Bay Biosciences provides high quality, clinical grade, fresh frozen tumor tissue bio-specimens, cryogenically preserved sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid samples from patients diagnosed with Neuroendocrine Tumors.
The sera (serum), plasma and PBMC biofluid specimens are processed from patient’s peripheral whole-blood using customized collection and processing protocols. The neuroendocrine tumors fresh frozen tissue samples and biofluids are collected from unique patients diagnosed with neuroendocrine tumors and are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.
Detailed clinical data, neuroendocrine tumors patients history, symptoms, complete blood count (CBC), serology, chemotherapy information, tumor biopsy tissue blocks, elevated biomarker levels, genetic and metabolic information, histopathological findings, annotations associated with neuroendocrine tumor specimens is provided to a valued customer for research, development and drug discovery.
The neuroendocrine tumor sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluid are processed from patients peripheral whole-blood using customized collection and processing protocols.
Neuroendocrine Tumors Overview
Tumors
A tumor begins when the DNA of healthy cells is damaged, causing the cells to change and grow out of control, forming a mass. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body if it is not found early and treated. A benign tumor means the tumor can grow but will not spread. A benign tumor usually can be removed without it causing much harm.
Neuroendocrine Tumors
Neuroendocrine tumors are cancers that begin in specialized cells called neuroendocrine cells. Neuroendocrine cells have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine tumors are rare and can occur anywhere in the body. Most neuroendocrine tumors occur in the lungs, appendix, small intestine, rectum and pancreas.
A neuroendocrine tumor (NET) begins in the specialized cells of the body’s neuroendocrine system. These cells have traits of both hormone-producing endocrine cells and nerve cells. They are found throughout the body’s organs and help control many of the body’s functions. Hormones are chemical substances that are carried through the bloodstream to have a specific effect on the activity of other organs or cells in the body. All neuroendocrine tumors (NETs) are considered malignant tumors. Most neuroendocrine tumors (NETs) take years to develop and grow slowly. However, some neuroendocrine tumor (NETs) can be fast-growing.
Neuroendocrine tumors (NETs) can begin in any part of the body, including the:
- Gastrointestinal (GI) tract: Neuroendocrine tumor (NETs) develop most commonly in the GI tract, specifically in the small intestine (19%), appendix (4%), and large intestine (20%). The GI tract plays a central role in digesting foods and liquid and in processing waste. GI tract neuroendocrine tumor (NETs) also used to be called carcinoid tumors.
- Lung. The lung is the second most common location of Neuroendocrine tumor (NETs). About 30% of Neuroendocrine tumor (NETs) occur in the bronchial system, which carries air to the lungs. Lung Neuroendocrine tumor (NETs) used to be called carcinoid tumors.
- Pancreas: Approximately 7% of neuroendocrine tumor (NETs) can develop in the pancreas, a pear-shaped gland located in the abdomen between the stomach and the spine. Pancreas neuroendocrine tumor (NETs) used to be called islet cell.
Neuroendocrine tumor (NETs) can also begin in other organs. In about 15% of cases, a primary site cannot be found. Sometimes, neuroendocrine tumor (NETs) may develop in or on the adrenal glands. These rare types of neuroendocrine tumor (NETs) are called pheochromocytoma and paraganglioma Other types of tumors that begin in hormone-producing cells are thyroid cancer, adrenal gland cancer, and pituitary gland tumors.
Classification of NETs
NETs may be classified, or described, in many different ways, including by where they are located, what the tumor cells look like under a microscope, and how fast the cells are growing and dividing. In addition, NETs are described as “functional” or “non-functional.” Functional NETs make and release hormones and other substances that cause symptoms. Carcinoid syndrome is one of the sign of a “functional” NET in which a substance called serotonin is released that can cause diarrhea and facial flushing. Non-functional NETs either do not release substances or do not release enough substances to cause symptoms. About 60% of NETs are non-functional. Because of a lack of symptoms, NETs are usually diagnosed at a more advanced stage.
Signs and Symptoms of Neuroendocrine Tumors
Depending on the type of NET, a person may experience the following tumor-related symptoms or signs:
General cancer symptoms:
- Fatigue
- Loss of appetite
- Unexplained weight loss
Symptoms related to the tumor size and/or location:
Symptoms related to the release of hormones:
- Diarrhea
- Facial flushing, usually without sweating
- Hyperglycemia, which is a high level of glucose in the blood. Glucose is a sugar that is converted into energy by the body. Hyperglycemia causes frequent urination, increased thirst, and increased hunger.
