Pancreatic neuroendocrine tumours (NETs)

Pancreatics NETs are rare. About 3600 Australians are diagnosed with a neuroendocrine tumour each year, but only about 6% of these  tumours are in the pancreas.

The causes of pancreatic NETS are not known, but research has shown that people with diabetes are more likely than others to develop pancreatic NETs. Other factors that may increase the risk include smoking, drinking alcohol, obesity and a family history of cancer.

Most people with pancreatic NETs do not have a family history of the disease. However, some  pancreatic NETs are caused by a rare inherited syndrome, such as multiple endocrine neoplasia type 1 (MEN1) or neurofibromatosis. If you are concerned about your family history or want to know more about genetic testing, talk to your doctor or call Cancer Council 13 11 20.

There are two main categories of pancreatic NETs: functioning and non-functioning. Functioning pancreatic NETS produce extra amounts of hormones, while non-functioning do not produce extra hormones.

Types of functioning NETS include:

• gastrinoma – produces too much gastrin
• insulinoma – produces too much insulin
• glucanoma – produces too much glucagon
• somatostatinoma – produces too much somatostatin
• VIPoma – produces a hormone-like substance called vasoactive intestinal polypeptide (VIP). 

The pancreas is part of both the digestive system and the endocrine (hormone-producing) system. It is a long, flat gland about 13–15 cm long that lies between your stomach and spine.

The pancreas is divided into three parts:

• a large rounded section, called the head of the pancreas
• the middle part, known as the body
• the narrow end, called the tail.

A tube called the pancreatic duct connects the pancreas to the first part of the small bowel (duodenum). Another tube, called the common bile duct, joins with the pancreatic duct and connects the liver and gall bladder to the duodenum. The common bile duct carries bile, a substance that helps the body to digest fats.

The pancreas acts as two glands in one – it functions as a gland to help with digestion (exocrine), and as a gland to control the amount of sugar in the blood (endocrine).

Exocrine function – Groups of exocrine cells (acini) produce juices called enzymes that help break down food. The juices flow through the pancreatic duct from the pancreas into the duodenum. Most of the pancreas is made up of exocrine tissue.

Endocrine function – Scattered among the exocrine tissue are small groups of endocrine cells called pancreatic islets (or islets of Langerhans). These release hormones that control the level of sugar in the blood – the hormone insulin decreases this level, while the hormone glucagon increases it.

The pancreas