Pancreatic neuroendocrine tumors (PNETs) are a different disease than pancreatic adenocarcinoma. They have their own risk factors and symptoms, and often need to be treated differently.
At Siteman, your care team will personalize your treatment plan depending on the exact type of tumor you have.
Kinds of Pancreatic NETs
Pancreatic NETs fall into two different groups with different symptoms. Sometimes these tumors produce hormones. Sometimes they don’t.
1.) Tumors that make hormones are called “functional tumors.” Functional tumors can make hormones such as gastrin, insulin, glucagon, and somatostatin. These hormones are already in the body, so more can create issues and drive symptoms.
2.) Tumors that do not make hormones are called “nonfunctional tumors.” These cause symptoms as the tumor spreads and grows.
Most pancreatic NETS are functional and are often noncancerous. Nonfunctional tumors are more likely to be cancer. Siteman treats every kind of pancreatic tumor, even if they are noncancerous (benign).
What are the symptoms of Pancreatic NETs?
Functional NETs symptoms
This kind of pancreatic tumor makes too many hormones for the body to use. It’s the hormones that cause symptoms.
- Extra gastrin causes stomach ulcers, belly pain, and acid reflux
- Extra insulin causes low blood sugar and a fast heartbeat
- Extra glucagon causes skin rashes, high blood sugar, blood clots, unintended weight loss, or a sore mouth
- Extra somatostatin causes high blood sugar, gallstones, or jaundice
What are the risk factors for PNETs?
In most cases, pancreatic NETs happen when a person has a hereditary genetic condition. These are conditions caused by changes in genes that are passed down from parents to children. A main condition is multiple endocrine neoplasia type 1 (MEN1) syndrome. Because it often runs in families (hereditary), Siteman’s High Risk Clinic can provide families with support and resources for every age.
What are the treatments for PNETs?
There are different types of treatment for patients with PNETs. Often, treatment includes surgery and medications.
Surgeries for NET pancreatic tumors include:
- Removing the tumor: This procedure is called “enucleation.” It is done when the tumor is in one small area of the pancreas. For this surgery, part of the pancreas is left to function normally in digestion and making insulin.
- Removing the body and tail of the pancreas: This procedure is called a “distal pancreatectomy.” It is done when more of the pancreas is affected by the tumor. Sometimes, surgeons will also remove the spleen.
- Whipple procedure: This is a procedure to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct. Enough of the pancreas is left to make digestive juices and insulin.
Not all patients can have surgery. Siteman excels at nonsurgical opinions, too. These are less invasive ways to shrink the tumor. These include:
- Radiofrequency ablation: Your surgeon will place a special probe with tiny electrodes into the tumor. The electrodes will kill the cancer cells.
- Cryoablation: Your surgeon will use an instrument that contains a very cold liquid to freeze the cancer cells in the pancreas.
Drug therapies for NET pancreatic tumors include:
- Chemotherapy: This is a type of medication that kills cancer cells. Chemotherapy drugs can be taken as pills or given through an IV.
- Hormone therapy: Sometimes, tumor cells respond to hormones. Taking hormone therapy can stop them from growing. Hormone therapy can also help treat symptoms caused by functional PNETS that make hormones.
- Targeted therapy: Targeted therapies change how cancer cells work. They keep the cancer cells from growing and making more cells. This can make the tumor stop growing and even shrink over time.
- Theranostics: Theranostics uses imaging with a type of drug called “radiopharmaceuticals.” During a theranostic treatment, you’ll get a medication containing a small amount of radiation. The radiation will travel to your cancer cells. It will make them more visible on an imaging scan. Once the imaging scan has shown exactly where the cancer cells are, you will receive another medication containing radiation. The radiation will kill the cancer cells.