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What is the difference in treatment for lung NETs and other types of neuroendocrine tumors?
Robert Ramirez, OD, a neuroendocrine cancer expert, answers questions about the treatment of lung neuroendocrine tumors, in this excerpt from the Facebook Live event on October 23, 2018. Watch the full Facebook Live program here: https://www.facebook.com/Carci....noid/videos/22720281


Neuroendocrine tumors (NETS) grow in hormonal glands in the lungs, stomach, pancreas, or gut. Some produce hormones that damage your digestive system or blood sugar. Lutathera treats NETS by slowing down or stopping tumor growth.
Find out more at: https://uvahealth.com/services..../imaging/nuclear-ima
Transcript
Matthew Reilly, MD:
One of the therapies that I use more commonly with neuroendocrine tumor patients is a class of therapies called peptide receptor radionucleotide therapy, or PRRT. Within that class, Lutathera, which is also known as lutetium 177 Lu DOTA-TATE, is an approved therapy approved in 2018 for patients with well differentiated metastatic neuroendocrine tumors.
Jeri Pugh, RN:
PRRT is used specifically for neuroendocrine cancer, also known as carcinoide cancer. And what that is is that is a cancer that develops cells in your body called neuroendocrine cells, which create hormones in the body. Essentially, it is a medication that's been specifically designed to bind to target sites on tumors, peptide receptors. And then the medication enters those cells and releases radiation over time, which then kills those tumors.
Lale Kostakoglu Shields, MD, MPH:
It gets internalized into the tumor, and allows this radiation to cause damage to tumor cell with an ultimate goal of a tumor shrinkage, control, progression. So it's a relatively highly safe treatment and effective treatment in disease control.
Matthew Reilly:
About one in five patients will see more of a response with tumor shrinkage. But for the most part, what we see is significant benefit in terms of stopping the tumor from growing, for what can be years, and overall benefit in survival.
Jeri Pugh:
So it also really improves their quality of life, as well as reduces the risk of that progressing. It turns an active progressing growing disease into more of a chronic stable disease state.
Lale Kostakoglu Shields:
Altogether, it's an eight month treatment. It consists of four cycles, separated approximately two months from one another. Patient arrives at Nuclear Medicine early in the morning. And it takes usually five hours to complete the treatment. So it's a full day out-patient treatment for each cycle.
Jeri Pugh:
The treatment itself is provided in Nuclear Medicine Clinic. So with the Nuclear Medicine radiologist, also our outstanding team of certified Nuclear Medicine technologists who actually handle the radioactive medication and provide the imaging.
Matthew Reilly:
When I take care of patients with neuroendocrine tumors, what we're often talking about is that this, unlike some cancers where we're very aggressively approaching patients with chemotherapy, we're really taking more of a longer game approach where we want to control the tumor and keep them doing well for ideally years to come.


Up to a quarter of all neuroendocrine tumors (NETs) originate in the lung. Neuroendocrine cancer expert Robert Ramirez, DO, FACP, describes the four types of lung neuroendocrine tumors, common respiratory symptoms, misdiagnoses, treatment options, and DIPNECH (diffuse idiopathic pulmonary neuroendocrine cell hyperplasia). Dr. Ramirez’s patient, Paige, experienced debilitating fatigue for months before being diagnosed with a lung NET. She emphasizes the importance of seeing NET specialists for this uncommon cancer. And hear from oncology nurse navigator Pamela Ryan, who has worked with the NET community for 15 years, about the advances she’s seen in NET imaging and treatments, and her hopes for the future.
Find out more at https://www.carcinoid.org/


Sridhar Rathinam of Glenfield Hospital in Leicester, United Kingdom, discusses surgical approaches for pulmonary neuroendocrine tumors.
Learn more: https://www.ctsnet.org/article..../surgical-approaches
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