Early Diagnosis of Neuroendocrine Tumors

In this discussion, neuroendocrine tumor specialists address the persistent challenge of delayed diagnosis in patients with functional NETs, notably those with carcinoid syndrome. Dr. Andrew Hendifar emphasizes that vague, slowly-progressing symptoms—such as flushing, diarrhea, hypoglycemia, or even hypertension—often lead to extensive diagnostic delays, with many patients identified only at advanced, sometimes incurable stages. Contrastingly, functional tumors with more severe, acute symptoms, like insulinomas, are diagnosed earlier due to their pronounced clinical presentation. The panel highlights the ever-expanding spectrum of neuroendocrine tumor manifestations, mentioning tumor-induced, non-islet cell hypoglycemia as a rare but important entity, especially in the context of high tumor burden. Recognizing this diverse symptomatology is difficult for busy primary care providers, who manage numerous patients with overlapping, nonspecific complaints. Specialists agree that ongoing education for clinicians and patients is essential, encouraging heightened vigilance and early diagnostic strategies to improve timely detection and management of functional neuroendocrine tumors.