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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK549108_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK549108_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK549108_"><span class="title" itemprop="name">Childhood Gastrointestinal Neuroendocrine Tumors Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Pediatric Treatment Editorial Board</span>.</p><p class="small">Published online: December 13, 2024.</p><p class="small">Created: <span itemprop="datePublished">October 25, 2019</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000798747__1">This PDQ cancer information summary has current information about the treatment of childhood gastrointestinal neuroendocrine tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000798747__2">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.</p></div><div id="CDR0000798747__6"><h2 id="_CDR0000798747__6_">General Information About Childhood Gastrointestinal Neuroendocrine Tumors</h2><div id="CDR0000798747__6.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000798747__7">A gastrointestinal neuroendocrine tumor forms in neuroendocrine cells in the lining of the digestive tract, appendix, and other organs in the abdomen.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__13">Signs and symptoms of gastrointestinal neuroendocrine tumors depend on where the tumor forms.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__20">Tests that examine the digestive tract, liver, and pancreas are used to diagnose gastrointestinal neuroendocrine tumors.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__24">Certain factors affect prognosis (chance of recovery).</a></div></li></ul></div><div id="CDR0000798747__7"><h3>A gastrointestinal neuroendocrine tumor forms in neuroendocrine cells in the lining of the digestive tract, appendix, and other organs in the abdomen.</h3><p id="CDR0000798747__9"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000810445/" class="def">Gastrointestinal neuroendocrine tumors</a> (also called gastrointestinal carcinoid tumors) form from a certain type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045803/" class="def">neuroendocrine</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cell</a> (a type of cell that is like a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269443/" class="def">nerve cell</a> and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormone</a>-making cell). These cells are scattered throughout the chest and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, but most are found in certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> in the abdomen. Neuroendocrine cells in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046447/" class="def">digestive tract</a> make hormones that help control digestive juices and the muscles used in moving food through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a>.</p><p id="CDR0000798747__10">Most gastrointestinal neuroendocrine tumors in children form in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044753/" class="def">appendix</a> (a pouch that sticks out from the first part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045097/" class="def">large intestine</a> near the end of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a>). The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is often found during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> to remove the appendix. They also form in the digestive tract (lining of the stomach or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a>), <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>.</p><p id="CDR0000798747__96">These tumors are usually small, slow-growing, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045614/" class="def">benign</a> (not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>). Some tumors may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> (cancer) and spread to other places in the body.</p><div id="CDR0000798747__103" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Gastrointestinal%20neuroendocrine%20tumors%20form%20in%20the%20lining%20of%20the%20gastrointestinal%20tract%20and%20other%20organs%20in%20the%20abdomen&p=BOOKS&id=610387_CDR0000805506.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK549108/bin/CDR0000805506.jpg" alt="Drawing of the gastrointestinal tract showing the liver, stomach, pancreas, small intestine, colon, and appendix." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Gastrointestinal neuroendocrine tumors form in the lining of the gastrointestinal tract and other organs in the abdomen. Most gastrointestinal neuroendocrine tumors in children form in the appendix, but they can also form in the stomach, intestines, pancreas, and liver.</p></div></div></div><div id="CDR0000798747__13"><h3>Signs and symptoms of gastrointestinal neuroendocrine tumors depend on where the tumor forms.</h3><p id="CDR0000798747__15">Check with your child's doctor if you are concerned about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> that may be caused by gastrointestinal neuroendocrine tumors or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>.</p><p id="CDR0000798747__16"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044904/" class="def">Neuroendocrine tumors</a> in the appendix may cause the following signs and symptoms:</p><ul id="CDR0000798747__17"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046684/" class="def">Abdominal</a> pain, especially on the lower right side of the abdomen.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">Fever</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">Diarrhea</a>.</div></li></ul><p id="CDR0000798747__18"> Gastrointestinal neuroendocrine tumors that are not in the appendix may release hormones and other substances. