NETS (Neuroendocrine Tumours) originate typically in the respiratory and digestive tracts and usually mature in a more prolonged span. Such type of cancers cannot be quickly diagnosed and hence delineating the spread of the disease is yet another challenge. Fear not; neuroendocrine tumour treatment in India is revolutionised and is delivered at an affordable cost. NETS can be malignant too, in all the cases of neuroendocrine tumours, two percent account to gastrointestinal cancers. The likelihood of such tumors is more significant than those cancers of the stomach and pancreas.
NET is a sporadic form of cancer, and hence the number of cases is also less. As per findings revealed by the National Cancer Institute, United States accounts for 2.5-5 cases per 100,000. However, the NCI reports have also highlighted the noted five-fold escalation in cases across the globe from 1973 to 2004. Very recently news surfaced that actor Irrfan Khan was diagnosed with a neuroendocrine tumour. The actor is sanguine about battling his cancer heroically, therefore; other patients should seek inspiration and should take a step towards treating their neuroendocrine low-grade neuroendocrine tumour before it becomes malignant and cost patients’ their lives.
“Your one step will make a difference in your and your dear ones’ lives- Let’s Combat your Stubborn Cancer Together.”
Neuroendocrine Tumours and its Types
There various types of neuroendocrine tumors. However, this article will predominantly shed light on three specific types of neuroendocrine tumours- Pheochromocytoma, Merkel cell cancer, and Neuroendocrine carcinoma. The other types of tumors that originate in hormone-producing cells are those of the thyroid, pituitary gland and pancreas, known as pancreatic neuroendocrine tumors. Some also develop in adrenal glands.
• Pheochromocytoma– An extremely rare type which originates in the adrenal medulla which is made of chromaffin cells in the adrenal gland. Tumour develops when the hormones adrenaline and noradrenaline are excessively produced by the adrenal gland, thereby elevating blood pressure levels and heart rate.
Pheochromocytoma is usually non-malignant, but it turns out to be lethal when it releases excess amounts of adrenaline into the bloodstream post an injury. Among patients who are suffering from pheochromocytoma, 80 percent of them have tumor in one adrenal gland, 10 percent of them have tumour in both glands, and 10%’s tumour develops outside the adrenal glands.
• Merkel cell cancer– Also known as neuroendocrine carcinoma of the skin or trabecular cancer, it is a malignant and widespread cancer which begins in hormone-producing cells just beneath the surface of the skin and the hair follicles. Such type of cancer is more common in the head and neck.
• Neuroendocrine carcinoma – Neuroendocrine carcinoma may originate in various organs of the body such as gastrointestinal tract, lungs and brain.
Neuroendocrine Tumour Signs & Symptoms
Individuals who exhibit any symptoms listed below should consult a doctor and hence if neuroendocrine is suspected, then the patient will be made to undergo various tests.
Symptoms of pheochromocytoma
• Elevated blood pressure levels
• Persistent headaches
• Night sweating
• Peripheral Edema
• Clammy skin due to a circulatory crisis
• Abnormal heart rate
• Heart palpitations
Symptoms of Merkel cell cancer
Formation of shiny lumps on the skin that become reddish, pinkish, or sometimes blueish.
Symptoms of neuroendocrine carcinoma
• Loss of appetite
• Husky voice or persistent coughing
• Lumps in any part of the body
• Unusual bowel movements
• Loss or gain in weight
- Abnormal bleeding or discharge
• Fever and night sweats
• Gastric ulcer disease
• Rashes on the skin
Risk Factors for Neuroendocrine Tumours
It is essential to know what factors account for elevating the risk of neuroendocrine cancer among individuals. If these contributors of cancer are known, the likelihood of neuroendocrine tumour would be mitigated. A few risk factors which have been found to be associated with risk of cancer are as follows:
• Age- Individuals whose age ranges between 40 and 60 are at greater odds of developing pheochromocytoma whereas the risk of Merkel cell cancer is high among senior citizens.
• Gender- The risk of both Merkel cell cancer and pheochromocytoma is greater in when compared to females.
• Ethnicity- The occurrence rate is comparatively higher among individuals with a fairer complexion. However, very few cases have been reported of black people and the ones who are of Polynesian developing the disease.
• Family history- Pheochromocytomas and Multiple endocrine neoplasia type 1 (MEN1) are two diseases which are passed on from generations.
