Questions About Cancer? 1-800-4-CANCER

Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®)

Patient Version
Last Modified: 02/06/2012

Treatment Options for Pancreatic Neuroendocrine Tumors

Gastrinoma
Insulinoma
Glucagonoma
Other Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)
Recurrent or Progressive Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Gastrinoma

Treatment of gastrinoma may include supportive care 1 and the following:

  • For symptoms caused by too much stomach acid, treatment may be a drug that decreases the amount of acid made by the stomach.

  • For a single tumor in the head of the pancreas:
    • Surgery to remove the tumor.
    • Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid.
    • Surgery to remove the whole stomach (rare).

  • For a single tumor in the body or tail of the pancreas, treatment is usually surgery to remove the body or tail of the pancreas.

  • For several tumors in the pancreas, treatment is usually surgery to remove the body or tail of the pancreas. If tumor remains after surgery, treatment may include either:
    • Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid; or
    • Surgery to remove the whole stomach (rare).

  • For one or more tumors in the duodenum (the part of the small intestine that connects to the stomach), treatment is usually pancreatoduodenectomy (surgery to remove the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct).

  • If no tumor is found, treatment may include the following:
    • Surgery to cut the nerve that causes stomach cells to make acid and treatment with a drug that decreases stomach acid.
    • Surgery to remove the whole stomach (rare).

  • If the cancer has spread to the liver, treatment may include:

  • If cancer has spread to other parts of the body or does not get better with surgery or drugs to decrease stomach acid, treatment may include:

  • If the cancer mostly affects the liver and the patient has severe symptoms from hormones or from the size of tumor, treatment may include:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with gastrinoma 2. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 3.

Insulinoma

Treatment of insulinoma may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with insulinoma 4. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 3.

Glucagonoma

Treatment may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with glucagonoma 5. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 3.

Other Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

For VIPoma, treatment may include the following:

For somatostatinoma, treatment may include the following:

  • Surgery to remove the tumor.
  • For tumors that have spread to distant parts of the body, surgery to remove as much of the tumor as possible to relieve symptoms and improve quality of life.
  • For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following:
    • Chemotherapy.
    • Targeted therapy.

Treatment of other types of pancreatic neuroendocrine tumors (NETs) may include the following:

  • Surgery to remove the tumor.
  • For tumors that have spread to distant parts of the body, surgery to remove as much of the tumor as possible or hormone therapy to relieve symptoms and improve quality of life.
  • For tumors that continue to grow during treatment or have spread to other parts of the body, treatment may include the following:
    • Chemotherapy.
    • Targeted therapy.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with islet cell tumor 6. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 3.

Recurrent or Progressive Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)

Treatment of pancreatic neuroendocrine tumors (NETs) that continue to grow during treatment or recur (come back) may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent islet cell carcinoma 7. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 3.



