Gastrointestinal Neuroendocrine Tumors

Gastrointestinal Neuroendocrine Tumors

Gastrointestinal neuroendocrine tumors (GI NETs), also known as carcinoid tumors, are rare tumors that affect the digestive system. These tumors are named after the type of cells called neuroendocrine cells. It comprises nerve cells and hormone-making cells. These cells are responsible for producing hormones in the chest and abdomen that regulate various bodily functions. 

While Gastrointestinal tumors are rare, their incidence has been increasing in recent years, due to certain lifestyle factors and medical conditions, and is difficult to diagnose as no signs and symptoms are noticeable at early stages.

Risk Factors

There are several risk factors that can increase the risk of Gastrointestinal tumors such as 

• Inherited syndromes –  Lung NETs, gastrointestinal (GI) tract NETs, and pancreatic NETs, and Pancreatic NETS are some of the inherited syndromes that can cause gastrointestinal tumors.

• Race/Ethnicity – It is more common in White people than Black people.

• Sex – It is more common in women than in men.

• Age – A person of any age can develop a NET.

• Environment and diet – There are no known connections between the environment and what a person eats and the risk of developing a NET.

Gastrointestinal Neuroendocrine Tumors

Symptoms

The symptoms of GI tract NET can vary depending on the type of tumor and its location. Some tumors may not cause any symptoms until they have grown and spread to other areas of the body. However, there are some common symptoms that patients with Gastrointestinal tumors may experience such as –

• Abdominal Pain
• Diarrhea
• Constipation
• Change in bowel movement
• Weight loss
• Jaundice
• Fatigue
• Nausea and vomiting
• Skin sores

Carcinoid Syndrome

It happens in people with small intestine NET. In carcinoid tumors, serotonin is produced by tumors and can cause symptoms. People having carcinoid tumors may experience 1 or more of the symptoms below –

• Sweating
• Diarrhea
• Shortness of breath
• Weakness
• Heart murmur
• High blood pressure
• Carcinoid heart disease
• Asthma 
• Facial flushing

Some foods can also trigger carcinoid syndrome conditions such as –

• Amines, such as aged cheeses, yeast extracts, tofu, sauerkraut, and smoked fish and meats
• Serotonin, such as walnuts, pecans, plantains, bananas, and tomatoes

It is important to note that these symptoms can be mistaken for other conditions, such as irritable bowel syndrome or inflammatory bowel disease. 

This is why it is crucial to seek medical attention if you experience any of these symptoms, especially if they persist or worsen over time.

Diagnosis

The GI tract NET is diagnosed by considering the factors such as type of cancer, signs and symptoms, age, and general health. Most GI tracts are found by doctors when they are testing for medical procedures or imaging scans. The tests performed for diagnosis of GI Tract NET are as follows –

1. Blood Tests – The doctor may need samples of your blood to check for abnormal levels of hormones and other substances. Some blood tests check for tumor markers which indicate whether the tumor is growing or not.
2. Biopsy – A small amount of tissue is removed for examination under a microscope to find the presence of cancerous cells.
3. Endoscopy – it helps to view the lining of the upper digestive system through a thin flexible tube called an endoscope.
4. Computed Tomography (CT) scan – A CT scan takes pictures of the inside of the body to show any abnormalities or tumors. CT scan also be used to measure the tumor size. 
5. Molecular testing – It identifies specific genes, proteins, and other tumors by running laboratory tests on tumor samples.
6. Endoscopy Ultrasound – It uses ultrasound waves to create a picture of internal organs. A transducer machine is inserted into the upper digestive tract through the mouth that shows enlarged lymph nodes that helps in identifying the presence of tumors.

Types of Gastrointestinal Neuroendocrine Tumors

There are several different types of GI NETs, which can affect different parts of the digestive system. The most common types include:

1. Carcinoid tumors in the small intestine
These tumors account for the majority of GI NETs and can cause symptoms such as abdominal pain, diarrhea, and flushing. It can cause the intestines to kink or block for a while.

2. Carcinoid tumors in the rectum
These tumors can cause symptoms such as rectal bleeding, constipation, and pain during bowel movements.

3. Gastric carcinoids
These tumors can cause symptoms such as abdominal pain, nausea, and vomiting.

4. Appendiceal carcinoids
These tumors are often discovered incidentally during an appendectomy and may not cause any symptoms.

It is important to note that the symptoms and treatment options can vary depending on the type of tumor and its location.

Treatments

The types of treatment options for Gastrointestinal tumors are –

1. Surgery – The surgical options for GI Tract NET includes –

• Local excision – The surgeon removes the tumor and surrounding healthy tissue. Most localized tumors can be surgically removed through incision.

• Partial gastrectomy – this surgery removes part of the stomach.

• Esophagectomy – It removes all part of the affected esophagus.

• Low anterior resection – Upper part of the rectum is removed.

• Liver resection – It removes cancer that has spread to the liver.

2. Radiation Therapy – It uses high energy x-rays to destroy cancer cells. It uses external beam radiation from a machine outside the body. It is specifically given to reduce pain in the bones and other parts of the body.

3. Chemotherapy – It uses drugs to destroy cancer cells. It keeps cancer cells from growing, multiplying and dividing thus preventing it from spreading to different organs of the body.

4. Targeted Therapy – It targets specific proteins, genes, or tissues that contributes to cancer survival and growth.

5. Immunotherapy – It boosts a patient’s immune system that helps in fighting against cancer. The substances are made either in  a body or laboratory to improve, target, or restore immune systems. 

Medications Used in the Treatment of Gastrointestinal NETs

Medications can be used to help control the symptoms of GI NETs and slow down the growth of the tumor. One of the most common medications used is octreotide, which is a synthetic hormone that blocks the release of hormones produced by the tumor. This can help reduce symptoms such as diarrhea and flushing.

Other medications, such as lanreotide and pasireotide, can also be used to control symptoms and slow down the growth of the tumor. These medications are typically administered through injections or infusions.

Conclusion

Overall, the prognosis for GI NETs depends on the stage and location of the tumor. Early diagnosis and treatment can improve the chances of successful treatment and increase the chances of a positive outcome. If you’ve concerns regarding your treatments and disorders then you can connect to Uhapo’s contact page – https://www.uhapo.co.in/contact/ or 24/7 Support Number +91-9137-44-1392 for supportive care regarding your necessary issues with cancer.