Carcinoid and Neuroendocrine Tumor Diagnostics & Treatments
Most carcinoid and neuroendocrine tumors are very difficult to diagnose when they are small and are not visible on routine types of imaging studies. However, advanced endoscopic procedures at Cedars-Sinai will usually find the hidden primary tumor causing intestinal obstruction or bleeding. These procedures include double balloon push enteroscopy, endoscopic ultrasound of the pancreas and wireless capsule endoscopy.
Computed tomography scans (CT), advanced types of magnetic resonance imaging (MRI) scans and positron emission tomography (PET) scans, MIBG scan and octreotide scans are used as needed to diagnose primary tumors and those that have spread, known as metastases. Neuroendocrine tumors that originate in the intestine and pancreas frequently spread to the liver.
The Carcinoid and Neuroendocrine Tumor Program provides comprehensive treatment for all types of neuroendocrine tumors. At Cedars-Sinai, we have access to the most sophisticated types of laparoscopic and minimally invasive surgery for primary tumors and liver metastases.
Specialized interventional radiology is available for Y-90 radio-embolization, hepatic artery chemo-embolization, radio frequency and microwave ablation, and other techniques for treating liver metastases. For carcinoid and neuroendocrine tumors, we have access to treatments including hormone therapies (somatostatin analogs), biotherapy, immunotherapy, targeted biologic agents and peptide receptor radiotherapy using Lu-177.
In addition, we use the latest endocrine techniques for managing hormone production syndromes from these tumors. The program's patients also have access to other Cedars-Sinai services, including the Samuel Oschin Comprehensive Cancer Institute, Endocrinology Services, the Comprehensive Transplant Center and the S. Mark Taper Foundation Imaging Center.
The Cedars-Sinai Carcinoid and Neuroendocrine Tumor Program has one of the largest and most comprehensive clinical research programs in the country devoted to these rare diseases, bringing leading-edge treatments to our patients.
Among the treatments under study are the new somatostatin analogs pasireotide and lanreotide, and multiple oral targeted biological agents that prevent cancer cells from multiplying without the toxicity of traditional chemotherapy. These include many types of m-TOR inhibitors, including everolimus and TORC-1+TORC-2 inhibitors, and peptide receptor radiotherapy PRRT. We also have clinical trials using immune stimulants and anti-angiogenic agents.
Cedars-Sinai is involved in numerous laboratory research studies related to neuroendocrine tumors. Some of these studies are funded by the National Institutes of Health (NIH). Researchers at the Carcinoid and Neuroendocrine Tumor Program are investigating the molecular genesis of carcinoid and neuroendocrine tumors.