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000339609/" class="def">Carcinoid syndrome</a> occurs when a neuroendocrine tumor in the digestive tract releases the hormone <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335511/" class="def">serotonin</a> and other substances. It may cause any of the following signs and symptoms. Check with your child’s doctor if your child has any of the following:</p><ul id="CDR0000798747__19"><li class="half_rhythm"><div>Redness and a warm feeling in the face, neck, and upper chest.</div></li><li class="half_rhythm"><div>A fast heartbeat.</div></li><li class="half_rhythm"><div>Trouble breathing.</div></li><li class="half_rhythm"><div>Sudden drop in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000462668/" class="def">blood pressure</a> (restlessness, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450096/" class="def">confusion</a>, weakness, dizziness, and pale, cool, and clammy skin).</div></li><li class="half_rhythm"><div>Diarrhea.</div></li></ul></div><div id="CDR0000798747__20"><h3><div class="milestone-start" id="CDR0000798747__21"></div>Tests that examine the digestive tract, liver, and pancreas are used to diagnose gastrointestinal neuroendocrine tumors.<div class="milestone-end"></div></h3><p id="CDR0000798747__22">The following tests and procedures may be used:</p><ul id="CDR0000798747__23"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798522/" class="def">health history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304685/" class="def">Blood chemistry studies</a></b>: A procedure in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> sample is checked to measure the amounts of certain substances released into the blood by organs and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic resonance imaging)</b>: A procedure that uses a magnet and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a> to make a series of detailed pictures of areas inside the body. The pictures are made by a computer. This procedure is also called nuclear magnetic resonance imaging (NMRI).<div id="CDR0000798747__91" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Magnetic%20resonance%20imaging%20(MRI)%20scan&p=BOOKS&id=610387_CDR0000775532.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK549108/bin/CDR0000775532.jpg" alt="Magnetic resonance imaging (MRI) scan; drawing shows a child lying on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Magnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> tumor cells in the body. A small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.<div id="CDR0000798747__92" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Positron%20emission%20tomography%20(PET)%20scan&p=BOOKS&id=610387_CDR0000775456.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK549108/bin/CDR0000775456.jpg" alt="Positron emission tomography (PET) scan; drawing shows a child lying on table that slides through the PET scanner." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Positron emission tomography (PET) scan. The child lies on a table that slides through the PET scanner. The head rest and white strap help the child lie still. A small amount of radioactive glucose (sugar) is injected into the child's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do. </p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.<div id="CDR0000798747__93" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Computed%20tomography%20(CT)%20scan&p=BOOKS&id=610387_CDR0000775531.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK549108/bin/CDR0000775531.jpg" alt="Computed tomography (CT) scan; drawing shows a child lying on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Computed tomography (CT) scan. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body.</p></div></div></div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046157/" class="def">Ultrasound</a> exam</b>: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonogram</a>. The picture can be printed to be looked at later.<div id="CDR0000798747__94" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Abdominal%20ultrasound&p=BOOKS&id=610387_CDR0000775457.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK549108/bin/CDR0000775457.jpg" alt="Abdominal ultrasound; drawing shows a child lying on an exam table during an abdominal ultrasound procedure. A technician is shown pressing a transducer (a device that makes sound waves that bounce off tissues inside the body) against the skin of the abdomen. A computer screen shows a sonogram (picture)." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Abdominal ultrasound. An ultrasound transducer connected to a computer is pressed against the skin of the abdomen. The transducer bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).</p></div></div></div></li><li class="half_rhythm"><div><b>Twenty-four-hour <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> test</b>: A test in which urine is collected for 24 hours to measure the amounts of certain substances, such as hormones. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. The urine sample is checked to see if it contains <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000798773/" class="def">5-HIAA</a> (a breakdown product of the hormone serotonin which may be made by neuroendocrine tumors). This test is used to help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> carcinoid syndrome.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390250/" class="def">Somatostatin receptor scintigraphy</a></b>: A type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046552/" class="def">radionuclide scan</a> that may be used to find tumors. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045141/" class="def">octreotide</a> (a hormone that attaches to tumors) is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> and travels through the blood. The radioactive octreotide attaches to the tumor and a special camera that detects radioactivity is used to show where the tumors are in the body. This procedure is also called octreotide scan and SRS.
