Diagnosis & Staging

How is neuroendocrine cancer diagnosed?

Often the symptoms can be very subtle or resemble other gastrointestinal illnesses, therefore, these neuroendocrine tumors or NETs can go undiagnosed for years. Many times, they are found incidentally or accidentally when working up other conditions. Once a mass or tumor is seen a biopsy may be needed to confirm the diagnosis. Urine and blood tests may also help, especially if the tumors have maintained the ability to function.

Are these tumors considered malignant?

All of these tumors should be considered to have the potential to behave like any other malignant tumor, but these tumors can vary dramatically between an extremely slow-growing tumor that grows over years and decades to one that is very fast growing. Most NET’s will grow slow. The term carcinoid means “cancer-like” because these tumors can behave like cancers just usually not at the same rate.

How do we know if it is fast or slow growing?

A pathologist is a doctor who will look at the tumor under the microscope and will measure two factors to predict how fast it is growing. These two measurements are the mitotic rate and the Ki67 percent. Both the mitotic rate and the Ki67 measure the number of tumor cells that are dividing. The more that are dividing the faster the tumor is growing. Using one of these two measurements the tumor is then placed into one of three categories; low, intermediate or high. These categories are also used to decide how to treat these tumors.

How is neuroendocrine cancer staged?

There is no standard staging for neuroendocrine tumors.

What does staging mean?

Once you have been diagnosed with cancer, your doctor will check to see if it has spread to other organs in your body and if so, how far. This is called staging. It is important to know the stage of your cancer in order to make your treatment plan.