- Hypoglycemia, which is a low level of glucose in the blood. It causes fatigue, nervousness and shakiness, dizziness or light-headedness, sweating, seizures, and fainting.
- Gastric ulcer disease
- Skin rash
- Confusion
- Anxiety
- Some people also experience nutritional deficiencies before a diagnosis, such as niacin and protein deficiency. Others develop this symptom later.
Carcinoid Syndrome
Carcinoid syndrome is the classic example of a sign of a functional neuroendocrine tumors (NETs). It occurs most commonly in people with small intestine and lung neuroendocrine tumors (NETs) that have spread to another part of the body, called metastatic. In carcinoid syndrome, serotonin is produced by the tumor and can cause one or more of the following symptoms or signs. Serotonin is most easily and reliably measured in the urine, when it gets converted into 5-hydroxyindoleacetic acid (5-HIAA), and it is measured with a 24-hour urine collection test. It is important to note that these symptoms alone are not enough to diagnose carcinoid syndrome. Blood or urine tests to measure for suspected hormones are also needed to make a diagnosis. Not all patients with a neuroendocrine tumor (NET) develop carcinoid syndrome.
- Facial flushing, which is redness and a warm feeling over the face
- Diarrhea
- Shortness of breath
- Wheezing or asthma-like symptoms
- Unexplained weight gain
- Weakness
- Fast heartbeat
- Heart murmur
- High blood pressure and significant fluctuations in blood pressure
- Carcinoid heart disease, which is a scarring of the heart valves caused by serotonin.
Stress, strenuous exercise, and drinking alcohol may make these symptoms worse. Some foods may also trigger the symptoms of carcinoid syndrome, including foods high in:
- Amines, such as aged cheeses, yeast extracts, tofu, sauerkraut, and smoked fish and meats
- Serotonin, such as walnuts, pecans, plantains, bananas, and tomatoes
Carcinoid Crisis
Carcinoid crisis is a term used when patients experience severe, sudden symptoms of carcinoid syndrome, usually in times of extreme stress, such as surgery. Carcinoid crisis primarily includes serious fluctuations in blood pressure and the heart rate. Carcinoid crisis is the most serious and life-threatening complication of carcinoid syndrome. It is generally recommended that patients receive intravenous octreotide (Sandostatin), a medication that helps control the production of hormones, before a planned surgery. Octreotide is also used to treat carcinoid crisis.
Causes of Neuroendocrine Tumors
Exact cause of neuroendocrine tumors isn’t known. These cancers begin in neuroendocrine cells that have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine cells are found throughout your body. Neuroendocrine tumors begin when neuroendocrine cells develop changes (mutations) in their DNA. The DNA inside a cell contains the instructions that tell the cell what to do. The changes tell the neuroendocrine cells to multiply rapidly and form a tumor. Some neuroendocrine tumors grow very slowly. Others are aggressive cancers that invade and destroy normal body tissue or spread (metastasize) to other parts of the body.
Risk Factors of Neuroendocrine Tumors
The risk of neuroendocrine tumors is higher in people who inherit genetic syndromes that increase the risk of cancer. Examples include:
- Multiple endocrine neoplasia, type 1 (MEN 1)
- Multiple endocrine neoplasia, type 2 (MEN 2)
- Von Hippel-Lindau disease
- Tuberous sclerosis
- Neurofibromatosis
Diagnosis of Neuroendocrine Tumors
The tests and procedures you might undergo to diagnose a neuroendocrine tumor will depend on where your tumor is located in your body. In general, tests might include:
- Physical exam. Your doctor may examine your body to better understand your signs and symptoms. He or she may feel for swollen lymph nodes or look for signs that a tumor is producing excess hormones.
- Tests to look for excess hormones: Your doctor may recommend testing your blood or your urine for signs of excess hormones that are sometimes produced by neuroendocrine tumors.
- Imaging tests: You might undergo imaging tests, such as ultrasound, CT and MRI, to develop images of the tumor. For neuroendocrine tumors, pictures are sometimes created using positron emission tomography (PET) with a radioactive tracer that’s injected into a vein.
- Procedures to remove a sample of cells for testing (biopsy): To collect the cells, the doctor might insert a long, thin tube with a light and a camera on the end into the lungs (bronchoscopy), the esophagus (endoscopy) or the rectum (colonoscopy), depending on the patients situation. Sometimes, collecting a biopsy tissue sample requires surgery.
If there’s a risk that the neuroendocrine tumor may have spread to other parts of the body, you might have additional tests to determine the extent of the cancer.
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