Pancreatic Neuroendocrine Tumors Treatment in Singapore
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What are Pancreatic Neuroendocrine Tumors?
Pancreatic neuroendocrine tumours (PNETs) represent a rare group of tumours arising from the neuroendocrine cells of the pancreas that produce hormones, including insulin, glucagon, somatostatin, etc. These tumours may be benign or malignant; they usually grow more slowly than other pancreatic tumours, most notably pancreatic adenocarcinoma.
What is the Importance of Timely Treatment?
- Improved Prognosis: The chances of curing or controlling the disease are substantially better with treatment when detected early, including surgical tumour removal. Early interventions lead to long-term survival in localised tumours.
- Preventing Complications: PNETs can lead to complications like hormonal imbalances (e.g., hypoglycemia in insulinomas), pain, or jaundice. Prompt intervention treats the tumours to relieve symptoms and prevent serious complications.
- Reduced Risk of Metastasis: Early diagnosis increases the possibility of metastasis to some distant organs. However, timely therapy can prevent the tumour from progressing and spreading to various organs, such as the liver.
- Better Life: Early treatments will help control symptoms, pain, and discomfort caused by more extensive or invasive tumours.
What are the Common Symptoms of Pancreatic Neuroendocrine Tumors?
- Hypoglycemia (Low Blood Sugar)
- Hyperglycemia (High Blood Sugar) or Diabetes
- Abdominal Pain
- Unexplained Weight Loss
- Jaundice
- Nausea and Vomiting
- Fatigue
- Palpitations or Rapid Heartbeat
Causes and Risk Factors of Pancreatic Neuroendocrine Tumors
Causes
- Genetic Mutations
- Endocrine Disruptions
- Sporadic Development
Risk Factors
- Genetic Syndromes
- Age
- Family History
- Hormonal Imbalances
- Environmental Factors
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Latest Research and Technologies in the Treatment of Pancreatic Neuroendocrine Tumors in Singapore
In Singapore, doctors use a mix of advanced surgery methods, newer drugs, and modern imaging to treat pancreatic neuroendocrine tumors (PNETs). Laparoscopic and robotic surgeries help tackle tumors in tough spots like the pancreatic uncinate process. These options yield better results and help patients recover more quickly. To treat cases that cannot be removed through surgery, treatments such as peptide receptor radionuclide therapy (PRRT), which target tumour-specific receptors, are used to combat the disease. Improvements in diagnostics, such as PET imaging, also make it easier to detect and track tumours earlier. These steps underline Singapore’s focus on providing personalised and precise care for those dealing with PNETs.
Pancreatic Neuroendocrine Tumors Prevention Tip:
- Genetic Counseling and Screening: Normal screening and genetic counselling are preventive measures in the timely diagnosis of PNETs for people with a familial history of genetic syndromes, such as MEN1 or von Hippel-Lindau disease.
- Healthy lifestyle choices: Consume a healthy, balanced diet rich in fresh fruits, vegetables, and whole grains, while reducing your intake of processed foods and red meat.
- Avoid Smoking: Smoking is a known carcinogen in most cancers, including the pancreatic types and possibly the PNETs.
- Confirming early detection for high-risk individuals: Individuals with a familial history of endocrine tumours are offered regular imaging and blood tests to check for possible tumours.
- Management of chronic pancreatitis: Chronic pancreatitis can be managed effectively by medical treatment, as it prevents possible PNET development.
Treatment options for Pancreatic Neuroendocrine Tumors
The medical treatment for Pancreatic Neuroendocrine Tumors requires evaluating the patient's severity and medical condition. The following are the treatment options:
Surgical Resection: Surgical tumour removal is the most effective treatment option for localised PNETs. Thus, surgery provides the best chance of cure or long-term control in the case of a tumour localised to the pancreas.
Targeted Therapy : Targeted therapies inhibit tumour growth in advanced-stage or metastatic PNET cases. These therapies help slow down disease progression and enhance survival.
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Chemotherapy: Chemotherapy with medications is used in aggressive or metastatic PNETs. Chemotherapy is most often used when surgery or targeted therapy proves ineffectual in curbing the disease.
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Whipple Procedure (Pancreaticoduodenectomy) : This procedure is performed for localised and resectable tumours. It is intended for functional or non-functional PNETs localised within the pancreas.
