles in regulating blood sugar. In cases where PNETs produce too much insulin, it can cause hypoglycaemia (low blood sugar), leading to symptoms like dizziness, confusion, or sweating. Conversely, if the tumour produces too much glucagon, it can result in hyperglycaemia (high blood sugar), causing symptoms like increased thirst, frequent urination, and fatigue. These fluctuations in blood sugar levels can significantly impact a person’s overall health and require careful management.

Fatigue 

can cause fatigue due to various reasons. Firstly, the tumour itself can disrupt normal pancreatic function, affecting the production of essential hormones and enzymes needed for energy metabolism. Additionally, the body’s response to the tumour, such as inflammation or changes in hormone levels, can contribute to feelings of fatigue. Moreover, the symptoms associated with PNETs, like abdominal discomfort or fluctuations in blood sugar levels, can also lead to fatigue indirectly by impacting overall well-being and quality of life. Thus, managing PNETs comprehensively involves addressing fatigue alongside other symptoms to improve the patient’s overall health and vitality.

 

Skin rash or redness 

can occasionally cause skin rashes or redness, particularly in certain cases where hormones like serotonin are overproduced. This phenomenon, known as carcinoid syndrome, can result in flushing or redness of the skin, especially on the face and neck. It occurs due to the release of certain substances from the tumour into the bloodstream, affecting blood vessels and leading to skin changes. Though not all PNETs cause carcinoid syndrome, when present, they contribute to the array of symptoms experienced by individuals affected by these tumours, adding to the complexity of their diagnosis and management.

Types of pancreatic neuroendocrine tumours

Pancreatic neuroendocrine tumours (PNETs) are a rare type of cancer that can develop in the pancreas. They can be either benign (noncancerous) or malignant (cancerous).

  • Functioning PNETs produce hormones that can cause a variety of symptoms, depending on the type of hormone being produced. The most common types of functioning PNETs include:
  • Insulinomas: These tumours produce insulin, which can cause low blood sugar (hypoglycaemia).
  • Gastrinomas: These tumours produce gastrin, which can cause ulcers and diarrhoea.
  • Glucagonomas: These tumours produce glucagon, which can cause high blood sugar (hyperglycemia).
  • VIPomas: These tumours produce vasoactive intestinal peptide (VIP), which can cause watery diarrhoea, flushing, and wheezing.
  • Somatostatinomas: These tumours produce somatostatin, which can cause a variety of symptoms, including diarrhoea, constipation, and abdominal pain.

Non-functioning PNETs do not produce hormones and, therefore, do not cause any symptoms. These tumours are usually diagnosed at a later stage when they are larger or have spread to other organs.

Pancreatic Neuroendocrine Tumour Treatment in Bangalore

While not as common as other pancreatic cancers, neuroendocrine tumours (PNETs) require specialised treatment. If you’re in Bangalore and facing a PNET diagnosis, here’s a look at some of the treatment options available:

  • Expert Care: Bangalore boasts several renowned hospitals with dedicated surgical oncology departments equipped to handle PNETs. These centres often have multidisciplinary teams involving surgeons, medical oncologists, endocrinologists, and radiologists to ensure a comprehensive treatment plan.
  • Surgery:  Surgical removal of a pancreatic neuroendocrine tumour (PNET) is often the primary treatment if the tumour is localised and deemed operable. The goal of surgery is to completely remove the tumour while preserving as much healthy pancreatic tissue as possible. This procedure may involve removing a portion of the pancreas (partial pancreatectomy) or, in some cases, the entire pancreas (total pancreatectomy). Surgeons may also remove nearby lymph nodes to check for spread. Surgical intervention offers the potential for long-term control or cure, particularly when the tumour is confined to the pancreas and has not spread to other organs.

Chemotherapy 

Chemotherapy for pancreatic neuroendocrine tumours (PNETs) involves the use of drugs to destroy cancer cells or slow their growth. While surgery is often the primary treatment for localized tumours, chemotherapy may be recommended for tumours that have spread beyond the pancreas or are unresectable. Chemotherapy drugs are typically administered intravenously or orally and work by targeting rapidly dividing cells, including cancer cells. Common chemotherapy drugs used for PNETs include streptozocin, 5-fluorouracil (5-FU), capecitabine, and temozolomide. Chemotherapy may be used alone or in combination with other treatments such as surgery or targeted therapy, depending on the individual’s specific situation and tumour characteristics.

Radiation therapy 

Radiation therapy for pancreatic neuroendocrine tumours (PNETs) involves using high-energy radiation to target and destroy cancer cells. It may be used as a primary treatment when surgery is not feasible or as an adjuvant therapy to reduce the risk of tumour recurrence. Radiation therapy can help shrink tumours, alleviate symptoms such as pain or blockage, and improve the overall quality of life. It’s often delivered externally using a machine called a linear accelerator or internally through a process called brachytherapy. Treatment plans are customized based on the tumour’s size, location, and individual health factors to optimize effectiveness while minimizing side effects.

Targeted therapy

Targeted therapy (TTM) is a weaponized treatment for pancreatic neuroendocrine tumours (PNETs). Unlike chemotherapy, it hits specific targets on cancer cells. This precision helps limit damage to healthy cells. Two FDA-approved drugs target blood vessel growth (Sunitinib) or a growth protein (Everolimus) to slow PNET expansion. These medications come in pill form, offering a convenient route compared to injections. While targeted therapy isn’t a cure-all, it can be a valuable tool to manage PNET growth.