Neuroendocrine Tumors

UCLA hosts the largest neuroendocrine tumor program in southern California and the Southwest. Our experts are nationally and internationally renowned in the diagnosis and treatment of neuroendocrine tumors (NETs). Clinicians in all disciplines join together to take care of people with neuroendocrine tumors.

The UCLA Neuroendocrine Tumor Program helped develop the latest treatments for neuroendocrine tumors, including the current gold-standard treatment, peptide receptor radiotherapy (PRRT). We perform hundreds of gallium-68 PET scans every year to diagnose possible NETs. Our expertise in diagnosing NETs is unmatched the region.

What Are Neuroendocrine Tumors?

Neuroendocrine tumors originate in the hormone-producing cells of the body’s neuroendocrine system. Neuroendocrine cells are in almost every organ of the body. That means NETs can appear almost everywhere, including the digestive system, pancreas and lungs.

NETs can be cancerous or noncancerous (benign). They have different symptoms, appearances and responses to treatment, depending on where they are located. Some NETs produce hormones, like other endocrine cells. Others are non-hormone-producing, but can still cause symptoms because of their location.

About 90% of NETs are gastrointestinal (GI) tumors. GI NETs grow in the lining of the gastrointestinal tract. They are sometimes called carcinoid tumors.

Who Is at Risk for Developing Neuroendocrine Tumors?

Having an inherited genetic syndrome can increase the chance of developing a gastrointestinal carcinoid tumor. These syndromes include:

• Multiple endocrine neoplasia, type I (MEN I)
• Neurofibromatosis type 1
• Tuberous sclerosis complex
• Von Hippel-Lindau syndrome
• Familial small intestinal neuroendocrine tumor

What Are the Symptoms of Neuroendocrine Tumors?

Many neuroendocrine tumors do not cause symptoms that are noticeable until they have existed for a long time. Sometimes, doctors spot them when people have imaging or other tests for an unrelated issue.

NETs sometimes produce symptoms that doctors may attribute to other causes. These symptoms vary by the tumor’s location. Symptoms might include:

• Abdominal pain, cramping, nausea or vomiting that come and go
• Jaundice (a yellow tint to the skin or eyes)
• Constipation
• Rectal bleeding
• Facial flushing (redness and warmth)
• Fast heartbeat
• Wheezing
• High blood pressure
• Elevated blood sugar or diabetes

How Are Neuroendocrine Tumors Diagnosed?

Diagnosing neuroendocrine tumors requires exceptional expertise. UCLA has a multidisciplinary team — including experts in surgery, medical oncology, gastroenterology, pathology, radiology and nuclear medicine — dedicated to treating patients with NETs. 

Diagnostic tests may include:

• Gallium-68 PET/CT dotatate scan: UCLA helped develop a new PET scan, the gallium-68 dotatate PET scan, which uses a radioactive element that attaches to GI NET cells. It is so effective that it’s nicknamed the “NET-spotter test.” Our doctors perform hundreds of gallium-68 PET scans every year, so you can trust their experience reading your results.
• Endoscopy: Using an endoscope, a thin tube inserted through the throat or rectum, your doctor can see inside the walls of the GI tract and surrounding organs. Or your doctor may use capsule endoscopy, where you swallow a capsule with a tiny camera to show the whole intestinal tract. Read more about interventional endoscopy.
• Barium X-ray: Sometimes doctors use a barium swallow test, where you drink a barium-containing liquid. Barium coats your esophagus, stomach and intestines and is visible on X-rays. It enables your doctor to see any abnormal areas.
• Advanced imaging: Your doctor may use CT scans, MRI scans and nuclear imaging techniques to identify neuroendocrine tumors. These imaging studies help distinguish localized tumors from those that might spread (metastasize).Learn more about our imaging technology.
• Blood and urine tests: Many NETs, especially in the small intestine, release serotonin, which breaks down into 5-hydroxyindoleactic acid (5-HIAA). A urine test that checks for 5-HIAA over 24 hours can look for signs of neuroendocrine tumors. Blood tests can reveal other hormones released because of NETs.

How Are Neuroendocrine Tumors Treated?

Before you decide on a treatment plan, our tumor board will discuss your case. The tumor board is a meeting of doctors in many different specialties. These experts consider state-of-the-art treatment approaches, innovative research protocols and evidence-based medicine to offer your best treatment options. Meet our doctors.

With world-class programs for pancreas diseases, liver transplantation, cancer and nuclear medicine, our team is committed to finding the best treatment for each individual. Your care may include:

Peptide receptor radionuclide therapy (PRRT)

PRRT combines a cell-targeting protein (or peptide) with a small radionuclide (or radioactive material). You take this hormone-like drug intravenously, so that it travels to tumor cells and delivers a high dose of radiation to destroy the tumor.

UCLA has an exceptional degree of experience in PRRT, beginning before PRRT was approved for widespread use. During PRRT’s study phase, UCLA doctors treated more people with PRRT than any other hospital in the U.S. and trained other centers to deliver it. Read more about PRRT for NETs (PDF).

Endoscopic mucosal resection (EMR)

For NETs in the upper GI tract, your doctor may be able to use an endoscope inserted through your throat to reach the tumor. Using a tool attached to the endoscope, your doctor “lassoes” the tumor with a thin wire. An electrical current removes the tumor and some surrounding cells. At the same time, it seals the cut. Read more about EMR .

Surgery

Your surgeon may remove part or all of your stomach, intestine, colon or rectum, depending where the tumor is located and how it is affecting your body. Your surgeon then reconnects your GI tract so that you can eat and eliminate waste as normally as possible. In some cases, you may have a minimally invasive procedure, which uses smaller incisions for less pain and a faster recovery.

Somatostatin analogs

These medications treat the symptoms of carcinoid tumors and sometimes shrink the tumors. They do not treat or cure the tumors. Somatostatin analogs include octreotide (Sandostatin®), Lanreotide(Somatuline®) and Telotristat (Xermelo™).

Hormone therapy

If a neuroendocrine tumor releases hormones, your doctor may prescribe medications to decrease the hormone production. This treatment can relieve symptoms and help you feel more comfortable.

Radiation therapy

Your doctor may recommend radiation therapy to shrink a tumor if you are unable to have surgery. Read more about radiation oncology.

Contact Us

To schedule an appointment with the UCLA Gastrointestinal Oncology Program, please call the UCLA Cancer Hotline at 888-ONC-UCLA (888-662-8252) Monday through Friday, 9am to 5pm, or our Physician Referral Service at 1-800-UCLA-MD1 (800-825-2631).