Glossary Terms

ablation (a-BLAY-shun)
In medicine, the removal or destruction of a body part or tissue or its function. Ablation may be performed by surgery, hormones, drugs, radiofrequency, heat, or other methods.
acid (A-sid)
A chemical that gives off hydrogen ions in water and forms salts by combining with certain metals. Acids have a sour taste and turn certain dyes red. Some acids made by the body, such as gastric acid, can help organs work the way they should. An example of an acid is hydrochloric acid. Acidity is measured on a scale called the pH scale. On this scale, a value of 7 is neutral, and a pH value of less than 7 to 0 shows increasing acidity.
bile duct (bile dukt)
A tube through which bile passes in and out of the liver.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
chemoembolization (KEE-moh-EM-boh-lih-ZAY-shun)
A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
combination chemotherapy (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee)
Treatment using more than one anticancer drug.
cryosurgery (KRY-oh-SER-juh-ree)
A procedure in which tissue is frozen to destroy abnormal cells. Liquid nitrogen or liquid carbon dioxide is used to freeze the tissue. Also called cryoablation and cryosurgical ablation.
distal pancreatectomy (DIS-tul PAN-kree-uh-TEK-toh-mee)
Removal of the body and tail of the pancreas.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
duodenum (DOO-ah-DEE-num)
The first part of the small intestine that connects to the stomach.
electrolyte (ee-LEK-troh-lite)
A substance that breaks up into ions (particles with electrical charges) when it is dissolved in water or body fluids. Some examples of ions are sodium, potassium, calcium, chloride, and phosphate. These ions help move nutrients into cells, help move waste out of cells, and help nerves, muscles, the heart, and the brain work the way they should.
fluid (FLOO-id)
A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.
gallbladder (GAWL-bla-der)
The pear-shaped organ found below the liver. Bile is concentrated and stored in the gallbladder.
gastrinoma (gas-trih-NOH-muh)
A tumor that causes overproduction of gastric acid. It usually begins in the duodenum (first part of the small intestine that connects to the stomach) or the islet cells of the pancreas. Rarely, it may also begin in other organs, including the stomach, liver, jejunum (the middle part of the small intestine), biliary tract (organs and ducts that make and store bile), mesentery, or heart. It is a type of neuroendocrine tumor, and it may metastasize (spread) to the liver and the lymph nodes.
hepatic arterial occlusion (heh-PA-tik ar-TEER-ee-ul uh-KLOO-zhun)
A block in blood flow to the liver. It can happen while giving chemotherapy through a catheter in the hepatic artery. Sometimes doctors use drugs or other agents to cause hepatic arterial occlusion on purpose. This block of blood flow to the liver helps kill cancer cells growing in the liver.
hormone (HOR-mone)
One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
hormone therapy (HOR-mone THAYR-uh-pee)
Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy, and hormone treatment.
insulin (IN-suh-lin)
A hormone made by the islet cells of the pancreas. Insulin controls the amount of sugar in the blood by moving it into the cells, where it can be used by the body for energy.
insulinoma (IN-suh-lih-NOH-muh)
An abnormal mass that grows in the beta cells of the pancreas that make insulin. Insulinomas are usually benign (not cancer). They secrete insulin and are the most common cause of low blood sugar caused by having too much insulin in the body. Also called beta cell neoplasm, beta cell tumor of the pancreas, and pancreatic insulin-producing tumor.
liver (LIH-ver)
A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
liver metastasis (LIH-ver meh-TAS-tuh-sis)
Cancer that has spread from the original (primary) tumor to the liver.
lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
nerve (nerv)
A bundle of fibers that receives and sends messages between the body and the brain. The messages are sent by chemical and electrical changes in the cells that make up the nerves.
neuroendocrine tumor (NOOR-oh-EN-doh-krin TOO-mer)
A tumor that forms from cells that release hormones in response to a signal from the nervous system. Some examples of neuroendocrine tumors are carcinoid tumors, islet cell tumors, medullary thyroid carcinomas, pheochromocytomas, and neuroendocrine carcinomas of the skin (Merkel cell cancer). These tumors may secrete higher-than-normal amounts of hormones, which can cause many different symptoms.
palliative therapy (PA-lee-uh-tiv THAYR-uh-pee)
Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.
pancreas (PAN-kree-us)
A glandular organ located in the abdomen. It makes pancreatic juices, which contain enzymes that aid in digestion, and it produces several hormones, including insulin. The pancreas is surrounded by the stomach, intestines, and other organs.
pancreatic (PAN-kree-A-tik)
Having to do with the pancreas.
pancreatoduodenectomy (PAN-kree-uh-toh-DOO-ah-deh-NEK-toh-mee)
A type of surgery used to treat pancreatic cancer. The head of the pancreas, the duodenum, a portion of the stomach, and other nearby tissues are removed. Also called Whipple procedure.
quality of life (KWAH-lih-tee ... life)
The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.
radiofrequency ablation (RAY-dee-oh-FREE-kwen-see a-BLAY-shun)
A procedure that uses radio waves to heat and destroy abnormal cells. The radio waves travel through electrodes (small devices that carry electricity). Radiofrequency ablation may be used to treat cancer and other conditions.
recur (ree-KER)
To come back or to return.
regional chemotherapy (REE-juh-nul KEE-moh-THAYR-uh-pee)
Treatment with anticancer drugs directed to a specific area of the body.
small intestine (... in-TES-tin)
The part of the digestive tract that is located between the stomach and the large intestine.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stomach (STUH-muk)
An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
systemic chemotherapy (sis-TEH-mik KEE-moh-THAYR-uh-pee)
Treatment with anticancer drugs that travel through the blood to cells all over the body.
targeted therapy (TAR-geh-ted THAYR-uh-pee)
A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.
therapy (THAYR-uh-pee)
Treatment.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

Table of Links

1http://www.cancer.gov/cancertopics/pdq/treatment/isletcell/Patient/Page4#Sectio
n_203
2http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38718&tt=1&a
mp;format=1&cn=1
3http://www.cancer.gov/clinicaltrials
4http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38792&tt=1&a
mp;format=1&cn=1
5http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38989&tt=1&a
mp;format=1&cn=1
6http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=550688&tt=1&
amp;format=1&cn=1
7http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=38794&tt=1&a
mp;format=1&cn=1