Neuroendocrine Tumor Treatment in India

Most people have never heard of a neuroendocrine tumor until they are told they have one.

Unlike colon cancer or stomach cancer, neuroendocrine tumours (NETs) don’t come with the same level of public awareness, because they often grow slowly and produce symptoms that look like a dozen other conditions, including irritable bowel syndrome, acid reflux, or hormonal imbalance. The average time from first symptom to correct diagnosis is five to seven years.

That delay is the real problem with NETs. This page explains what NETs are, how they are diagnosed, and what treatment actually involves.

What is a Neuroendocrine Tumor?

A neuroendocrine tumour (NET) is a growth that starts in the neuroendocrine cells of the body. These are specialised cells that act as a bridge between the nervous system and the hormone-producing (endocrine) system. NETs can develop almost anywhere in the body, but the majority form in the gastrointestinal tract, pancreas, or lungs.

The gastrointestinal tract has the highest concentration of neuroendocrine cells in the body, which is why GI NETs are the most common type. They most frequently develop in the small intestine, rectum, appendix, stomach, and pancreas.

NETs were previously called carcinoid tumours. You may still hear that term used, particularly for tumours in the small intestine and appendix.

Are Neuroendocrine Tumours Cancerous?

NETs exist on a spectrum. Some are slow-growing and behave almost like benign tumours for years. Others are aggressive and spread quickly. What determines this is the tumour grade, which reflects how fast the cells are dividing. Grade 1 and Grade 2 NETs grow slowly. Grade 3 neuroendocrine carcinomas behave more like conventional cancers.

This is why two patients with a NET diagnosis can have very different treatment plans and outlooks. A Grade 1 rectal NET found incidentally during a colonoscopy is a very different situation from a Grade 3 pancreatic neuroendocrine carcinoma.

Knowing your tumour grade, location, and whether it is functional (producing hormones) or non-functional is the starting point for any treatment decision.

What Are the Symptoms of Neuroendocrine Tumours?

This is where NETs get complicated. The symptoms of NETs depend entirely on where the tumour is and whether it is producing hormones.

Non-functional NETs (the majority) produce no hormones and often cause no symptoms at all in the early stages. They are frequently discovered accidentally during imaging done for another reason.

Functional NETs produce hormones and cause symptoms related to those hormones. The most well-known is carcinoid syndrome, which occurs when a NET in the small intestine or appendix spreads to the liver and begins releasing hormones into the bloodstream.

Symptoms of carcinoid syndrome include:

• Sudden flushing of the face and neck (redness and warmth without fever)
• Watery diarrhoea, often severe
• Wheezing or breathlessness
• Rapid heartbeat

For pancreatic NETs specifically, symptoms vary depending on the hormone produced. Insulinomas cause low blood sugar (shakiness, sweating, confusion). Gastrinomas cause severe, recurring peptic ulcers. Many pancreatic NETs produce no hormones and are found only on imaging. 

How Are NETs Diagnosed?

Diagnosis of NETs usually requires a combination of blood tests, imaging, and tissue sampling.

• Blood and urine tests: Elevated levels of chromogranin A (CgA) in the blood and 5-HIAA in the urine are markers commonly associated with NETs.
• Imaging: CT scans and MRI show the tumour’s size and location.
• Ga-68 DOTATATE PET-CT is one of the most sensitive imaging tests for neuroendocrine tumours. It detects receptors commonly found on NET cells, helping determine the tumour’s location, extent of spread, and suitability for PRRT. 
• Endoscopy or colonoscopy: For GI NETs, direct visualisation of the tumour is often possible. A biopsy taken during endoscopy confirms the diagnosis.
• Biopsy and grading: The tissue sample is sent to a pathologist, who assesses the Ki-67 index (a measure of how fast cells are dividing) to grade the tumour. 

What Are the Treatment Options for Neuroendocrine Tumours in India?

• Surgery

The first choice for NETs that can be removed. Small rectal NETs under 1cm are often removed endoscopically during colonoscopy. Larger tumours in the small intestine or pancreas need formal surgical resection.

For pancreatic NETs, the approach depends on location within the pancreas: distal pancreatectomy for tail tumours, Whipple procedure for tumours in the head.

Dr. Deep Goel performs laparoscopic and minimally invasive surgery for eligible patients.

• Somatostatin Analogues 

Monthly injections that suppress hormone production in functional NETs and slow tumor growth. Well tolerated by most patients.

• PRRT (Lutetium-177 DOTATATE)

Targeted radiation delivered directly to NET cells. Used when the tumour has spread or progressed on other treatments.

• Targeted Therapy and Chemotherapy

Everolimus or Sunitinib for progressive NETs. Chemotherapy reserved for aggressive, poorly differentiated Grade 3 tumours.

What Does NET Treatment Cost in India?

Costs vary considerably depending on the tumour grade, location, and treatment approach.

• Surgical resection: Rs. 2,00,000 to Rs. 5,00,000 depending on complexity
• Dotatate PET scan: Rs. 35,000 to Rs. 55,000
• PRRT (per cycle): Rs. 2,50,000 to Rs. 3,50,000; most patients need 3 to 4 cycles
• Somatostatin analogue therapy: Rs. 20,000 to Rs. 40,000 per monthly injection

For international patients, detailed cost estimates can be provided once imaging and pathology reports are reviewed by the team

Why Trust Dr. Deep Goel for Neuroendocrine Tumour Treatment in Delhi?

Neuroendocrine tumours often require specialised surgical expertise and a multidisciplinary treatment approach. Patients choose Dr. Deep Goel for:

• 27+ years of experience in GI and HPB surgery
• 20,000+ gastrointestinal surgical procedures performed
• Advanced laparoscopic and minimally invasive surgical techniques
• Specialist in complex pancreatic surgery, including Whipple procedures
• Collaborative care with oncology, gastroenterology, and nuclear medicine specialists
• Personalised treatment planning for every patient

Consult Dr. Deep Goel’s Team

If you have been diagnosed with a neuroendocrine tumor, or are waiting for a confirmed diagnosis after abnormal imaging, getting a specialist opinion early makes a real difference.

Dr. Deep Goel and his team at BLK-Max Super Speciality Hospital see patients with GI cancers including NETs from across India and internationally, with in-person and online consultation options available.

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