As the news of Bollywood actor Irrfan Khan being diagnosed with NeuroEndocrine Tumour (NETs) broke the internet, people have gotten curious about this rare disease.
According to the Canadian Cancer Society, NETs may not cause any signs or symptoms if they grow slowly and don't make too much of a certain hormone.
Signs and symptoms may appear as the tumour grows or if hormones are released by the tumour - if it is a functional tumour. Other health conditions can cause the same symptoms as NETs.
The signs or symptoms of NETs vary depending on where the tumour develops in the body.
Symptoms of gastrointestinal neuroendocrine tumours (GI NETs)
Gastrointestinal neuroendocrine tumours (GI NETs) can develop in any part of the gastrointestinal tract, including the small or large intestine and stomach. Signs or symptoms of GI NETs may include:
- Discomfort or pain in the abdomen or rectum
- Nausea and vomiting
- Bleeding from the rectum or blood in the stool
- Anaemia - may cause fatigue
- Heartburn or indigestion
- Stomach ulcers - can cause heartburn, indigestion, and pain in the chest or abdomen
- Weight loss
- Blockage in the intestine (bowel obstruction) - may cause pain in the abdomen or constipation
Carcinoid syndrome is a group of symptoms caused by NETs releasing large amounts of serotonin and other chemicals into the blood. Carcinoid syndrome may happen in people with any type of NET.
It most commonly occurs with NETs of the small intestine that have spread to the liver (liver metastases). The signs or symptoms of carcinoid syndrome include:
- Flushing of the skin, mainly the face and neck
- Wheezing and difficulty breathing
- Fast or irregular heartbeat
- Low blood pressure
- Heart damage (carcinoid heart disease)
Carcinoid crisis is a severe case of flushing, low blood pressure, difficulty breathing and an irregular heartbeat. It may be triggered by anesthesia, surgery or other treatments. Carcinoid crisis is a serious and possibly life-threatening problem that needs to be treated right away. A drug called octreotide (Sandostatin) can be given to treat and reduce the risk of carcinoid crisis.
Symptoms of lung neuroendocrine tumours (lung NETs)
Lung neuroendocrine tumours (lung NETs) usually develop in the airways (bronchi). Signs or symptoms of lung NETs may include:
- A cough that doesn't go away
- Coughing up blood
- Difficulty breathing
- Carcinoid syndrome - includes flushing of the skin, diarrhea and wheezing
Cushing syndrome is a group of symptoms caused by too much cortisol in the body. Cushing syndrome may happen in people with NETs, including some lung NETs, when too much adrenocorticotropic hormone (ACTH) is released. This causes too much cortisol to be made by the adrenal glands.
The signs or symptoms of Cushing syndrome include:
- Weight gain
- A red, round and full face
- Muscle weakness
- Increased hair growth on the face and body
- A build-up of fat between the shoulders or above the collarbone
- Purple lines on the skin
- High blood pressure
- High blood sugar (glucose) levels
- Changes in mood and behaviour
Symptoms of pancreatic neuroendocrine tumours (pNETs)
Signs or symptoms of pancreatic neuroendocrine tumours (pNETs) depend mainly on the type of hormone released by the tumour. The signs or symptoms of pNETs include:
- Low blood sugar levels (hypoglycemia) - may cause sweating, shakiness, dizziness, extreme hunger and problems concentrating
- High blood sugar levels (hyperglycemia) - may cause extreme thirst and frequent urination, diarrhea, and fatty stools
- Stomach ulcers - may cause heartburn, indigestion, and pain in the chest or abdomen
- Weight loss
- Patches of red, itchy and painful skin
- Blood clots
Zollinger-Ellison syndrome is a condition caused by too much gastrin in the body. This increases the amount of stomach acid made, which can eventually lead to ulcers of the stomach or small intestine.
Zollinger-Ellison syndrome may happen in people with gastrin-producing NETs of the pancreas or small intestine (gastrinoma).
The signs or symptoms of Zollinger-Ellison syndrome include:
- Pain in the abdomen
- Severe diarrhoea
- Nausea and vomiting, sometimes vomiting blood
- Weight loss