What is Pancreatic NET?

Insulinomas are the most prevalent type of functional pancreatic neuroendocrine tumor (PNET). Most pancreatic endocrine tumors are insulinomas, which produce hormones when they are active.

Five other types of PNETs are as follows:

1. Glucagonomas: Develop from the cells that produce glucagon, a hormone that increases blood sugar levels.
2. Gastrinomas: Develop from the cells that produce gastrin, the hormone that instructs your body to produce stomach acid.
3. VIPomas: Develop from the cells that produce vasoactive intestinal peptide, a substance that controls the movement of specific chemicals through your small intestine.
4. Somatostatinomas: Somatostatin-producing cells give rise to these tumors. Somatostatin helps control glucagon and insulin levels.
5. Adrenocorticotropic hormone (ACTH)-secreting tumors: Formed by cells that produce ACTH.

Depending on the type of tumor, you may experience distinct pancreatic neuroendocrine tumor (PNET) symptoms. Some PNETs develop in nonfunctional cells. These don't produce hormones and don't show signs right away. They eventually impose pressure on other organs, such as the bile ducts, which may produce various symptoms in the body. Other PNETs produce too many hormones, resulting in symptoms.

Here are the symptoms associated with the following types of PNETs:

• Nonfunctioning PNET
  • The yellow-tinted sclera (whites of the eyes) and skin, characterizing jaundice
  • Indigestion and diarrhea
  • Lump and pain in the stomach
  • Nausea
  • Appetite loss
• Gastrinoma
  • Acid reflux
  • Pain in the abdomen or back
  • Diarrhea
  • Stomach ulcers
• Glucagonoma
  • Feeling unusually thirsty and hungry
  • Frequent urination
  • Diarrhea
  • Unintended weight loss
• Insulinomas
  • Weakness
  • Intense hunger
  • Confusion
  • Seizures
  • Loss of consciousness
  • Coma
  • Sweating
  • Rapid heartbeat
• Somatostatinoma
  • Diarrhea
  • Gallstones
  • High blood sugar symptoms (such as weakness, hunger, confusion, headaches, frequent urination, and dry skin)
  • Yellowing of the skin or eyes
  • Unexplained weight loss
• VIPoma
  • Diarrhea that worsens over time
  • Nausea and vomiting
  • Muscle cramps
  • Fatigue
  • Flushing (your face and neck feel warm and become red)

The most popular staging method used for staging pancreatic neuroendocrine tumors (PNETs) is the American Joint Committee on Cancer (AJCC) TNM system.

• T denotes the size of the tumor
• N stands for the spread of cancer to nearby lymph nodes
• M describes metastasis (spread of cancer to other body parts)

People with pancreatic neuroendocrine tumor (PNET) might get various treatments, such as:

• Surgery: The tumor may be removed surgically. Any of the following surgical procedures could be used:
  • Enucleation: A surgical procedure that solely removes the tumor. This is used when pancreatic cancer affects only one area.
  • Pancreatoduodenectomy: A surgical procedure in which the pancreatic head, the gallbladder, adjacent lymph nodes, and a portion of the stomach, small intestine, and bile duct are removed. The pancreas still has enough tissue to produce insulin and digest acids. The organs that are removed during this treatment depend on the person’s health. This process is also known as the Whipple method. The chances of long-term survival with pancreatic cancer are increased after a Whipple procedure.
  • Distal pancreatectomy: Removes the body and tail of the pancreas. In addition, the spleen too may be removed if cancer has spread to this organ. 
  • Total gastrectomy: Removes the entire stomach.
  • Parietal cell vagotomy: This surgery removes the nerve that triggers acid production by stomach cells.
  • Liver resection: A surgery that removes the liver partially or completely.
  • Cryosurgical ablation: A process in which aberrant cells are removed from tissue by freezing it. Liquid nitrogen or liquid carbon dioxide is typically used in a specialized device. The device may be implanted through the skin or used during a laparoscopy or surgery. Cryoablation is another name for this process.
  • Radiofrequency ablation: A unique probe with small electrodes is used in radiofrequency ablation to eliminate cancer cells. Sometimes only local anesthetic is required because the probe can be inserted directly through the skin. In other instances, an abdominal incision is made to place the probe.
• Chemotherapy: A type of cancer treatment that uses medications to kill or prevent the division of cancer cells to stop the spread of the disease. When administered orally, intravenously, or intramuscularly, chemotherapy medications can reach cancer cells throughout the body. Direct injection of chemotherapy into the cerebrospinal fluid, an organ, or a body cavity, such as the abdomen, causes the medications to primarily target cancer cells in those regions (regional chemotherapy). The use of multiple anticancer drugs is known as combination chemotherapy. Chemotherapy is administered differently depending on the type of cancer being treated.
• Hormone therapy: Hormone treatment removes or hinders the action of specific hormones to prevent the proliferation of cancer cells. Hormones are created by glands in the body and then released into circulation. Some hormones may cause certain tumors to enlarge. If tests show that the cancer cells have receptors where hormones can bind, the synthesis of hormones is suppressed or their activity is stopped using drugs, surgery, or radiation therapy.
• Targeted therapy: Targeted therapy is medical care that isolates and destroys cancer cells using medicines or other substances. Compared with chemotherapy and radiation therapy, targeted therapies typically don't kill healthy cells. Treatment of PNETs with specific targeted treatments is currently under investigation.
• Hepatic arterial occlusion or chemoembolization: The practice of stopping or reducing blood flow from the hepatic artery (the major blood vessel that carries blood to the liver) to the liver using drugs, minute particles, or other substances. The intention is to stop the development of malignant liver cells. The tumor is deprived of the oxygen and nutrition needed to flourish. The hepatic portal vein, which takes blood from the stomach and intestine, continues to provide blood to the liver.