The expert notes that the “challenge” in treating a neuroendocrine tumor is to diagnose it before it becomes metastatic.

MADRID, 10 years (EUROPE PRESS)

Enrique Grande, head of the medical oncology service at the Madrid MD Anderson Cancer Center Hospital, noted that the “challenge” in achieving a cure for neuroendocrine tumors is to “diagnose them earlier, when they have not yet metastasized,” since the average diagnostic delay is currently “ five years.”

“If we can diagnose a tumor at a localized stage, that is, when it affects only the organ from which it originates and at most the lymph nodes in that area, most of them can be cured. Unfortunately, it is precisely because of this delay that according to the diagnosis we have, most patients are diagnosed with tumors when the tumor is metastatic. At that time, it will be very difficult for us to achieve a cure,” Grande explained this Friday in an interview with Europa Press.

On the occasion of World Neuroendocrine Tumor Day, which is celebrated this Sunday, Dr. Enrique Grande detailed that these cancers “are not very common”, since in Spain about 4,000 cases are diagnosed every year, a figure that is far from reality. . compares with more than 30,000 for breast or prostate cancer, for example.

“These tumors can arise from different organs because they are produced by endocrine cells located in different places. They are primarily located in the pancreas and digestive tract, but they can also be found in the lungs and organs such as the adrenal glands. lymph nodes, lymphatic vessels or liver,” the specialist noted.

As for complications, Grande explained that in addition to the complications that occur with any solid tumor, about 20 to 30 percent of neuroendocrine tumors can produce hormones. “That’s why they are called functional, because by producing hormones they cause associated hormonal syndromes,” he pointed out. Among these syndromes, the “most common” is carcinoid, which causes the patient to experience conditions including “diarrhea, suffocation, palpitations, tachycardia and sweating.”

A specialist from the MD Anderson Cancer Center Hospital in Madrid noted that in most patients with these tumors, their origin is in the digestive tract. Thus, the main symptoms before diagnosis will be the usual symptoms of poor digestion, such as sporadic episodes of diarrhea, flatulence and heartburn.

“These are very trivial symptoms, we usually don’t associate them with anything serious,” he said. However, he recommended that if they recur in a “periodic” manner over time and “become increasingly frequent,” you should activate the alarms and see a doctor.

APPROACH AND TREATMENT

The heterogeneous nature of these tumors, which can be diagnosed between the ages of 30 and 80 (with the most common occurrence in people aged 50), coupled with their rarity, makes it difficult to find someone who is an expert in them or a hospital with sufficient experience and the necessary multidisciplinary team, the specialist noted.

“It’s not just a surgeon who operates and an oncologist who treats. It’s a surgeon who operates, an oncologist who provides treatment, an endocrinologist who monitors hormonal symptoms, interventional radiologists (…),” he emphasized. about the specialists needed to manage it.

Regarding its treatment, there are different methods. Among the most common are somatostatin analogues, which block this particular protein, located in the membrane of neuroendocrine cells and responsible for cell growth and proliferation.

“This is what we call the first line. From here we give hot somatostatin analogues. What does it mean? Well, it’s the same thing, the same concept, targeting this receptor, but to the drug. We associate radioactivity with this. So it’s like selective radiation therapy. These are new treatment methods called theranostics,” he emphasized.

A key aspect Grande wanted to highlight is research, noting that “in Spain we have one of the main cooperative groups treating neuroendocrine tumors worldwide.” This is the Spanish Group of Neuroendocrine Tumors (GETNE), which is the “world reference” for the treatment of this pathology and is leading many of the studies that are currently being carried out.

“The Spanish Neuroendocrine Tumor Group has five different studies currently underway,” Grande said. As explained, one of them targets neuroendocrine carcinomas, which are the most aggressive tumors among them. “Their prognosis in this case is much worse: survival rarely exceeds one year, and so we have a huge need to move forward in this sense. Fortunately, these later neuroendocrine carcinomas make up only 10 percent of the total,” he said. indicated.

Enrique Grande has called for the referral of patients to referral centers as a challenge facing the National Health System (SNS). “Centers that have the experience and the interdisciplinary team needed to treat them, and access to technology, both nuclear medicine technology for diagnosis and targeting, and the most innovative medicines we have,” he concluded.