Neuroendocrine Tumor Diagnosis and Treatment

Diagnosing Neuroendocrine Cancer

At University Hospitals Seidman Cancer Center, we have a number of different evaluations and tests we use for NET cancer diagnosis. These include:

• Blood and urine tests
  • Complete blood count (CBC)
  • Blood chemistry studies to check certain substances in the blood
  • 24-hour urine collection to detect the level of serotonin in the body
  • Tumor marker: Measures the amount of chromogranin A – a protein released from neuroendocrine cells – in the blood


• Imaging tests
  • Colonoscopy
  • Upper endoscopy
  • Endoscopic ultrasound (EUS)
  • Multiphasic computed tomography (CT) or magnetic resonance imaging (MRI) scans
  • Octreotide scan, in which an octreotide, or radioactive hormone drug, is injected into a vein and attaches to tumor cells. A radiation-measuring instrument shows where the octreotide has collected.
  • Ga 68 Netspot PET/CT scan: An imaging procedure that uses a radioactive substance that binds to hormone receptors, highlighting the neuroendocrine tumors on the PET scan. This information enables your physician to make an early diagnosis and plan the most effective treatment.


• Biopsy:
  • Needle biopsy: A needle is inserted into the tumor. An ultrasound or CT scan may be used to guide the needle.
  • Surgery: A tissue sample is taken from the abdomen during surgery

Neuroendocrine Tumor Treatment

Neuroendocrine tumor treatment depends on the tumor’s size, site, if the cancer is localized or spread (metastasize), as well as your current symptoms. Therefore, every patient with a neuroendocrine neoplasm needs multidisciplinary team management to develop the best treatment plan for their individual needs.

Neuroendocrine tumor treatment options include:

• Surgery to remove the tumor: Used for localized NETs as well as some metastatic cases
• Liver-directed therapy: Aimed at treating neuroendocrine tumors of the liver, these procedures include:
  • Cryotherapy
  • Bland embolization
  • Chemoembolization
  • Radioembolization
• Chemotherapy, including:
  • Targeted chemotherapy drugs such as Everolimus and Sunitinib
  • Cytotoxic chemotherapy for fast-growing tumors
• Peptide receptor radionuclide therapy (PRRT): A molecular therapy given intravenously to treat neuroendocrine tumors. PRRT is typically given every two months for four cycles.
• Immunotherapy, which uses the body’s immune system to fight cancer
• Sandostatin analogues: Hormone drugs used to control symptoms such as diarrhea and flushing in patients with NETs
• Clinical trials and research: Patients with NETs have the opportunity to participate in a clinical trial, which can offer them access to new therapies not widely available at other cancer hospitals. Search our clinical trials directory for more information.
• Nutritional support specialized for patients with neuroendocrine cancers

Neuroendocrine Tumor Follow-Up Care

Neuroendocrine cancer tends to grow slowly and may be similar to a chronic illness, so care for people diagnosed with a NET does not end when active treatment has finished. Patients will have a follow up every four to six months that will include regular physical examinations, blood tests, and imaging studies such as multiphasic CT and MRI scans.