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</div></li></ul></div><div id="CDR0000798747__24"><h3>Certain factors affect prognosis (chance of recovery).</h3><p id="CDR0000798747__26"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">Prognosis</a> depends on the following:</p><ul id="CDR0000798747__27"><li class="half_rhythm"><div>Where the tumor first formed in the body.</div></li><li class="half_rhythm"><div>The size of the tumor.</div></li><li class="half_rhythm"><div>Whether the tumor has spread to other parts of the body.</div></li><li class="half_rhythm"><div>Whether the tumor is newly diagnosed or has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back).</div></li></ul><p id="CDR0000798747__28">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> for neuroendocrine tumors in the appendix in children is usually excellent after surgery to remove the tumor. Gastrointestinal neuroendocrine tumors that are not in the appendix are usually larger or have spread to other parts of the body at the time of diagnosis and do not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044085/" class="def">respond</a> well to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>. Larger tumors are more likely to recur (come back).</p></div></div><div id="CDR0000798747__29"><h2 id="_CDR0000798747__29_">Stages of Gastrointestinal Neuroendocrine Tumors</h2><div id="CDR0000798747__29.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000798747__30">After a gastrointestinal neuroendocrine tumor has been diagnosed, tests are done to find out if cancer cells have spread to nearby areas or to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__33">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__35">Cancer may spread from where it began to other parts of the body. </a></div></li></ul></div><div id="CDR0000798747__30"><h3>After a gastrointestinal neuroendocrine tumor has been diagnosed, tests are done to find out if cancer cells have spread to nearby areas or to other parts of the body.</h3><p id="CDR0000798747__32">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread to nearby areas or other parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. There is no standard <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689095/" class="def">staging system</a> for childhood <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000810445/" class="def">gastrointestinal neuroendocrine tumors</a>. </p><p id="CDR0000798747__102"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044904/" class="def">Neuroendocrine tumors</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044753/" class="def">appendix</a> are not known to spread, but other gastrointestinal neuroendocrine tumors may spread. The results of <a href="#CDR0000798747__21">tests and procedures</a> done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> gastrointestinal neuroendocrine tumors are used to help make decisions about treatment.</p><p id="CDR0000798747__101">Sometimes childhood gastrointestinal neuroendocrine tumors <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recur</a> (come back) after treatment.</p></div><div id="CDR0000798747__33"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000798747__33_md_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000798747__33_md_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
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</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
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</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
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</div></li></ul></div><div id="CDR0000798747__35"><h3>Cancer may spread from where it began to other parts of the body. </h3><p id="CDR0000798747__35_md_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer cells break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000798747__35_md_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000798747__38">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is the same type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>. For example, if neuroendocrine tumor cells in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a> spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, the cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the liver are actually neuroendocrine tumor cells. The cells in the liver are metastatic neuroendocrine tumor cells, not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044242/" class="def">liver cancer</a>.</p><div id="CDR0000798747__95" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div></div><div id="CDR0000798747__41"><h2 id="_CDR0000798747__41_">Treatment Option Overview</h2><div id="CDR0000798747__41.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000798747__42">There are different types of treatment for children with gastrointestinal neuroendocrine tumors.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__44">Children with gastrointestinal neuroendocrine tumors not in the appendix should have their treatment planned by a team of doctors who are experts in treating childhood cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__48">Five types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000798747__50">Surgery</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__53">Embolization</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__56">Hormone therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__98">Peptide receptor radionuclide therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__59">Targeted therapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000798747__74">New types of treatment are being tested in clinical trials.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__77">Treatment of gastrointestinal neuroendocrine tumors may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__82">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__84">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000798747__86">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000798747__42"><h3>There are different types of treatment for children with gastrointestinal neuroendocrine tumors.</h3><p id="CDR0000798747__42_md_79">Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.</p><p id="CDR0000798747__42_md_80">Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000798747__44"><h3>Children with gastrointestinal neuroendocrine tumors not in the appendix should have their treatment planned by a team of doctors who are experts in treating childhood cancer.</h3><p id="CDR0000798747__46">Treatment will be overseen by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000693555/" class="def">pediatric oncologist</a>, a doctor who specializes in treating children with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. The pediatric oncologist works with other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046245/" class="def">pediatric</a> health professionals who are experts in treating children with cancer and who specialize in certain areas of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicine</a>. This may include the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478785/" class="def">specialists</a> and others:</p><ul id="CDR0000798747__47"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000757278/" class="def">Pediatrician</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318823/" class="def">Pediatric surgeon</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">Pathologist</a>.