Neuroendocrine tumours can be found anywhere in the body. They are classified according to their site of origin and whether they are functioning (hormone secreting) or non-functioning (non-hormone secreting). There are many types of neuroendocrine tumours including: medullary thyroid cancers, paragangliomas, phaeochromoctomas, bronchial carcinoids and the most common gastroenteropancreatic (GEP) tumours which encompass pancreatic islet cell tumours (e.g. insulinoma, gastrinoma, VIPoma, glucagonoma and non-functional tumours) as well as gastrointestinal carcinoid tumours originating in the foregut, midgut or hindgut.
There are several types of pancreatic cancer, the most common of which is ductal adenocarcinoma.
Ductal adenocarcinoma of the pancreas develops from cancerous cells in the pancreatic duct. As the tumour grows it can block the bile duct or the main pancreatic duct. This stops the drainage of bile or pancreatic fluid into the duodenum. The cancer then spreads deeper into the pancreas. It may even pass through the wall of the pancreas and affect nearby organs such as the duodenum, stomach or the liver.
In addition, some cells may break off into the lymph channels or bloodstream. The cancer may then spread to nearby lymph nodes or spread to other areas of the body (metastasise).
Treatment
Treatment options include surgery, chemotherapy and radiotherapy. The treatment advised for each case depends on a number of factors such as how large the cancer is, whether it has spread, and the general health of the patient. Most cancers of the pancreas are advanced before they cause symptoms and are diagnosed. A cure is unlikely in most cases. However, treatment may slow down the progression of the cancer.
Rectal cancers are common in the UK with a similar number of cases to cancer of the bowel.
Treatment
Once the size and particular stage of development of the cancer has been identified the patient may be given chemotherapy or radiotherapy to shrink the tumour before surgery. Surgical techniques are now much more advanced than before with a far higher prevention of recurrent disease. There can still be some complications depending on the size of the tumour and complexity of the surgery. Surgery can be followed by chemotherapy and/or radiotherapy.
There are a number of different types of stomach cancer, each with different causes. Cancers may begin as a result of chronic inflammation, ulcers, large polyps or as a result of pernicious anaemia. Smoking or eating food with a high salt or high nitrite content are also associated with a higher incidence of stomach cancers but by and large, stomach cancer is not hereditary.
Treatment
Once checks have been made that it has not spread anywhere else, most stomach cancers will be removed by surgery. Either a part of the stomach or the whole stomach is removed, with lymph glands that are close by. The stomach or gullet is then joined to the bowel. Once the cancer has been removed it is examined closely under the microscope to decide exactly what stage it is at. If the cancer is at an early stage and has not spread through the stomach wall, then no further treatment may be necessary. If the cancer has spread through the wall, or involved lymph glands a patient may be offered further treatment such as chemotherapy, radiotherapy or a combination of both. Sometimes chemotherapy is given before surgery in order to shrink a tumour.
