Chemotherapy for neuroendocrine cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells but it can also damage healthy cells.

Chemotherapy is sometimes used to treat neuroendocrine tumours (NETs). It’s more often used to treat neuroendocrine carcinomas (NECs). If you have chemotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Chemotherapy may be the only treatment you have or it may be used along with other cancer treatments. You may have chemotherapy to:

• treat a NEC
• treat a high-grade NET
• treat a NET that does not respond to other treatments
• shrink a tumour before other treatments such as surgery or radiation therapy (called neoadjuvant chemotherapy)
• destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy)

Chemotherapy and radiation therapy may be given during the same time period to treat neuroendocrine cancer. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own.

Chemotherapy drugs for neuroendocrine cancer are usually given through a needle into a vein (by intravenous, or by IV). The drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy.

Sometimes chemotherapy is used as a regional therapy for a specific area of the body. Chemoembolization delivers chemotherapy drugs directly to metastatic liver tumours when neuroendocrine cancer spreads to the liver. Find out more about liver-directed therapy.

Chemotherapy drugs used alone for neuroendocrine cancer include:

• capecitabine
• temozolomide
• streptozotocin
• 5-fluorouracil
• cisplatin
• carboplatin
• etoposide
• doxorubicin

The most common chemotherapy drug combinations used for neuroendocrine cancer are:

• capecitabine and temozolomide
• carboplatin and etoposide
• carboplatin and paclitaxel
• cisplatin and etoposide

The type of chemotherapy drug or combination of drugs used depends mainly on where the cancer started and whether the cancer is a NET or NEC.

Side effects of chemotherapy will depend mainly on the drug, the dose, how it’s given and your overall health. Tell your healthcare team if you have side effects that you think are from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Common side effects of chemotherapy drugs for neuroendocrine cancer include:

• nausea and vomiting
• hair loss
• loss of appetite
• weight loss
• sore mouth and throat
• diarrhea or constipation
• fatigue
• higher risk of infection
• bruising easily

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.