The treatment you have for a lung neuroendocrine tumour (NET) depends on a number of things. This includes the type of NET, where the tumour is, its size and whether it has spread (the stage).
NETs grow at different rates, but they often grow very slowly. Some might not grow at all for months or years. So you might not need treatment straight away. Your doctor might just keep an eye on it with regular tests.
Deciding which treatment you need
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).
The treatment you have depends on:
- where the lung NET started (the primary tumour)
- the type of lung NET
- whether it has spread
- how the cells look under the microscope (the grade)
- the symptoms you have
You are likely to have a clinical nurse specialist (or CNS). They go to the MDT meetings. They can help answer your questions and support you. They are often your main point of contact throughout your treatment.
Treatment for typical and atypical lung carcinoids
The main treatment for typical carcinoid (TC) and atypical lung carcinoid (AC) is surgery.
You may also have one or more of the following treatments:
- somatostatin analogues
- a targeted drug called everolimus
The type of surgery you have depends on the size of the cancer, where it is in the lung and whether it has spread.
Your surgeon might remove:
- a section (lobe) of the lung (lobectomy)
- an area of the lung along with the veins, arteries and airways (segmentectomy)
- the whole lung (pneumonectomy)
- nearby lymph nodes (lymphadenectomy)
Surgery is usually the only treatment you need to cure most lung carcinoids.
Remember to click back to return to the neuroendocrine tumour section. The rest of the information in the lung cancer treatment section will not apply to you.
You may have treatment with somatostatin analogues such as octreotide and lanreotide. These are proteins that can help with symptoms.
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You may have it if you have a typical or atypical carcinoid that is likely to grow quickly and you can’t have other types of treatment.
You might have treatment with temozolomide, oxaliplatin, or a combination of cisplatin and etoposide.
Everolimus stops a protein called mTOR from working properly. It can help to stop or slow down the growth of lung NETs.
You may have everolimus if you have typical or atypical carcinoid that has spread to other parts of the body.
You might have other treatments if your lung NET has spread to the liver. This includes:
- chemoembolisation (TACE)
- a type of internal radiotherapy called PRRT
Treatment for large cell neuroendocrine carcinoma (LCNEC)
You usually have surgery for an early stage LCNEC. This means that the cancer is small and hasn’t spread. You usually have an operation to remove the part of the lung that contains the cancer (a lobectomy). You usually have chemotherapy afterwards and might also have radiotherapy.
You have chemotherapy if your cancer is more advanced. You usually have a combination of chemotherapy drugs such as etoposide and either cisplatin or carboplatin.
This is the same treatment as for small cell lung cancer (SCLC).
Treatment for small cell lung cancer (SCLC)
The main treatment is chemotherapy and radiotherapy together (chemoradiotherapy). You usually have chemotherapy drugs such as:
- etoposide and either cisplatin or carboplatin
- irinotecan and cisplatin
- gemcitabine and carboplatin
You may have surgery followed by chemotherapy if you have a very small cancer that hasn’t spread.
Doctors are always trying to improve treatments, and reduce side effects. As part of your treatment, your doctor might ask you to take part in a clinical trial. This might be to test a new treatment or to look at different combinations of existing treatments.