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Stereotactic Radiotherapy (SRT) is the treatment modality for localised, inoperable, or metastatic PNETs when surgery is not performed. It is also for patients who cannot undergo surgery or whose disease has already spread to other sites.
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CyberKnife : The CyberKnife system is typically beneficial in managing small to medium-sized tumours that have proven inoperable, are subject to difficult surgical excision, or have metastasised into surrounding organs or tissue planes.
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Proton Therapy : Proton therapy is for such out-of-sight or inoperable PNETs. Given its significance in tumours near critical structures such as blood vessels or the spine, it is also applicable in treatment for metastatic PNETs when the cancer has spread elsewhere.
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These are the standard diagnostic methods for diagnosing Pancreatic Neuroendocrine Tumors:
Imaging Studies
- CT Scan: This is one of the most common imaging techniques used for PNET detection, i.e. determining tumour size, location, and evidence of metastasis, if any, especially to the liver or lymph nodes.
- MRI: Generates high-definition images of the pancreas, particularly for delineating soft tissue, and assesses the extent of the tumour.
- Endoscopic Ultrasound: Provides even better imaging of the pancreas and surrounding structures, allowing guidance for fine-needle aspiration (FNA) to acquire biopsy samples.
- Positron Emission Tomography: It plays a vital role in tracking a radioactive glucose analogue to locate areas of high metabolic activity associated with malignant tumours.
Biopsy
- Fine Needle Aspiration: Fine needle aspiration techniques, typically performed following an imaging modality that indicates tumour presence, are considered concurrent with an essential ultrasound study, during which tissue samples are taken for histopathological examination, thereby confirming the diagnosis of PNETs.
- Core Needle Biopsy: If a more definitive diagnosis is needed, a small core needle biopsy can be performed to obtain a tissue sample.
Blood Tests
- Tumour Markers: Serum tumour markers, such as chromogranin A (CgA) and pancreatic polypeptide (PP), can be used as an additional means of blood work to diagnose PNETs; elevated levels would strongly suggest the presence of neuroendocrine tumours in the patient.
Somatostatin Receptor Scintigraphy (SRS)
- Octreotide Scan: This technique uses radioactive tracers bound to somatostatin to detect somatostatin receptors on neuroendocrine tumour cells. Generally, this will be applicable in detecting localised, nonmetastatic PNETs amenable to surgical intervention.
MediRehab (a chain of Rehab centres, part of MediGence) provides comprehensive rehabilitation services to support patients through Teleconsulations and online therapy sessions.
- Rehabilitation following Surgery: Postoperative rehabilitation aims to help patients return to their daily lives after surgical tumour excision by regaining strength and improving mobility.
- Lifestyle modification: Nutritional counselling is essential for patients, especially those who have undergone surgery to the pancreas, as they may experience digestive problems due to the pancreas' diminished function.
- Pain Management: For those who experience pain after treatment, especially surgery or chemotherapeutic agents, it will be helpful to return to pain management therapy after these therapies.
- Hormone and Endocrine Therapy: Patients with functional PNETs (producing excess hormones) may require, in addition to managing symptoms of hypoglycemia and gastric issues, some form of hormonal therapy to alleviate their symptoms.
- Psychosocial Support: A diagnosis of cancer creates a stir in the mind and soul of a patient. Counselling, support groups, or any form of mental health assistance helps patients and families cope with the emotional aspects of this disease, PNET.
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Hospitals for Pancreatic Neuroendocrine Tumors in Singapore
Mount Elizabeth Novena Hospital
Novena, Singapore
Mount Elizabeth Novena Hospital located in Novena, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Capacity of 333 beds
- Intensive Care Unit beds
- Endoscopy beds
- Day ward with 20 beds
- 13 Operating Theatres, which includes 1 Neurological operating room, 2 Cardiac operating rooms, 4 Orthopaedic operating rooms, etc.
