Is Neuroendocrine Cancer Slow Growing or Aggressive?

Neuroendocrine cancers are types of cancers that originate from cells in the neuroendocrine system. These cells are located throughout the body in the organs and are responsible for controlling most of the bodily functions. The cells in the neuroendocrine system receive signals from the nervous system then respond by releasing hormones.

Neuroendocrine tumors are grouped depending on where they originate in the body, for example, gastrointestinal neuroendocrine tumors which develop in organs in the gastrointestinal tract – small intestines, stomach, rectum, appendix, and esophagus. There are also lung neuroendocrine tumors e.g. small cell and large cell lung neuroendocrine carcinomas as well as typical and atypical carcinoid tumors. Another common type of neuroendocrine tumors is the pancreatic neuroendocrine tumors which are named based on the hormone they produce. The PNETs are; gastrinomas, glucagonoma, VIPoma, insulinoma, and somatostatinoma.^[1]

When neuroendocrine tumors are aggressive, it basically means that they are growing really fast, whereas if they are slow-growing, then they are indolent. Some of the extremely slow-growing tumors are carcinoid tumors originating in the lungs and gastrointestinal tract as well as pancreatic neuroendocrine tumors. Neuroendocrine tumors that are aggressive are high-grade neuroendocrine carcinomas. Neuroendocrine tumors can also be categorized as functional or non-functional tumors. Functional neuroendocrine tumors are those that make and release hormones, thus cause individuals to experience symptoms. On the other hand, non-functional neuroendocrine tumors are those tumors that do not release enough hormones to cause symptoms or do not release any substances at all. Generally speaking, most types of neuroendocrine tumors take years to develop and grow slowly. Nevertheless, there are those that grow fast.^[2]

Neuroendocrine tumors can also metastasize from their original location to other areas/organs. It is important to understand how a particular type of cancer grows and its likelihood to spread. Some of the areas where neuroendocrine tumors can spread to include the tissues and lymph nodes near the organ where the tumor originated, and liver, lungs, pancreas and even to the bones.^[3] Considering that most neuroendocrine tumors grow slowly and maybe non-functional, then it may take a really long time to diagnose them. Therefore, the diagnosis may be done when the tumor is in the last stage. Aggressive neuroendocrine tumors tend to spread to other parts of the body since they grow abnormally quick, thus their likelihood of metastasis is high.^[1]

Symptoms Of Neuroendocrine Tumors

Neuroendocrine tumors at the beginning do not cause any symptoms. In most cases, they are usually discovered during an unrelated examination or surgery for another condition. Otherwise, if the tumor causes symptoms, they are often associated with the size and/or location, as well as the release of hormones by the tumor. These symptoms are referred to as carcinoid syndrome. General symptoms of neuroendocrine tumors include fatigue, sudden weight loss and loss of appetite. Symptoms that may arise from the size and/or location from the tumor include; lump in any part of the body, nausea or vomiting, as well as persistent pain in a particular part of the body. In the case of hormone release, then one may have symptoms such as diarrhea, flushing of the skin, anxiety, gastric ulcer disease, hyperglycemia or hypoglycemia, and some people may have nutritional deficiencies.

Carcinoid syndrome arises when the tumor causes the release of hormone serotonin thus causing specific symptoms. As much as these specific symptoms may be an indication of carcinoid syndrome, they are not enough to diagnose the condition. Needless say, not every patient with a neuroendocrine tumor develops carcinoid syndrome. Symptoms that are associated with carcinoid syndrome are; diarrhea, shortness of breath, facial flushing, wheezing, unexplained weight gain, carcinoid heart disease, high blood pressure and heart murmurs.^[4]

Conclusion

Cancers have a different impact on every individual and the way they manifest also differs from patient to patient. Neuroendocrine tumors are generally indolent meaning they grow slowly. As a matter of fact, most of them take time to develop and barely have any indication in terms of symptoms showing. The aggressive types of neuroendocrine tumors are high-grade neuroendocrine carcinomas, which fall under the category of poorly-differentiated neuroendocrine tumors. Poorly-differentiated neuroendocrine tumors are those that have very abnormal cells, which grow and divide quickly.^[1]

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Is Neuroendocrine Cancer Slow Growing or Aggressive?