Neuroendocrine Tumor Treatment

Radiologist Daniel Appelbaum, MD, left, and endocrine surgeon Xavier Keutgen, MD — Sophisticated non-invasive imaging gives our neuroendocrine tumor experts a better view of tumors to inform treatment planning. Here, radiologist Daniel Appelbaum, MD, left, meets with endocrine surgeon Xavier Keutgen, MD.

Offering a Full Range of Treatment Options for Neuroendocrine Tumors

At the University of Chicago Medicine, patients with neuroendocrine tumors (NETs) receive innovative treatments from internationally-renowned specialists in the field, including the newest targeted therapies and surgical techniques that can destroy, remove or shrink even the most advanced tumors. Physicians in our NET program design individual treatment plans for each patient based on several objective, evidence-based factors, as well as on the wishes of the patient. Our specialists follow and reassess patients rigorously during and after their treatments, with the constant aim of improving patient care through the discovery and application of novel diagnostic tools and treatments. Numerous options exist for treating neuroendocrine tumors, and your doctor will help you decide which one will be most effective.

Surgery

Surgically removing a neuroendocrine tumor is almost always the preferred option and can often be done even if your cancer has spread to other parts of the body. Depending on where the tumor is located, surgeons may remove all or part of the organ that harbors it—for instance, for NETs in the stomach, your doctor may remove all or part of the stomach.

UChicago Medicine physicians emphasize surgical techniques that are proven to minimize the time it takes patients to recover, such as minimally invasive or robotic techniques. When required, they may also use open surgery to remove NETs.

Surgery for NETs That Have Spread to the Liver

When neuroendocrine tumors spread outside of their original location, they most commonly seed to the liver. The amount of tumor in the liver is directly proportionate to your prognosis, which is why NET specialists at UChicago Medicine design a comprehensive treatment plan to destroy and remove NETs using the following techniques:

Parenchymal-sparing Neuroendocrine Tumor Resections

Laparoscopic Liver Surgery

Intraoperative Microwave Ablation

Liver Transplantation

Systemic Therapy

When other treatments may not be suitable, cancer cell-killing drugs may be recommended. The newest advances in targeted therapy for NETs are available at UChicago Medicine. These medications are increasingly taken by mouth and have less side effects when compared to older chemotherapy courses.

Radiation

Peptide Receptor Radionuclide Therapy (PRRT)

PRRT is an innovative theranostics treatment in which synthetic proteins capable of targeting specific cells are combined with radioactive material. This creates radiopeptides, which are then injected into a patient’s bloodstream to deliver targeted radiation to NET cells. PRRT takes a total of eight months, with patients receiving infusions every two months. UChicago was one of the first centers in the nation to offer this therapy and has since developed a very robust and experienced PRRT treatment program. The FDA-approved drug used in PRRT is lutetium Lu 177 dotatate (Lutathera®).

Video Transcript

Theranostics is a growing field that's showing significant improvement for many cancer types, including thyroid, neuroendocrine, prostate, and neuroblastoma. A combination of therapeutics and diagnostics, Theranostics works very differently from chemotherapy or traditional radiation treatments. Theranostics uses special compounds called radiotracers, which are injected into the bloodstream.

Like using a GPS, the radio tracers travel through the body to target and bind to specific cancer cells, which are then visible on a PET scan. The first step is to use these radio tracers to simply identify the tumor cells in the body and determine if the patient is a good candidate for treatment. The second step is to add a more powerful radioactive component to the radiotracers that can kill the cancer.

By navigating a path which reduces the risk of harming nearby healthy tissues, the radiotracers can deliver targeted radiation to kill the cancer cells with lower side effects than many alternative treatments. For many patients, Theranostics offers new hope, helping them live longer, and with a better quality of life. At the only hospital in Illinois to have a medical cyclotron, physicians at University of Chicago Medicine Comprehensive Cancer Center, are leaders in research and development in this emerging field, and those same physicians are treating our patients. UChicago Medicine Comprehensive Cancer Center, at the forefront of Theranostics.

Intra-Arterial Therapies and Histotripsy

When surgical removal of liver metastases is not indicated or desired, liver-directed therapies can help treat patients with NET and liver involvement. These therapies include:

Percutaneous Microwave or Radiofrequency Ablation

Transarterial Chemoembolization (TACE) or Hepatic Artery Embolization (HAE)

Yttrium-90 Radioembolization

Histotripsy

Histotripsy is an innovative, non-invasive treatment for liver tumors that uses a robotic machine to target and destroy cancer tissue with ultra-precise sound waves. It’s a powerful tool for doctors to treat certain tumors without any needles, radiation or surgery, even allowing most patients to go home the same day.

UChicago Medicine is one of the first medical centers in the nation to offer histotripsy for liver tumor treatment. As early adopters, our doctors have deep expertise with the procedure, allowing them to deliver the highest level of care.

Clinical Trials

UChicago Medicine is at the forefront of medical and surgical discoveries. If you’re seeking a clinical trial targeting neuroendocrine tumors, please check our trials database or speak with your doctor about whether participating in a study is right for you.

Understanding Neuroendocrine Tumors

UChicago Medicine was one of the first hospitals to offer peptide receptor radionuclide therapy (PRRT) to treat neuroendocrine tumors. Learn more about these tumors and how they can be treated.

Video Transcript

Understanding neuroendocrine tumors. Neuroendocrine cells are found throughout the body, particularly in the small bowel, pancreas, stomach, adrenal glands, lungs and thyroid. When these cells received messages from the nervous system, they release hormones. Neuroendocrine tumors, or NETs, are tumors that form in neuroendocrine cells.

NETs are rare and complex. Because their behavior can be difficult to predict, it is important for patients to be seen by an experienced team of doctors for diagnosis and treatment. The NETs care team at University of Chicago Medicine includes experts across many specialties.

They work together to accurately diagnose neuroendocrine tumors, and to determine the most effective treatment for each patient. At UChicago Medicine, treatment for NETs often includes surgery, even for tumors that have spread to other organs.

Our surgeons are some of the most experienced in the country at treating NETs, and to use unique state of the art techniques to destroy and remove tumors. In addition, we were one of the first centers in the country to offer a promising treatment called Peptide Receptor Radionuclide Therapy, or PRRT.

PRRT combines a targeting molecule that binds to specific receptors on tumor cells and a radioactive particle that destroys cancer cells. PRRT is given to patients through an IV infusion, and has fewer side effects than other chemotherapies. A course of treatment typically includes four doses given eight weeks apart.

At UChicago Medicine, our researchers are working to find the underlying cause of these tumors, and to bring new treatments, including innovative clinical trials, for the most challenging cases. Want to learn more about treatment and the newest clinical trials for neuroendocrine tumors? UChicago Medicine is here to help. Visit UChicagoMedicine.org/nets.

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