9. Gastrointestinal Endocrine Cancer

  1. Janusz Jankowski MB ChB, MSc, MD, PhD, FRCP, FACG, AGAF2,3,4 and
  2. Ernest Hawk MD, MPH5
  1. Mohid Shakil Khan and
  2. Martyn Caplin

Published Online: 15 NOV 2012

DOI: 10.1002/9781118423318.ch9

Handbook of Gastrointestinal Cancer

Handbook of Gastrointestinal Cancer

How to Cite

Khan, M. S. and Caplin, M. (2012) Gastrointestinal Endocrine Cancer, in Handbook of Gastrointestinal Cancer (eds J. Jankowski and E. Hawk), John Wiley & Sons, Inc., Hoboken, NJ, USA. doi: 10.1002/9781118423318.ch9

Editor Information

  1. 2

    Sir James Black Professor of Gastrointestinal Biology and Trials, Centre for Digestive Diseases, Barts and Th e London School of Medicine and Dentistry, London, UK

  2. 3

    Consultant Gastroenterologist, University Hospitals of Leicester, Leicester, UK

  3. 4

    James Black Senior Fellow, University of Oxford, Oxford, UK

  4. 5

    Vice President and Division Head, Division of Cancer Prevention & Population Sciences, Boone Pickens Distinguished Chair for Early Prevention of Cancer, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Author Information

  1. Royal Free Hospital, London, UK

Publication History

  1. Published Online: 15 NOV 2012
  2. Published Print: 12 JUL 2012

ISBN Information

Print ISBN: 9780470656242

Online ISBN: 9781118423318

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Keywords:

  • Neuroendocrine tumor;
  • carcinoid syndrome;
  • carcinoid tumor;
  • somatostatin analogs;
  • octreotide;
  • cancer management;
  • gastrinoma;
  • insulinoma

Summary

Neuroendocrine tumors (NETs) are increasingly common neoplasms that often present diagnostic dilemmas due to obscure or nonspecific symptoms. The ability of NETs to cause clinical symptoms by secretion of hormones is best recognized in the form of the carcinoid syndrome. Although generally slow growing, a significant proportion demonstrates aggressive tumor growth.

Diagnosis involves biochemistry, imaging, endoscopy, nuclear medicine, and histopathology. The therapeutic options reviewed including use of somatostatin analogs; the role of surgery, chemotherapy, and biotherapy using interferon; and peptide receptor targeted therapy (PRRT). Additionally, the challenging interventional management of liver metastases is discussed, including the role of hepatic-artery embolization, radiofrequency ablation, and the place of orthotopic liver transplantation. We discuss the newer therapeutic modalities, for example, PRRT with Y90 and Lu177, newer somatostatin analogs, and tyrosine kinase inhibitors.

We conclude that with the increasing number of investigative procedures and therapeutic options available, it is vital to have a multidisciplinary approach.