Diagnosis and investigation

Blood and urine tests will be carried out to help confirm the diagnosis and are also used as part of the follow up treatment.

Fasting gut hormone

This is a fasting blood test to help diagnose NETs. This means you should not to eat or drink anything (other than water) for at least six hours prior to the test. You may also be told not to smoke.

This test looks for any excess gut hormones that the tumour may be producing which may help with diagnosis. Test results can take a few weeks to process.

Chromogranin A and B

These are proteins (tumour markers) which can be measured in the bloodstream. If you have a neuroendocrine tumour, the level of proteins are often higher. This can be helpful to monitor the tumour activity, but is not always the case. Test results can take a few weeks to process.

Urine 5-HIAA

This is a urine test which requires you to collect every drop of your urine during a specified 24-hour period. The test measures the amount of serotonin breakdown products in your body which can help to diagnose carcinoid syndrome and monitor the effectiveness of treatment.

You will need to avoid certain foods for a few days before the test and on the day of the test. A list will be provided with the collection bottle.

You may be offered an endoscopy to help with the diagnosis of neuroendocrine tumours.

This procedure allows the doctor to see inside your stomach and colon by using a long, thin and flexible telescope with a camera at one end. This is usually carried out under sedation.

What happens during an endoscopy?

Small tissue samples (biopsies) may be taken to confirm diagnosis and provide information about how fast the tumour is growing.

Small tumours in an early stage can sometimes be removed from the stomach or colon during the endoscopy, so long as the cancer hasn't spread to elsewhere in the body.

The small intestine (where most tumours of this type develop) can't be accessed easily by endoscopy. In this case, a camera in a pill is used to obtain pictures. This is known as capsule endoscopy.

Endoscopic ultrasound can be used to get a clearer picture of the tumours before undertaking surgery or obtaining a tissue sample. This uses a special telescope with a miniature ultrasound scanner on the tip.

Endoscopic services are available in Southampton, Portsmouth and Dorset.

Diagnostic radiology, also known as 'imaging', is crucial in the diagnosis, assessment and management of neuroendocrine tumours. 

We use state-of-the-art equipment to determine the extent of the cancer and measure its response to treatment.

Types of scans used include:

• CT (computerised tomography)
• MRI (magnetic resonance imaging)
• PET (positron emission tomography)

We may also suggest the use of an octreotide scan where we will inject you with a small amount of radioactive liquid and use a special camera to highlight any cancerous cells.

If you need a tissue biopsy or a tumour needs to be removed, the cellular pathology team will help us manage your care especially for tumours in the bowel, pancreas or liver.

Tissue biopsies or removal of the tumour will help to confirm the nature of the cancer and also provides information (tumour grading and staging) that the clinical team will use to make decisions about how we manage the cancer.