Following your diagnosis, we will discuss your individualised treatment plan with you. We will always try to minimise the effect of any neuroendocrine tumour and, where possible, use the least invasive techniques.

Before suggesting a form of treatment, we will fully investigate the tumour and hold a discussion with our multidisciplinary team.

We have been recognised as a European Neuroendocrine Tumours (ENETS) Centre of Excellence. This means that the treatment we offer to our patients is at the forefront of scientific research and development.

The type of treatment you receive will depend on several factors including:

the size and position of the tumour
how advanced your condition is (the stage)
your overall health

Find out more about how we treat neuroendocrine tumours below.

Surgery

After you've been diagnosed with a neuroendocrine tumour, we will complete some investigations to help us gather more information about the cancer.

As with common bowel cancers, surgery remains the main form of treatment for neuroendocrine tumours.

This usually involves removing the tumour, together with the lymph nodes in the surrounding area. More extensive surgery may be required to remove cancer in the lining of the stomach or liver. This may be performed at a later time and is often combined with other treatments.

Occasionally, heart surgery and valve replacement is required to treat carcinoid heart disease, a complication of carcinoid syndrome.

Drug treatment

There are a range of drug treatments available to control symptoms and delay progression of the cancer. These are offered to patients whose tumours cannot be completely removed by surgery.

There are three principle forms of drug treatment:

Somatostatin analogues

These drugs can stop abnormal hormone production and tumour growth and are effective for stopping diarrhoea and flushing caused by carcinoid syndrome. They're delivered in the form of a monthly injection.
You may be given one of the following drugs:
- Lanreotide
- Sandostatin LAR
Most patients have few side effects and can be used for long periods without difficulty.
Conventional chemotherapy

This form of treatment is not effective in many neuroendocrine tumours, especially those that are growing very slowly. However, it would be appropriate in selected cases - usually those with tumours that are growing faster.

You may be given one of the following drugs:
- Carboplatin
- Etoposide
- Streptozcin
- Capecitabine
The aim of the treatment is to shrink the tumours which in turn will improve symptoms. Side effects may include sickness, diarrhoea, hair loss and the increased risk of infection.
Targeted treatments

These treatments are often taken as a daily tablet. It's unusual for these treatments to shrink tumours but are effective in stabilising tumour growth in certain groups of patients.

You may be given one of the following drugs:
- Sunitinib
- Everolimus
They are usually continued with until there is evidence of tumour growth or unacceptable side effects. Side effects may include fatigue, mouth ulcers, diarrhoea, high blood pressure and skin rash. Most are manageable with adjustments to your dose and breaks in treatment, but please speak to your clinical team beforehand.

You may receive more than one of the above treatments but the objective is always to optimise quality and length of life. At present, there are no drugs that can cure neuroendocrine tumours.

Treatment