Chemotherapy for neuroendocrine cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout your body in the bloodstream.

Chemotherapy is a common treatment for neuroendocrine carcinomas (NECs). You might also have it if you have a neuroendocrine tumour (NET) that has spread or come back. 

You might have a combination of different chemotherapy drugs. You can have chemotherapy into a vein or as tablets, depending on the drug.

We have further information about the chemotherapy drugs on this page. You can select the name of your drug or treatment combination on our A-Z list of cancer drugs.

When do you have chemotherapy for neuroendocrine cancer?

Your treatment plan depends on what type of neuroendocrine cancer you have. 

Neuroendocrine tumours (NETs)

You might have chemotherapy for a NET that has spread to other parts of the body. Or if you can't have surgery to remove the NET. You usually have it when other treatments are no longer working.

Neuroendocrine carcinoma (NEC)

For NEC you usually have chemotherapy as part of your main treatment. You might have it combined with other treatments such as radiotherapy or surgery.

Types of chemotherapy for neuroendocrine cancer

There are a number of different chemotherapy drugs. You usually have a combination of drugs. The type of chemotherapy drugs you have depends on different things. This includes whether you have a neuroendocrine tumour (NET) or neuroendocrine carcinoma (NEC).

For a NET there are different chemotherapy options including:

• temozolomide
• fluorouracil or capecitabine
• streptozotocin
• oxaliplatin

For an NEC you might have some of the following drugs together:

• carboplatin or cisplatin
• etoposide
• irinotecan

How you have chemotherapy

You usually take chemotherapy in treatment cycles. This means you have the drug for a set period, followed by a break. For example, you might take a drug every day for a week and then not take it for 2 weeks. This 3 week period in total is one cycle of treatment.

The break from treatment is important too. For many cancer drugs, it allows your body to recover. 

You might have chemotherapy:

• into your bloodstream - this is intravenous chemotherapy
• by mouth as tablets or capsules

Into your bloodstream

You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.

Taking your tablets or capsules

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

Side effects

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

Side effects depend on:

• which drugs you have

• how much of each drug you have

• how you react

Tell your treatment team about any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements
• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

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.