While neuroendocrine tumors (NETs) are described as a rare cancer (with only 200,000 cases treated nationally), it is not a rare cancer here.
Penn Medicine's Abramson Cancer Center has been treating patients with intestinal and pancreatic neuroendocrine tumors (GEP-NETs), paragangliomas and pheochromocytomas for over 20 years.
As the only academic medical center in the United States with a unified program, NETs is always on our minds — from advancing clinical care and leading clinical trials to supporting our local NET advocacy groups.
With former program director Dr. David Metz, MD, recent retirement, the Neuroendocrine Cancer Program has had a seamless transition under the direction of nationally-known medical oncologist, Jennifer Eads, MD. A national leader in the area of NETs, Dr. Eads oversees gastrointestinal (GI) cancer clinical trials, which includes NET clinical trials and patient care for the NET program. Alongside Dr. Eads are multiple physician experts with a broad range of clinical expertise, making up the multidisciplinary NET team. Key representatives include Dr. Michael Soulen (interventional radiology), Dr. Daniel Pryma (nuclear medicine), Dr. Debbie Cohen (nephrology), Dr. Robert Roses (surgical oncology), Dr. Katherine Nathanson (genetics) among others.
Meet Dr. Eads
Dr. Eads has served on the Neuroendocrine guidelines panel for the National Comprehensive Cancer Network (NCCN) and is involved with the Eastern Cooperative Oncology Group (ECOG) GI committee, where she serves as the working group leader for neuroendocrine tumors. She also serves on the board of directors for the North American Neuroendocrine Tumor Society (NANETS).
Q&A With Dr. Eads:
Can you give some background on why you went into oncology, with a specialty in NETs?
Honestly, becoming a NET expert was a little bit of an accident. I originally wanted to be a gastroenterologist, but then discovered my love for oncology as a resident in internal medicine. During fellowship. I came to realize that it was possible to marry the two by becoming a medical oncologist with a focus on gastrointestinal malignancies. The focus on neuroendocrine tumors happened as a result of several opportunities presenting themselves which ultimately led me down the neuroendocrine path. I'm so happy that it did as it is a great group of physicians and patients to interact with.
What is the most interesting or rewarding thing about working with NET patients?
One really great thing about working with neuroendocrine patients is that it is often somewhat of a chronic cancer so I am able to get to know my patients quite well over time and establish long standing relationships. With the multitude of treatment options that have become available over the past years, it is also nice to be able to offer a variety of options to patients.
Types of NETs
Neuroendocrine tumors are a rare, heterogeneous group of malignancies that originate in the cells of the neuroendocrine system. First described in the 1870s, NETs have since gathered a unique etymology.
- NETs occurring in the gastrointestinal tract and pancreas are known as gastroenteropancreatic neuroendocrine tumors (GEP-NETs)
- GEP-NETS and NETS in the lungs are also known as carcinoids
- Carcinoid syndrome occurs when the tumor produces the hormone serotonin, thereby producing a constellation of symptoms including diarrhea, flushing and sometimes pulmonary symptoms and cardiac problems
- NETS of whatever origin or type can be either functional or nonfunctional, depending upon their capacity to emit hormones
- Pheochromocytomas (PHEOs) are tumors that originate from unregulated growth of neuroendocrine chromaffin cells, and occur in the adrenal glands
- When tumors originating in the neuroendocrine chromaffin cells appear outside of the adrenal glands, they are known as paragangliomas (PARAs). Both PHEOs and PARAs are rarer than carcinoids, and most are noncancerous
Penn Medicine's NET Team: Helping NET Patients Navigate a Complex Diagnosis
Having a GEP-NET diagnosis is a complex, ongoing disease that is best treated by a multi-specialty team. Depending on their current and future medical needs, patients personalized team may include specialists in: genetics, cardiology, endocrine and ENT surgery, endocrinology, interventional radiology, medical oncology, nephrology, nuclear medicine, radiation oncology, pathology, and pediatrics.
To ensure we are providing the best possible care and support to patients, the NET program:
- Holds weekly tumor board reviews with the multi-disciplinary team
- Hosts the Annual Focus on Neuroendocrine Tumors Patient Conference (watch our 10th Annual Conference video)
- Offers a monthly virtual support group for patients and families, which is always attended by a Penn NET specialist
Learn more about neuroendocrine tumors and what to expect at the Abramson Cancer Center