</div></li><li class="half_rhythm"><div>Pediatric <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046439/" class="def">endocrinologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318821/" class="def">Pediatric nurse specialist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044730/" class="def">Social worker</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318825/" class="def">Rehabilitation specialist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044716/" class="def">Psychologist</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000690737/" class="def">Child-life specialist</a>.</div></li></ul></div><div id="CDR0000798747__48"><h3><div class="milestone-start" id="CDR0000798747__49"></div>Five types of standard treatment are used:<div class="milestone-end"></div></h3><div id="CDR0000798747__50"><h4>Surgery</h4><p id="CDR0000798747__52"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is the only treatment needed for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044904/" class="def">neuroendocrine tumors</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044753/" class="def">appendix</a>.</p></div><div id="CDR0000798747__53"><h4>Embolization</h4><p id="CDR0000798747__55"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046436/" class="def">Embolization</a> is a treatment in which <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">contrast dye</a> and particles are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044563/" class="def">hepatic artery</a> through a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> (thin tube). The particles block the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440100/" class="def">artery</a>, cutting off <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a> flow to the tumor. Sometimes a small amount of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance is attached to the particles. Most of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> is trapped near the tumor to kill the cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>. This is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000644772/" class="def">radioembolization</a>.</p></div><div id="CDR0000798747__56"><h4>Hormone therapy</h4><p id="CDR0000798747__58"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> with a somatostatin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044919/" class="def">analogue</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045141/" class="def">octreotide</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767370/" class="def">lanreotide</a>) may be used to treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000810445/" class="def">gastrointestinal neuroendocrine tumors</a> that have spread or cannot be removed by surgery. This treatment stops extra <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a> from being made by the neuroendocrine tumor. Octreotide or lanreotide are somatostatin analogues which are injected under the skin or into the muscle.</p></div><div id="CDR0000798747__98"><h4>Peptide receptor radionuclide therapy</h4><p id="CDR0000798747__100">Sometimes a small amount of a radioactive substance is attached to the somatostatin analogue <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> octreotide or lanreotide to kill the cancer cells.</p></div><div id="CDR0000798747__59"><h4>Targeted therapy</h4><p id="CDR0000798747__61"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> do.</p><ul id="CDR0000798747__73"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">Tyrosine kinase inhibitors</a>: These targeted therapy drugs block signals needed for tumors to grow. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000468779/" class="def">Sunitinib</a> is used to treat gastrointestinal neuroendocrine tumors that are not in the appendix.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mTOR inhibitors</a>: A type of targeted therapy that stops the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> that helps cells divide and survive. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">Everolimus</a> is used to treat gastrointestinal neuroendocrine tumors that are not in the appendix.</div></li></ul></div></div><div id="CDR0000798747__74"><h3>New types of treatment are being tested in clinical trials.</h3><p id="CDR0000798747__76">Information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a> is available from the <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000798747__77"><h3>Treatment of gastrointestinal neuroendocrine tumors may cause side effects.</h3><p id="CDR0000798747__77_md_76">To learn more about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> that begin during treatment for cancer, visit <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a>.</p><p id="CDR0000798747__79"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">Side effects</a> from cancer treatment that begin after treatment and continue for months or years are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390292/" class="def">late effects</a>. Late effects of cancer treatment may include:</p><ul id="CDR0000798747__80"><li class="half_rhythm"><div>Physical problems.</div></li><li class="half_rhythm"><div>Changes in mood, feelings, thinking, learning, or memory.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046658/" class="def">Second cancers</a> (new types of cancer) or other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>.</div></li></ul><p id="CDR0000798747__81">Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. See the PDQ summary on <a href="/books/n/pdqcis/CDR0000373791/">Late Effects of Treatment for Childhood Cancer</a> for more information.</p></div><div id="CDR0000798747__82"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000798747__82_md_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000798747__82_md_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000798747__82_md_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000798747__84"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000798747__84_md_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000798747__84_md_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000798747__86"><h3>Follow-up tests may be needed.</h3><p id="CDR0000798747__86_md_55">As your child goes through treatment, they will have follow-up tests or check-ups. Some tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000798747__86_md_56">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back). </p></div></div><div id="CDR0000798747__62"><h2 id="_CDR0000798747__62_">Treatment of Gastrointestinal Neuroendocrine Tumors</h2><p id="CDR0000798747__63">For information about the treatments listed below, see the <a href="#CDR0000798747__49">Treatment Option Overview</a> section.</p><p id="CDR0000798747__64">Treatment of newly <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044904/" class="def">neuroendocrine tumors</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044753/" class="def">appendix</a> in children may include the following:</p><ul id="CDR0000798747__65"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the appendix.</div></li></ul><p id="CDR0000798747__66">Treatment of newly diagnosed neuroendocrine tumors in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045097/" class="def">large intestine</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> is usually surgery.