Pancreatic neuroendocrine cancer
VIP stands for vasoactive intestinal peptide. VIP relaxes the muscles in the stomach and bowel. And it helps to control the balance of sugar, salt and water in the gastrointestinal (GI) tract.
VIPomas are a rare type of neuroendocrine tumour that usually develop in the .
Doctors sometimes group NETs depending on whether they make and release abnormal levels of hormones:
Non functioning NETs make and release normal levels of hormones.
Functioning NETs make and release abnormal levels of hormones.
They are also called gastro entero pancreatic neuroendocrine tumours (GEP NETs). Or pancreatic neuroendocrine tumours (pNETs).
The pancreas is part of our .
The pancreas is quite high up in the tummy (abdomen). It lies across your body where the ribs meet at the bottom of the breastbone, just behind your stomach. It is about 6 inches long (15 centimetres) and shaped like a leaf.
The pancreas has 3 parts:
the wide part is the head
the thin end is the tail
the part in the middle is the body
The pancreatic duct is a tube that collects the digestive juices made by the pancreas. It carries them into the first part of the small bowel (duodenum).
Around 90 out of every 100 VIPomas (around 90%) start in the pancreas. Most of these start in the tail of the pancreas.
More rarely, VIPomas can start in the:
lungs
bowel
liver
VIPomas can spread to other parts of the body. The most common places where VIPomas spread to are the liver and .
VIPomas are very rare. Less than 1 person in every million develop a VIPoma every year.
VIPomas make large amounts of the hormone VIP. VIP relaxes the muscles in the stomach and bowel. It also helps to control the balance of sugar, salt and water in the gastrointestinal (GI) tract.
Symptoms usually develop slowly. In most people, the tumour has already started to spread to other parts of the body by the time it is diagnosed.
You usually have symptoms caused by the increase in the amount of VIP in your body. Symptoms include loose or watery poo (diarrhoea) which can be severe.
Other symptoms might include:
dehydration
a low level of potassium in your blood
weight loss
flushing of the skin of your face, neck and chest
tummy pain
The diarrhoea can be severe. You might have large amounts of watery poo (stools). Some people need to go to the toilet more than 20 times a day. You can have diarrhoea even when you haven’t eaten beforehand.
Dehydration and low potassium can cause symptoms such as:
feeling thirsty
feeling weak and tired
headaches and feeling dizzy
weak muscles and muscle cramps
Verner Morrison syndrome is the name given to the collection of symptoms caused by having high levels of the hormone VIP. It’s also called:
VIPoma syndrome
pancreatic cholera
watery diarrhoea, hypokalaemia and hypochlorhydria or achlorhydria syndrome (WDHA)
If you have symptoms, you usually see your GP first. They might organise some tests. Your GP will decide if you need to see a specialist. They might refer you to a gastroenterology specialist. These doctors specialise in problems affecting the digestive system.
VIPomas are rare tumours. So your doctor might ask you to have tests that check for other conditions first.
If your doctor suspects cancer, you have tests to check the type of cancer you have. If tests show that you have a VIPoma, your specialist will refer you to a team of doctors and specialist nurses who have expertise in treating NETs
Find out more about seeing a specialist
Tests are to check the type of cancer you have. Tests also show the size of the cancer and whether it has spread. This helps your doctor plan your treatment.
Tests might include:
checking your blood VIP level - you mustn’t eat anything before this test
blood tests to check your general health and to check the levels of other substances raised by NETs
radioactive scans – these are octreotide scans (or ) and gallium PET scans
an of your tummy to look at your stomach, pancreas and and to take biopsies
You may have other tests depending on your symptoms. Your doctor will tell you which tests you need.
Read more about the tests you might have
The looks at a sample of VIPoma cells under a microscope. They look at:
how abnormal the cancer cells look – doctors call this differentiation
how quickly or slowly they are dividing and growing – this is grading
VIPomas are well differentiated cancers. This means the NET cells look abnormal. But they still have some similarities to normal neuroendocrine cells.
You have tests to find out the size of the VIPoma and whether it has spread. This is your stage. Doctors use your stage to plan your treatment.
There are different ways to stage pancreatic NETs. Doctors usually use the TNM system or number stages. There are 4 main stages of pancreatic NETs - stage 1 to stage 4.
Read more about the stages and grades of pancreatic NETs
Your doctor will use a different staging system if your VIPoma starts outside the pancreas. They can tell you more about that.
A risk factor is anything that increases your risk of getting a disease.
We don’t know what causes most neuroendocrine cancers. But there are some risks factors that can increase your risk of developing it. Having one of these risk factors doesn’t mean that you will definitely develop a cancer.
The risk factors for pancreatic NETs include:
inherited conditions such as and
having a family history of cancer
Read more about the risks and causes of neuroendocrine cancer
The first treatment you have is to control your symptoms. And to replace the fluids and minerals you may have lost because of diarrhoea. You then might have surgery to try to get rid of the cancer.
But surgery isn’t always possible. Some VIPomas may have already started to spread when you are diagnosed. Or you may not be well enough to have it. You continue to have treatment to help your symptoms if surgery isn’t an option.
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 NET is and its size
how many tumours you have
whether it has spread to other parts of the body
your general health and fitness
the symptoms you have
Your doctor will discuss your treatment. And tell you about its benefits and the possible side effects.
You are likely to have a clinical nurse specialist (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.
Your MDT also consider whether you have MEN 1. This might affect treatment decisions.
Click on the headings below to read more about the different treatment options.
You usually have follow up appointments after treatment. This is to check how you are and see whether you have any problems or worries.
You might also have tests on some visits. The tests might include:
blood tests
an MRI or CT scan
How often you see your doctor depends on:
the grade of your NET
whether it has spread to other parts of the body
what treatment you have had
any side effects you might have
It is important you contact your doctors if you have any worrying symptoms between appointments.
The best person to talk to you about your outlook () is your doctor. Not everyone wants to know. People cope differently with cancer and want different information.
Survival depends on many factors. So no one can tell you exactly how long you will live. Your doctor might be able to give you some guide, based on their knowledge and experience.
Your prognosis will depend on the type of NET you have and what it is.
Read more about survival for neuroendocrine cancers
Diarrhoea can have a massive impact on your life and how you are feeling. We have some information about diarrhoea and diet.
Read more about diet and neuroendocrine cancer
You might have physical changes to your body because of your cancer or the treatment. These changes can be hard to cope with and can affect the way you feel about yourself. It can help to talk to friends and family. Or join a support group to meet people in a similar situation.
We have a discussion forum called Cancer Chat. It is a place for anyone affected by cancer. You can share experiences, stories and information with other people with cancer.
You might need practical advice about benefits or financial help. There is help and support available. There are also organisations to support and provide information to people affected by neuroendocrine cancer.
We have information about living and coping with a neuroendocrine cancer
Last reviewed: 12 Mar 2025
Next review due: 12 Mar 2028
There are different types of neuroendocrine cancer that develop in the pancreas. Pancreatic neuroendocrine tumours (NETs) include insulinoma, gastrinoma, somatostatinoma, glucagonoma and VIPoma.
Grade means how quickly or slowly the cancer cells are dividing and growing. The stage of a neuroendocrine cancer tells you its size and whether it has spread. There are many different types.
Practical and emotional support is available to help you cope with neuroendocrine cancer.
Treatment depends on the type of neuroendocrine cancer you have, where it is, its size and whether it has spread (the stage).
Neuroendocrine cancers develop in cells of the neuroendocrine system. They can develop in different parts of the body including the lungs, stomach, pancreas and bowel.
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