A neuroendocrine tumor (NET) comes from the embryonic neural crest cells. These cells migrate to areas throughout the body as the fetus matures, typically in the GI tract, lungs and pancreas. These cells can turn into a neuroendocrine tumor later in life.
The tumors are unique, because they can create proteins (peptides) that can cause a variety of unique and unusual symptoms not seen in other cancers. These symptoms may not occur until later, making it tougher to diagnose the disease late in its onset.
The most common carcinoid tumors, NET of the small intestine, may produce no symptoms for years. They are very slow growing tumors. The first symptom to present may be intermittent abdominal pain. That tummy ache will commonly result in an immediate IBS diagnosis, not the discovery of a tumor.
An undiagnosed tumor can lead to wheezing, diarrhea and flushing. These three symptoms are the result of an overproduction of peptides by the tumor. Watery, profuse diarrhea that cause nighttime rushes to the bathroom is a distinct symptom. The flushes are hot, dry, deep red flushes to the face and neck. It can even lead to carcinoid heart disease.
Prolonged, unexplainable diarrhea should prompt a physician to investigate the condition further. A blood test and 24-hour collection of urine are diagnostics for neuroendocrine tumors. Avoid aged cheeses, alcohol, smoked or salted fish and meats, fermented foods, caffeine, cocoa, peanuts, brazil nuts, bananas, avocados, soybeans and fava beans before testing.
Patients diagnosed with NET require a two part approach.
- Alleviating the symptoms. These symptoms can be debilitating. Controlling the diarrhea can be done with dietary changes and medication.
- Containing the spread of the tumor. Localized treatment and systemic treatment are options. Individualized care is important.
Listen in as Dr. Hal Gerstein discusses the symptoms of NET cancer.
Dr. Hal Gerstein is a former Clinical Instructor at NYU Medical School, Founding President of LI Oncology Network and a Senior Attending Physician at North Shore University Hospital. He is a medical oncologist based in Great Neck, New York. He has been treating NET patients for over a decade.