Types of surgery

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). 

The surgery you have depends on:

• where the NET started (the primary tumour)
• how big the tumour is
• whether it has spread
• how the cells look under the microscope (the grade)
• the symptoms you have
• your general health

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. 

Types of surgery

Your surgeon aims to remove the tumour completely. For some NETs, surgery is the only treatment you need. 

For a NET that has spread to other parts of the body, your surgeon might still do surgery to remove most of the tumour. This is called debulking. Debulking surgery can help to control your symptoms and help you feel better, but won’t get rid of the NET.

Surgery for lung NETs

Surgery is the main treatment for typical carcinoid (TC) and atypical carcinoid (AC). These are types of lung neuroendocrine tumours (NETs). You might also have surgery for large cell neuroendocrine carcinoma (NEC) that hasn't spread.

A thoracic or cardiothoracic surgeon does the operation. They usually remove a small section of the lung (lobectomy). Or they may remove the whole lung (pneumonectomy).

Surgery for NETs of the pancreas

You see a surgeon who specialises in surgery of the pancreas. Your surgeon might remove:

• just the cancer - this is called enucleation

• the part of the pancreas where the cancer is

• part of the pancreas and some nearby organs such as the gallbladder

• the whole pancreas

Your surgeon may also remove the lymph nodes around the pancreas. The lymph nodes drain away fluid, waste products and damaged cells, and contain cells that fight infection. They are often the first place where cancers spread to.

Surgery for gut NETs

The digestive system includes the:

• stomach

• small and large bowel

• back passage (rectum)

For small early stage cancers
You often have keyhole or laparoscopic surgery. Your surgeon makes small cuts in your tummy (abdomen). They pass a long tube called a laparoscope and other instruments through these cuts. The laparoscope has a light and camera on the end, so your surgeon can look into your abdomen. They use the instruments to remove the cancer. 

For large cancers
You are more likely to have open surgery. This means your surgeon makes one long cut down your abdomen to remove the cancer. 

Other treatments

There are other types of treatment if you can’t have surgery. These include:

• somatostatin analogues

• radiotherapy

• chemotherapy

• targeted drugs

These treatments can control your symptoms and help you feel better. But they won’t get rid of the NET.

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. 

This page is due for review. We will update this as soon as possible.