Types of surgery

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). 

The surgery you have depends on:

  • where the NET started (the primary tumour)
  • how big the tumour is
  • whether it has spread
  • how the cells look under the microscope (the grade)
  • the symptoms you have
  • your general health
Your doctor will discuss your surgery, its benefits and the possible risks with you.

You are likely to have a clinical nurse specialist (or CNS). They go to the MDT meetings. They can help answer your questions and support you. They are often your main point of contact throughout your treatment. 

Types of surgery

Your surgeon aims to remove the tumour completely. For some NETs, surgery is the only treatment you need. 

For a NET that has spread to other parts of the body, your surgeon might still do surgery to remove most of the tumour. This is called debulking. Debulking surgery can help to control your symptoms and help you feel better, but won’t get rid of the NET.

Some of these are major operations and there are possible risks. But if the aim is to try to cure the NET, you might feel it is worth some risks.

Surgery for lung NETs

Surgery is the main treatment for typical carcinoid (TC) and atypical carcinoid (AC). These are types of lung NETs. 

A doctor specialising in lung surgery (known as a thoracic or cardiothoracic surgeon) does the operation. They usually remove a small section of the lung (lobectomy). Or they may remove the whole lung (pneumonectomy) in some cases.

Surgery for NETs of the pancreas

You see a surgeon who specialises in surgery of the pancreas. Your surgeon might remove:

  • just the tumour
  • the part of the pancreas where the tumour is
  • part of the pancreas and some nearby organs such as the spleen
  • the whole pancreas

Your surgeon may also remove the lymph nodes around the pancreas. The lymph nodes drain away fluid, waste products and damaged cells, and contain cells that fight infection. They are often the first place where cancers spread to.

Surgery for gut NETs

The gut includes the:

  • stomach
  • small and large bowel
  • back passage (rectum)

You usually have keyhole or laparoscopic surgery to remove small NETs of the gut. Your surgeon makes small cuts in your tummy (abdomen). They pass a long tube called a laparoscope and other instruments through these cuts. The laparoscope has a light and camera on the end, so your surgeon can look into your abdomen and use the instruments to remove the tumour. 

For large gut NETs or for a gut NET that is difficult to reach, you have an open surgery. This means your surgeon makes one long cut down your abdomen to remove the tumour. 

We have more information about surgery on the treatment pages for your type of gut NET. 

Other treatments

There are other types of treatment for NETs if you can’t have surgery. These include:

  • somatostatin analogues
  • radiotherapy
  • chemotherapy
  • targeted drugs

These treatments can control your symptoms and help you feel better. But they won’t get rid of the NET.

Coping

Treatment for neuroendocrine tumours can be difficult to cope with for some people. Your nurse will give you phone numbers to call if you have any problems at home. 

If you have any questions about treatment, you can talk to Cancer Research UK’s information nurses on freephone 0808 800 4040, 9am to 5pm, Monday to Friday.
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    Annals of Oncology, 2015. Vol 26, Issue 8, Pages 1604-1620

  • Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    M. Pavel and others
    Annals of Oncology 2020, Vol 31, Issue 5 

  • ENETS consensus guidelines of the management of patients with liver and other distant metastases from neuroendocrine neoplasms of foregut, midgut, hindgut and unknown primary
    M Pavel and others
    Neuroendocrinology, 2012. Vol 95, Pages 157-176 

  • ENETS consensus guidelines update for neuroendocrine neoplasms of the jejunum and ileum
    B Niederle and others
    Neuroendocrinology, 2016. Vol 103, Pages 125-138

Last reviewed: 
15 Mar 2021
Next review due: 
15 Mar 2024

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