• Immune system suppression- Individuals with human immunodeficiency virus (HIV) and Immune Deficiency Syndrome (AIDS), and the ones whose immune systems have become weak post an organ transplant are at risk of neuroendocrine cancer.
• Merkel cell polyomavirus (MCV)- The association between this virus and Merkel cell cancer has been backed by solid research.
• Exposure to Arsenic – Arsenic exposure ups the risk of Merkel cell cancer.
• Exposure to sunrays- Body parts such as the head and neck which are exposed to direct sunrays has been found to be a significant contributor to cancer.
Neuroendocrine Tumour Treatment in India: A promise to Patients
Indian hospitals have a panel of highly-skilled oncologists, supporting staff, oncology nurses, pharmacists, dietitians and counsellors who promise an absolute gold standard of care to their patients. The various treatment options for treating neuroendocrine cancer are as follows:
Surgery is performed both for treating pheochromocytoma (for which a laparoscopic procedure is performed) and Merkel cell cancer. When a tumour becomes inoperable, then therapies come into play.
• Radiation therapy
• Targeted therapy
• Nutrition therapy
Clinical Trial– Clinical trials are a customised form of treatment that involves evaluation of FDA-approved drugs and assess patient’s response to these drugs. The procedure is more personalised and explores a combination of existing treatments coupled with nascent approaches and the clinical trials of the same is conducted before patients are made to undergo that treatment.
Palliative Care for managing pain– This treatment helps patients in managing the side effects of therapies and meds, such as nausea, drowsiness and constipation.
Best Nuclear Oncologists and Hospitals for Neuroendocrine Tumour in India
The best oncologists and the hospitals for neuroendocrine tumour in India are as follows:
• Fortis Memorial Research Institute, Gurugram- Dr Vinod Raina
• Fortis Memorial Research Institute, Gurugram – Dr Ishita B Sen
• Fortis Memorial Research Institute, Gurugram – Dr Rahul Bhargava
• Max Smart Super Speciality Hospital, Saket – Dr Rahul Naithani
• BLK Super Speciality Hospital, New Delhi- Dr Amit Agarwal
• BLK Super Speciality Hospital, New Delhi- Dr Dharma Choudhary
Neuroendocrine Tumour Treatment Cost in India
Neuroendocrine cancer treatment in India is cost-effective when compared to other countries. The cost of undergoing surgery for removing the cancer is USD 8000. Radiation therapy costs near about USD 5000, and the cost of chemotherapy per cycle is USD 500.
The variations in treatment expenses depend on factors such as:
• Type of health care centre or hospital in which one undergoes treatment
• Choice of Nuclear oncologist
• Grade and type of neuroendocrine cancer
• Post-treatment care cost
Debunking Molecular Pathway Expression for Improvising Cancer Diagnosis: Study
A panel of researchers has potentially shed light on the role of on the molecular pathways that are driving force of a neuroendocrine tumour. However, the study warrants further research. If the mechanism of these molecular pathways is decoded, then it will pave the way for the development of efficient and improvised therapeutics for such type of cancer.
Various healthcare platforms like MedMonks help patients across the globe in availing low-cost treatment. They have tie-ups with niched Indian hospitals and oncologists who have various ground-breaking surgeries to their credit. Such platforms make patients’ treatment smooth, thereby shouldering the responsibility of arranging logistics, accommodation and even medical visa to India. MedMonks provides a free quote to patients and counsel them regarding their ailment and help them sail through the dilemmatic task of zeroing out suitable specialists.
1. What are the various diagnostic tests required for a neuroendocrine tumour?
Diagnosis of tumour is again dependent on factors such as type, grade and site of cancer. Indian hospitals are equipped with state-of-the-art machinery that is potential for diagnosis.
• Laboratory tests, cytopathology
• Blood/ urine tests
• Biopsy, endoscopic ultrasound
• Computed tomography (CT or CAT) scan and angiography
• Magnetic resonance imaging (MRI
• Positron emission tomography (PET) or PET-CT scan
• Molecular testing of the tumour
• Various gene tests
2. What are metastatic neuroendocrine tumours?
Metastatic neuroendocrine tumours are cancers which rampantly spread and invade other body parts too. For such types of cancers, patients may be made to undergo clinical trials. Surgery, chemotherapy and radiation therapy are also conducted and along with it palliative care is given which holds potential in delivering emotional support and helps patients cope with the aftermath of these taxing therapies.