Neuroendocrine tumours are rare tumors

Bollywood actor Irrfan Khan has recently revealed in a tweet that he has been suffering from neuroendocrine tumour (NET). Fans all over the world seem to be worried. There are misconceptions that NET is a case of advanced terminal illness or cancer. In reality NETs are very different and rare in nature.

Neuroendocrine tumors (NETs) are actually neoplasms which arise from cells of the endocrine (hormonal) and nervous systems. NETs can be benign (non-cancerous) or malignant (cancerous). In case of Irrfan Khan we are yet to know whether it is a benign or malignant one.

These abnormal growths or tumours begin in the neuroendocrine cells and are distributed widely throughout the body. Interestingly, the NETs first appear in the lungs or the gastrointestinal tract, including the stomach, pancreas, appendix, intestines, colon and rectum and can also appear in the thymus, thyroid gland, adrenal gland and pituitary glands. The neuroendocrine tumours are classified according to the predominant hormone they secrete and the resulting clinical syndrome (eg, insulinoma, gastrinoma, glucagonoma, VIPoma, somatostatinoma). As far as symptoms are concerned, NETs are often misdiagnosed as irritable bowel syndrome (IBS). No doubt, abdominal discomfort in IBS is usually relieved by going to the bathroom. The presence of the carcinoid syndrome may be suspected when a patient has suggestive symptoms, such as otherwise unexplained diarrhea or flushing. In case of diagnosis, a useful initial diagnostic test for the carcinoid syndrome is to measure 24-hour urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA), which is the end product of serotonin metabolism. This specific test has a sensitivity of over 90% and specificity of 90% for the carcinoid syndrome. To grade the tumor and provide better guidance for chemotherapy, it is necessary to assess the tumor's proliferativerate by both mitotic count and Ki-67 labeling index. Often, imaging studies are done to search for a carcinoid tumor.

The diagnosis of neuroendocrine tumours revolves around surgical options.

According to DrManas Panigrahi, senior neruosurgeon at KIMS hospital, “The primary treatment goal for patients with NETs should be curative with symptom control and the limitation of tumor progression as secondary goals. The whole treatment procedure is time taking and costly at the same time. In case of benign tumours, with complete removal the life span of the person concerned isn’t affected. In such case, Irrfan Khan can definitely resume his working schedule.

In case of malignancy, the whole situation depends on outcome of chemotherapy and other available traditional way outs.” If it is a case of Pheochromocytoma or neuroendocrine carcinoma, the treatment is most likely to respond but in case of much aggressive, Merkel cell cancer, the situation is indeed serious. Nowadays treatment for neuroendocrine tumours is done in India and for benign tumours, it can be fully cured.

For Appointments : Dr. Manas Kumar Panigrahi MCh., (NIMHANS), FACS Sr. Consultant Neuro Surgeon Neurosurgery, Spine Surgery, Stroke Unit Kims Hospitals Secunderabad .