Gastrointestinal and neuroendocrine clinic

Description

What is gastrointestinal neuroendocrine cancer?

Gastrointestinal neuroendocrine cancer is the uncontrolled growth of cells in the digestive or gastrointestinal tract. It includes tumors such as:

  • Esophageal
  • Gastric
  • Colo-rectal
  • Annal
  • Pancreatic
  • Liver and biliary tract
  • Neuroendocrine tumors

 

 

Cancer types

 

  • Adenocarcinoma: Stomach or gastric cancer is an adenocarcinoma in the majority of cases. It originates in the internal cells of the stomach (mucosa).
  • Lymphoma: Cancerous tumor of the immune system which is sometimes detected in the gastric wall. Treatment depends on the type of lymphoma.
  • Gastrointestinal stromal tumors: These tumors originate very early on in the cells of the stomach wall and although they may arise in any part of the digestive tract, the majority originate in the stomach.
  • Carcinoid tumors: These tumors arise from cells that produce stomach hormone. Most of these tumors spread to other organs.

Symptoms

The symptoms of gastrointestinal neuroendocrine cancer are often different in each individual, and not everyone exhibits prior symptomatology.

Alarm signals include:

  • Low appetite.
  • Unintended weight loss.
  • Abdominal pain.
  • Imprecise abdominal discomfort, usually just above the umbilicus.
  • Fullness sensation in the upper abdomen after a light meal.
  • Acid reflux (heartburn) or indigestion.
  • Nausea.
  • Vomiting, with our without blood.
  • Abdominal swelling or fluid accumulation.
  • Blood in the stools.
  • Low red blood cell counts (anemia).

Diagnosis

How is diagnosis made? 

 It begins with the suspicion, which can be verified by means of:

  • Physical examination:The physician performs a medical exam to detect any type of mass or abnormal finding in the body.
  • Blood work: Blood tests are used to analyze hormones released by different organs into the system in order to determine if there are abnormal levels that could be a sign of alarm. 
  • Imaging finding: on CT scan, magnetic resonance, endoscopic ultrasound and colonoscopy, among others. 

Following suspicion, the specialist physician determines the process for diagnosing cancer. Biopsy is performed to retrieve cells and determine if there are signs of cancer. 
 

 

Treatment

 

Cancer is treated in different ways depending on the type of cancer and whether it has spread or not. Treatment options include: 

  • Surgery

Surgery is used in the majority of patients with neuroendocrine gastrointestinal cancer as part of the treatment. The type of surgical procedure will depend on the intention to treat and the clinical and/or pathological stage of the disease. It is also important to mention that a combination of different surgical procedures can be used.

 

  • Immunotherapy

Immunotherapy is the use of drugs to stimulate the patient’s immune system so that it can recognize and destroy cancer cells more effectively. This therapy can be used to treat some types of gastrointestinal neuroendocrine cancer.

  • Chemotherapy

The aim is to shrink or eliminate the tumor using drugs administered as tablets or by the intravenous route. Chemotherapy treatment is indicated in some cases, depending on the stage of the disease or the patient’s clinical condition.

  • Radiotherapy

Radiotherapy uses high-energy beams (or particles) that destroy or reduce cancer cells.   It can be used in several situations, such as: 

After surgery to lower the probability of the cancer reappearing in the same site or in adjacent lymph nodes. 

After surgery in the case of a tumor lesion or if cancer was found in many lymph nodes, or if cancer is present in certain surgical margins, such as skin or muscle margins.

If cancer has spread to other parts of the body, such as the bones or the brain.

  • Hormone therapy

This type of therapy is indicated mostly in tumors with positive hormone (estrogen and progestogen) receptors. However, there are some cases in which their use is recommended considering the risk-benefit balance.