Pancreatic Neuroendocrine Tumor, from the CureRays guide library.

Pancreatic neuroendocrine tumors grow from the pancreas's hormone-making cells; many grow slowly, and a targeted radioactive medicine (PRRT) can treat tumors that have spread.

What it is.

The pancreas has two jobs: it makes digestive juices and it makes hormones. Pancreatic neuroendocrine tumors (pNETs, sometimes called islet cell tumors) start in the hormone-making cells and behave very differently from ordinary pancreatic (exocrine) cancer — they usually grow more slowly and have a much better outlook. Some release excess hormones that cause symptoms (functional tumors, like insulinomas or gastrinomas); most make no hormones and are found as a mass or after they spread, often to the liver. Because these cells carry docking sites called somatostatin receptors, they can be both imaged and treated with receptor-targeted radioactive drugs.

How radiation treats it.

Most radiation for these tumors is given as PRRT — a targeted radioactive medicine. A molecule that mimics the hormone somatostatin carries a radioactive atom (Lutetium-177) directly to the tumor's docking sites, where it releases short-range radiation that breaks the cancer cells' DNA. Because the drug seeks out tumor cells specifically, it can treat deposits all over the body at once with relatively mild side effects. A scan with a similar tracer (DOTATATE PET) first confirms the tumor will 'light up' and respond. External-beam radiation, when used, is reserved for relieving symptoms at a specific spot.

The ways we can treat it.

PRRT — Lutetium-177 DOTATATE. A somatostatin look-alike is tagged with a radioactive atom, given through an IV, and homes in on the tumor's receptors — delivering radiation directly to deposits throughout the body while sparing healthy tissue. This is 'radiation from within.'

Liver-directed therapy. When the tumor spreads mainly to the liver, treatments aimed at the liver — bland or radioactive bead embolization, ablation, or surgery — control disease and symptoms.

External-beam radiation (selective). Used for symptom relief, such as a painful bone deposit or a spot pressing on a nerve; not a primary treatment for the pancreas tumor itself.

Questions we hear often.

Is this the same as pancreatic cancer? No. Ordinary pancreatic cancer (adenocarcinoma) comes from the digestive cells and is aggressive. Neuroendocrine tumors come from the hormone cells, usually grow more slowly, and have a much better outlook — even when they have spread.

What is PRRT and is it safe to be around others? PRRT is a targeted radioactive medicine given through an IV that seeks out tumor cells. You'll receive simple precautions for a short time afterward, but it is well tolerated, and the radiation is delivered mainly to the tumor.

My tumor has spread to the liver — is treatment still worthwhile? Yes. These tumors can be controlled for many years with injections, PRRT, targeted pills, and liver-directed therapy, often with a good quality of life.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.