Frontline Gastrointestinal NETs: The approach to diagnosis and initial management

Thank you for listening to this podcast, where Frontline Gastroenterology Trainee Editor Dr Philip Smith talks to Professor Mark Pritchard, Professor and Head of the Department of Gastroenterology and Honorary Consultant Gastroenterologist at the University of Liverpool, UK. The podcast is an accompaniment to the Frontline Gastroenterology Twitter Debate (#FGDebate) held on Tuesday 10th February 2015, 8-9pm GMT, entitled, 'Frontline Gastrointestinal NETs: The approach to diagnosis and initial management'. Prior to the debate Professor Pritchard said: 'Neuroendocrine tumours (NETs) are relatively rare, but because they are often associated with a good prognosis, they have a high prevalence. They are said to be more prevalent than stomach and exocrine pancreatic cancers combined. There is often a delay in initial diagnosis as NETs may cause similar symptoms to other more common conditions such as IBS. As many patients present with metastatic disease at the time of diagnosis, management usually requires the involvement of a multidisciplinary team of clinicians. A gastroenterologist is a crucial member of this team, as many NETs occur in the GI tract and pancreas where they are amenable to endoscopic detection, evaluation and removal. In the #FGDebate we hope to cover the endoscopic evaluation of NETs, particularly how to determine the type of a gastric NET and whether it requires treatment. We will also discuss other tests, particularly how to interpret chromogranin A blood test results and the role of the new highly sensitive and specific PET scans. There have also been several recent advances in NET management, such as clinical trial evidence to support the use of long acting somatostatin analogues to delay disease progression as well as treat the symptoms of carcinoid syndrome, the more widespread use of targeted radionuclide therapies for metastatic NETs and the development of new drugs such as gastrin/CCK-2 receptor antagonists to treat specific tumour types. Finally we hope to consider how easy it is for patients to access specialist NET teams and therefore the various investigations and treatments that may be needed for optimal management’ The purpose of the podcast is to 'fill any gaps' the #FGDebate may have left. Professor Pritchard has also provided the slides he used in #FGDebate to help those interested understand the issues associated with Gastrointestinal NETs. We hope you enjoy this and that it is informative. View the slides: http://goo.gl/x159bU Don't miss the next #FGDebate with Professor Brian Saunders, Consultant Gastroenterologist at St Mark’s Hospital, London and Adjunct Professor of Endoscopy at Imperial College London on Tuesday 3rd March 2015, at 8-9pm GMT and will discuss, 'Frontline Endoscopy: Polypectomy – tips, tricks and which to remove endoscopically.’