</p><p id="CDR0000798747__97">Treatment of newly diagnosed tumors that cannot be removed by surgery, multiple tumors, or tumors that have spread may include the following:</p><ul id="CDR0000798747__67"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046436/" class="def">Embolization</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045110/" class="def">Hormone therapy</a> with a somatostatin <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044919/" class="def">analogue</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045141/" class="def">octreotide</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767370/" class="def">lanreotide</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000794423/" class="def">Peptide receptor radionuclide therapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> with a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000468779/" class="def">sunitinib</a>) or an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000753869/" class="def">mTOR inhibitor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386203/" class="def">everolimus</a>).</div></li></ul><p id="CDR0000798747__105">Sometimes childhood gastrointestinal neuroendocrine tumors can recur (come back) after treatment. Your child's doctor will work with you to plan treatment if your child is diagnosed with a recurrent gastrointestinal neuroendocrine tumor. </p><p id="CDR0000798747__TrialSearch_62_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000798747__88"><h2 id="_CDR0000798747__88_">To Learn More About Gastrointestinal Neuroendocrine Tumors</h2><p id="CDR0000798747__89">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000810445/" class="def">gastrointestinal neuroendocrine tumors</a>, see the following:</p><ul id="CDR0000798747__90"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/gi-carcinoid-tumors/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Gastrointestinal Carcinoid Tumors Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/ct-scans-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Computed Tomography (CT) Scans and Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Cancer Therapies</a>
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</div></li></ul><p id="CDR0000798747__88_md_44">For more childhood cancer information and other general cancer resources, visit:</p><ul id="CDR0000798747__88_md_45"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/childhood-cancers" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Childhood Cancers</a>
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</div></li><li class="half_rhythm"><div><a href="http://www.curesearch.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CureSearch for Children's Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000373791/">Late Effects of Treatment for Childhood Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/aya" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Adolescents and Young Adults with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/guide-for-parents" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Children with Cancer: A Guide for Parents</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer in Children and Adolescents</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors, Caregivers, and Advocates</a>
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</div></li></ul></div><div id="CDR0000798747__AboutThis_1"><h2 id="_CDR0000798747__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000798747__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000798747__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000798747__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000798747__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000798747__AboutThis_6">This PDQ cancer information summary has current information about the treatment of childhood gastrointestinal neuroendocrine tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000798747__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000798747__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000798747__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Pediatric Treatment Editorial Board</a>.
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</p></div><div id="CDR0000798747__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000798747__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000798747__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000798747__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000798747__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000798747__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000798747__AboutThis_21">PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Gastrointestinal Neuroendocrine Tumors Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/gi-neuroendocrine-tumors/patient/child-gi-neuroendocrine-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/gi-neuroendocrine-tumors/patient/child-gi-neuroendocrine-treatment-pdq</a>. Accessed <MM/DD/YYYY>. </p><p id="CDR0000798747__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000798747__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000798747__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000798747__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000798747__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK549108/?report=reader">PubReader</a></li><li><a href="/books/NBK549108/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK549108" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK549108" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Pediatric Treatment Editorial Board. Childhood Gastrointestinal Neuroendocrine Tumors Treatment (PDQ®): Patient Version. 2024 Dec 13. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm">NBK549108.6</span> December 13, 2024 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK549108.5/">NBK549108.5</a></span> December 22, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK549108.4/">NBK549108.4</a></span> June 25, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK549108.3/">NBK549108.3</a></span> December 22, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK549108.2/">NBK549108.2</a></span> July 10, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK549108.1/">NBK549108.1</a></span> October 25, 2019</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000798747__6" ref="log$=inpage&link_id=inpage">General Information About Childhood Gastrointestinal Neuroendocrine Tumors</a></li><li><a href="#CDR0000798747__29" ref="log$=inpage&link_id=inpage">Stages of Gastrointestinal Neuroendocrine Tumors</a></li><li><a href="#CDR0000798747__41" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000798747__62" ref="log$=inpage&link_id=inpage">Treatment of Gastrointestinal Neuroendocrine Tumors</a></li><li><a href="#CDR0000798747__88" ref="log$=inpage&link_id=inpage">To Learn More About Gastrointestinal Neuroendocrine Tumors</a></li><li><a href="#CDR0000798747__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK549122/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389212" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Gastrointestinal Neuroendocrine Tumors Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Gastrointestinal Neuroendocrine Tumors Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31661212" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Gastrointestinal Stromal Tumors Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span 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class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Chordoma (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389279" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Rhabdomyosarcoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer 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