Survival rate depends on many factors

Interview/ Dr Anil Heroor, head, surgical oncology, SRV Mamata Hospital, Thane


Which is the most common form of Neuroendocrine Tumour (NET) found in India, and among which age group?

The most common NETs are the carcinoid tumours. A carcinoid tumour is a specific type of neuroendocrine tumour that often develops in the GI tract, in organs such as the stomach or intestine, or in the lungs. It can also develop in the pancreas, testicles, or ovaries. In fact, more than one carcinoid tumour can develop in the same organ. About 39 per cent of carcinoid tumours begin in the small intestine, 15 per cent occur in the rectum,10 per cent in the bronchial system of the lungs, seven per cent in the appendix, 5 to 7 per cent in the colon, 2 to 4 per cent in the stomach, 2 to 3 per cent in the pancreas and about 1 per cent in the liver. As far as age is concerned, it usually happens in the fifth or sixth decade of life.

Is it prevalent more among men or women?

Almost equal incidence in men and women, with slight preponderance in women.

Can a person go through with his full life, living with NET?

Very unlikely. The survival rates for NET depend on many factors such as the affected body organs and whether the tumour is benign or malignant. The disease is considered rare, and is actually a broad term used for a heterogeneous group of neoplasms. So, the survival rates depend on many factors and cannot be generalised.

What does the future hold, for the treatment of NETs?

The future is very exciting in the sense that there are a lot of molecules coming in. Surgery is the main treatment for both pheochromocytoma [NET that develops in the adrenal gland] and Merkel cell cancer [rare skin cancer]. During surgery, we remove the tumour along with some surrounding healthy tissue, known as the margin. For pheochromocytoma, laparoscopic surgery may be performed. Laparoscopic surgery is a less invasive type of surgery that uses three or four small incisions instead of one large incision.

Are treatment options limited?

I do not think treatment options are limited. During the past several years, a wealth of positive clinical trials, coupled with an evolution in the understanding of cancer types, has altered the treatment landscape. Although carcinoid tumours and pancreatic NETs look identical under the microscope, they respond differently to treatments.

Radiation therapy is generally recommended when a neuroendocrine tumour has spread, or is in a location that makes surgery difficult or impossible. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen [schedule] usually consists of a specific number of treatments given over a period of time.

Can you explain the last stages of NET?

A tumour begins when healthy cells grow out of control, forming a mass. A tumour can be cancerous or benign. A cancerous tumour [malignant] can grow and spread to other parts of the body, if it is not found early and treated. A benign tumour means the tumour can grow but will not spread. A benign tumour usually can be removed, without it causing much harm. People with a neuroendocrine tumour may or may not have any external symptoms. Or, the cause of a symptom may be because of another medical condition that is not cancer. In the last stage, the tumour spreads to the liver, lungs, bones, and even brain.