- High Dependency Unit (HDU)
- Neonatal Intensive Care Unit (NICU)
- 24/7 Accident & Emergency Department
- Maternity ward
- 1 major operating unit with 13 operating rooms inclusive of 1 hybrid theatre
- In-house Pharmacy
- Rooms are categorized as Single Signature Rooms, Junior Suite and Regal Suite
- All patient rooms are equipped with electric safe, LCD, sofa cum bed, wardrobe, radio channels, and much more
Parkway East Hospital
Singapore, Singapore
Parkway East Hospital located in Joo Chiat Pl, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Total capacity for 143 beds
- Hospital rooms are available- Single room, 2-bedded room (8), 4-bedded room (2), Deluxe room, and Orchid/Hibiscus Suite
- All rooms are equipped with all ensuite facilities like Free wifi, mini fridge, sofa couch, telephone, in-room safe, TV, etc.
- Maternity wards- Accredited as a baby-friendly hospital under the World Health Organisations Baby-Friendly Hospital Initiative (BFHI)
- 1 Neonatal Intensive Care Unit (NICU) with 14 cots
- Intensive Care Unit
- 1 Operation Theatre with 5 Operating rooms
- 1 Nursery with 30 cots
- 1 Parentcraft room
- 24-hour walk-in-clinic (for emergency)
- 24-hour Pharmacy
Mount Elizabeth Hospital
Singapore, Singapore
Mount Elizabeth Hospital located in Singapore, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- 345 bedded Hospital
- Maternity wards
- The Mount Elizabeth Patient Assistance Centre (MPAC)
- 1 major operating unit with 12 operating rooms and 1 operating theatre dedicated to in vitro fertilisation (IVF)
- Intensive Care Unit
- High Dependency Unit (HDU)
- Neonatal Intensive Care Unit (NICU)
- Accident & Emergency Department
- Rooms are categorized as Single rooms, 2-bedded rooms, 4-bedded rooms, Executive deluxe suite, Daffodil/Magnolia suite, VIP Room, and Royal Suite
- All patient rooms are equipped with electric safe, LCD, sofa cum bed, wardrobe, radio channels, and much more
- Parking lot
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Why Choose Singapore for Pancreatic Neuroendocrine Tumor Treatment?
The following are the growing reasons for Singapore being frequented for Pancreatic Neuroendocrine Tumor treatment:
- A world-class cancer centre in Singapore, it boasts modern hospitals and highly competent oncologists.
- Innovative treatment modalities, including peptide receptor radionuclide therapy (PRRT), targeted therapy, and robotic surgery, have been employed as potentially effective treatments.
- Affordable Quality Care: Singapore offers treatments specialised in cancer therapy at a fraction of the cost that such conditions would incur for a patient anywhere in the Western world.
- Internationally Recognised Hospitals: JCI-accredited medical centres are guaranteed to provide quality treatment and safety for their patients.
- Comprehensive Patient Care: Patients from outside the country will receive complete assistance and a comprehensive support program, including travel and accommodation arrangements.
Frequently Asked Questions
The prognosis of PNETs is based on the tumour's size, location, and functional status, as well as the presence of metastases. Early detection and surgery are the best options for offering a good prognosis, whereas therapies must be combined with advanced or metastatic cases for managing PNETs.
Most PNETs are sporadic, although they can be combined with some genetic conditions, such as MEN1 syndrome and von Hippel-Lindau disease. Individuals with family histories of these conditions might require genetic counselling and regular screening.
Currently, there is no known preventive measure against PNETs. Yet, a healthy lifestyle that avoids smoking and genetic screening for higher-risk individuals can contribute to early detection and improved management of the disease.
Long-term effects will depend on the treatment method used. Surgical recovery can cause digestive problems, chemotherapy has intermediate side effects such as nausea and lethargy, and targeted therapies can cause skin rashes or fatigue. Monitoring for recurrence or complications requires regular follow-up care to ensure timely detection.
Even after treatment, the PNETs can recur depending on whether the tumour was removed entirely or metastasised. Regular follow-up scans and monitoring are crucial for detecting recurrences at an early stage.
A nutritious diet, physical exercise, and abstinence from alcoholic beverages and smoking may enhance a patient's health. Hormone-secreting tumours may also require an individual to follow directed medical advice in managing portions of low blood sugar or digestive issues.
Peptide receptor radionuclide therapy (PRRT) is a targeted nuclear medicine treatment available in Singapore.
Yes, surgeries in robotic and laparoscopic procedures are practised primarily for faster recovery.
The duration of treatment varies according to tumor type and stage, but usually lasts several weeks to several months.
In Singapore, specialised centers are looking into international patients seeking comprehensive care.