Neuroendocrine Tumors (NET)
A malignant neuroendocrine tumor is a tumor that arise from cells of the endocrine (hormonal) and nervous system. These tumors commonly occur in the intestine, pancreas, and lung, but can also develop in the rest of the body.
Signs and symptoms of the disease are wide and can include flushes, diarrhea, asthma, heart failure, abdominal cramps and edema, but the disease can also be completely asymptomatic and is diagnosed as an auxiliary finding. In case of a suspicion of a cancerous disease, usually a PET-CT-Scan is performed, which helps to see whether tumor masses are located. If a mass has been confirmed, it should be biopsied in order to perform a histopathological analysis. Neuroendocrine tumors show tissue immunoreactivity for markers of neuroendocrine differentiation and may secrete various peptides and hormones.
Once this has been done, the patient is evaluated for a therapeutic protocol which is mostly consistent of chemotherapy and/or a radiotherapy. Surgery in neuroendocrine cancer often plays a role for a relief of symptoms and prolonging life. A very encouraging treatment for feasible NETs is the targeted radionuclide therapy, in which peptide- or hormone conjugates are given intravenously to a patient. As neuroendocrine tumors are known to be highly immunogenic tumors, also immunotherapy can be evaluated for these cancer types.
What most patients do not know is, that when the first examination (histopathological analysis) on the biopsy has been performed, the tissue is kept and stored at the histopathology department of the hospital, where the biopsy has been performed. This stored tissue material can be used for further thorough (genetic) tissue analyses and in-depth sequencing. It is known that tumors show the accumulation of several genetic modifications, thus providing cancer cells with the selective growth advantage to initiate expansion. Now, sophisticated high-throughput technologies enable the identification of these mutated genes in cancers that can lead to a potent targeted therapy within a so called combined concept.
Combined concept
A combined approach consists mainly of systemic treatment in combination with local therapy and the addition of an immunotherapeutic approach depending on the outcome of the in-depth analysis of the biopsy. With a combined approach, the aim is to achieve the best possible reduction of the tumour burden in order to evaluate a less intensive maintenance therapy. Based on the patient’s medical history, general condition and diagnostic constellation, a precision-based treatment protocol is analysed for each individual case.
Thus, it is crucial to perform a thorough broad-spectrum screening so that every patient has a chance to explore all possibilities of a targeted treatment, may it be in a private setting or a clinical trial elsewhere. So it is most important to first find a laboratory that looks for all markers and mutations, and second, to find an oncologist who is willing to work with you in the best (and targeted) way possible.
Important: Our oncological team is happy to talk to you by phone to get a deeper understanding about your specific case, enabling to provide you with a provisional treatment plan and cost estimate. Our oncologists will provide you all the details on medications, therapeutics and treatments including underlying mechanism and side effects. After a physical examination and an in-depth discussion with you on-site, the definite treatment plan will be discussed. Please understand that complex medical processes as mentioned above can only be explained through a thorough consultation on-site.