Between a rock and a hard place
A slide showing carcinoid tumor cells, arranged in discrete and organized "nests" and separated by bands of surrounding tissue. The cells appear relatively uniform and grow slowly – one reason they may be less responsive to traditional chemotherapy agents than other cancers.
Some patients are more fortunate than others: Their neuroendocrine tumors never cause problems or are caught early and removed surgically. Others don't realize they have cancer in these hormone-making cells until it has spread. Medications can control some patients' symptoms and prolong life, according to the American Cancer Society, but they aren't very effective at getting rid of the disease.
"Carcinoid and other neuroendocrine cancers grow slowly, and that's also the reason they're so hard to treat," explains Dana-Farber's Matthew Kulke, MD. "Chemotherapy likes to attack rapidly dividing cells. And so it's like giving chemotherapy to a big rock; it doesn't care."
Unfortunately, neuroendocrine tumors are not unusual when it comes to being stubborn, notes Kulke's DFCI colleague Ramesh Shivdasani, MD, PhD. "They're hard to treat because all tumors are hard to treat," he says. "Our lack of genetic understanding of neuroendocrine cancers certainly doesn't make things any easier. That's what we're trying to change."
