Types of surgery for neuroendocrine cancer

Your surgeon might be able to completely remove an early cancer that hasn't spread. For some neuroendocrine cancer, surgery is the only treatment you need. 

Surgery can also be an option for neuroendocrine cancer that has spread. 

There are different ways of doing surgery, and different types of operation. Your team will tell you about your surgery and what it involves.

Aims 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 aim of surgery and the type of surgery you have depends on your situation. Factors your team consider include:

• where the neuroendocrine cancer is
• the type of neuroendocrine cancer
• the size and whether it has spread (stage)
• your symptoms
• your general health and fitness
• the side effects of the operation

There are different aims of surgery:

To completely remove your cancer
Your surgeon might be able to completely remove an early cancer that hasn't spread. For many people, this cures their cancer. Doctors call this curative surgery.

To remove as much cancer as possible
Your surgeon may not be able to remove all the cancer. But they might remove as much as possible. This can help with symptoms. You might have this alongside other treatments. Doctors call this debulking surgery.

To help with symptoms
You sometimes have surgery to remove cancer that has spread to you liver. Or you might have surgery to bypass cancer that is causing a blockage in your digestive system . The aim of this surgery is to control the cancer and to help with symptoms. Doctors call this palliative surgery.

How you have surgery

Your team will tell you about your type of surgery. This will include information about the length of hospital stay, risks and recovery time. There are different ways of doing surgery. Sometimes surgeons combine these:

• Open surgery means the surgeon makes a large cut (incision) through the skin.
• Keyhole or laparoscopic surgery means the surgeon makes several small cuts through the skin. They use a laparoscope to look inside your body and remove tissue through the cuts.
• Robotic surgery means the surgeon uses a robotic machine to help with keyhole surgery.
• Endoscopic surgery means the surgeon removes or destroys tissue through a tube (endoscope). They pass the tube into your body, usually through your mouth or back passage (rectum).

Types of surgery

Surgery for lung neuroendocrine cancer

Surgery is the main treatment for typical carcinoid (TC) and atypical carcinoid (AC). These are types of lung neuroendocrine tumours (NETs). You might also have surgery for large cell neuroendocrine carcinoma (NEC) that hasn't spread.

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).

Surgery for pancreatic neuroendocrine cancers

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

• just the cancer - this is called enucleation

• the part of the pancreas where the cancer is

• part of the pancreas and some nearby organs such as the gallbladder

• 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 neuroendocrine cancers of your digestive system

The digestive system includes the:

• stomach

• small and large bowel

• back passage (rectum)

For small early stage cancers
You often have keyhole or laparoscopic surgery. 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. They use the instruments to remove the cancer. 

For large cancers
You are more likely to have open surgery. This means your surgeon makes one long cut down your abdomen to remove the cancer. 

Other treatments

There are other types of treatment 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 cancer 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.