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Pancreatic Neuroendocrine Tumor (NET)
Pancreatic neuroendocrine tumors (NETs), or islet cell tumors, are a type of cancer that starts in the pancreas. (Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer?)
Pancreatic NETs are a less common type of pancreatic cancer. They make up less than 2% of pancreatic cancers, but tend to have a better outlook (prognosis) than the more common type.
Pancreatic neuroendocrine tumors start in neuroendocrine cells, a special kind of cell found in the pancreas. Neuroendocrine cells are also found in other areas of the body, but only cancers that form from neuroendocrine cells in the pancreas are called pancreatic neuroendocrine tumors.
Neuroendocrine cells are like nerve cells in some ways and like hormone-making endocrine cells in other ways. Cells in this system don't form actual organs. Instead, they are scattered throughout other organs like the esophagus, stomach, pancreas, intestines, and lungs.
Neuroendocrine cells (sometimes just called endocrine cells) in the pancreas are found in small clusters called islets (or islets of Langerhans). These islets make important hormones like insulin and glucagon (which help control blood sugar levels), and release them directly into the blood.
The pancreas is an organ that sits behind the stomach. It's shaped a bit like a fish with a wide head, a tapering body, and a narrow, pointed tail. In adults it's about 6 inches (15 centimeters) long but less than 2 inches (5 centimeters) wide.
Neuroendocrine tumors start in the endocrine cells of the pancreas. But most of the pancreas is actually made up of another type of cell called exocrine cells. These cells form the exocrine glands and ducts. The exocrine glands make pancreatic enzymes that are released into the intestines to help you digest foods (especially fats). The most common type of pancreatic cancer, adenocarcinoma of the pancreas, starts from exocrine cells. See Pancreatic Cancer for more about this type.
If you are diagnosed with pancreatic cancer, it’s very important to know if it's an exocrine cancer (see Pancreatic Cancer) or endocrine cancer (discussed here). They have distinct risk factors and causes, have different signs and symptoms, are diagnosed with different tests, are treated in different ways, and have different outlooks.
Pancreatic neuroendocrine tumors (NETs) are classified by tumor grade, which describes how quickly the cancer is likely to grow and spread.
Cancers that are grade 1 or 2 are called pancreatic neuroendocrine tumors. These cancers tend to grow slowly and can possibly spread to other parts of the body.
Cancers that are grade 3 are called pancreatic neuroendocrine carcinomas (NECs). These cancers tend to grow and spread quickly and can spread to other parts of the body.
Another important part of grading is measuring how many of the cells are in the process of dividing into new cells. This is described in more detail in Pancreatic Neuroendocrine Tumor Stages.
Pancreatic NETs are also named based on whether they are functioning (making hormones that cause symptoms) or non-functioning (not making hormones).
Functioning NETs: About half of pancreatic NETs make hormones that are released into the blood and cause symptoms. These are called functioning NETs. Each one is named for the type of hormone the tumor cells make.
Most (up to 70%) functioning NETs are insulinomas. The other types are much less common.
Non-functioning NETs: These tumors don’t make enough excess hormones to cause symptoms. Because they don’t make excess hormones that cause symptoms, they can often grow quite large before they're found. Symptoms that may occur when they grow to a large size include abdominal (belly) pain, lack of appetite, and weight loss.
Carcinoid tumors: These NETs are much more common in other parts of the digestive system, although rarely they can start in the pancreas. These tumors often make serotonin.
The treatment and outlook for pancreatic NETs depend on the specific tumor type and the stage (extent) of the tumor, but the outlook is generally better than for pancreatic exocrine cancers.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Joint Committee on Cancer. Neuroendocrine Tumors of the Pancreas. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017.
National Cancer Institute. Physician Data Query (PDQ). Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment – Patient Version. 2018. Accessed at https://www.cancer.gov/types/pancreatic/patient/pnet-treatment-pdq on October 10, 2018.
Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Chapter 71: Cancer of the endocrine system. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa. Elsevier: 2014.
Strosberg JR. Classification, epidemiology, clinical presentation, localization, and staging of pancreatic neuroendocrine neoplasms. UpToDate website. https://www.uptodate.com/contents/classification-epidemiology-clinical-presentation-localization-and-staging-of-pancreatic-neuroendocrine-neoplasms. Updated Jan. 23, 2018. Accessed October 10, 2018.
Yao JC, Evans DB. Chapter 85: Pancreatic neuroendocrine tumors. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Last Revised: January 21, 2020
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