Many options exist to treat neuroendocrine tumors (NETs), but knowing when to use each one requires expertise. Doctors must take into account available therapies as well as the unique features and growth rates of NETs.
At Penn Medicine, we have deep experience with these judgment calls. We first consider surgery, but many people need a range of therapies over time. Each time, we recommend the neuroendocrine tumor treatments most likely to help without limiting future options. We also consider quality of life afterward, including the ability to focus on the other things that matter to you.
New Treatments for Neuroendocrine Tumors
At Penn, we have access to the full range of NET treatment options. And our team continues to work to improve these therapies and identify new ones. We also explore combinations of treatments.
We have led national clinical trials that led to significant advances in how NETs are treated when they metastasize (spread). We’re now investigating new ways of targeting NETs, including harnessing the immune system.
Learn more about our clinical trials for NETs and research.
Localized Therapy for NETS
Localized therapy focuses on a particular area in the body, such as an organ or gland, or part of one. At our program, we offer:
- Ablation: Using special needles to heat or freeze tumors can destroy them. We may recommend ablation for small metastatic tumors, particularly in the lungs, liver and bones.
- External radiation therapy: Radiation therapy delivered by a machine from outside the body can relieve symptoms and treat confined tumors. Many programs just use it for paragangliomas in the head and neck or for cancer that has spread to bones. At Penn, we may consider radiation more often, including for some lung NETs and after certain surgeries to target remaining cancer cells. We may also use it if a metastatic spot appears after other treatment. We offer the latest approaches, including proton therapy, with the expertise to get good results.
- Liver-directed therapy: When NETs spread to the liver, treating them is a priority because of the organ’s critical role. Therapies destroy tumors or slow their growth, using needles or catheters (thin tubes). Our team recommends when to treat the liver, and which options to use. Learn more about liver-directed therapy for NETs.
- Surgery: If possible, we try to completely remove neuroendocrine tumors, even those that have spread. If we can’t, other types of surgery can still play a key role in treatment. Learn more about surgery for NETs.
Systemic Therapy for NETs
Systemic therapy attempts to treat all tumors in the body. Many systemic therapies control tumors, rather than shrink them. But even stabilizing the disease can make a big difference.
We often wait to give systemic therapies until cancer has spread, but not always. We recommend certain drugs for pancreatic NETs and gastrointestinal NETs much sooner.
Systemic therapy includes:
- Drug therapy: We have a range of options for medications, with more in clinical trials. One class of drugs mimics a particular hormone, to relieve symptoms and control tumor growth. A newer approach, targeted therapy, aims at features tumor cells use to grow. And chemotherapy can shrink cancer that has spread further and aggressive NETs. Learn more about drug therapy for NETs.
- Nuclear medicine: This newer form of treatment delivers internal, targeted radiation therapy to control tumors. It combines radioactive isotopes with molecules that many NETs take in. We led the national trials for the current options, peptide receptor radionuclide therapy (PRRT) and metaiodobenzylguanidine (MIBG) therapy. Learn more about nuclear medicine for NETs.
Our Approach to Neuroendocrine Tumor Treatment
At Penn, we believe each NET we treat is unique, as is each person we help. We take the time to listen to your concerns, priorities and preferences, and adjust our recommendations accordingly.
At our program, you’ll find:
- Experience and expertise: With a few exceptions, NET care follows general guidelines, not set paths. That fact provides both challenges and opportunities. Our team knows all the available evidence on how to proceed and combines it with years of direct experience. We can suggest options other programs may not have considered. Learn more about our neuroendocrine tumor team.
- Personalized plans: Because NETs are unique, no two treatments are exactly the same. Every aspect of your care is customized — the order of your therapies, how long you stay on them and the therapy doses you receive. In addition to stage (extent of the disease) we regularly check the grade (how aggressive the tumor cells look and act). We also make adjustments based on how you feel and respond to treatment.
- Deliberate approach: We strike the balance between treating cancer when needed and not overdoing it. If a therapy ends up not working, we can try another, perhaps even returning to an earlier option.
- Flexibility: We help with coordination if you choose to receive some of your care closer to home. If you want all your therapy at Penn, we can provide some options beyond our main Philadelphia location, at additional Abramson Cancer Center locations.
- Support: A nurse navigator or coordinator arranges your appointment and is always ready to help with any need. We provide gastrointestinal management for NET symptoms and side effects, as well as a wide range of other NET support.
Request an Appointment
To make an appointment, please call 800-789-7366 or request a callback.