Barts Cancer Centre

Barts Cancer Centre | Cancer types | Endocrine cancer

Endocrine cancer

Our services
Types of endocrine cancers treated
Research and clinical trials
For patients
For clinicians
Sources for further information
Meet the team

Our services

At Barts Cancer Centre, we offer very specialist treatment and care for patients with endocrine cancers. These are relatively rare types of cancer, but our team diagnoses and treats approximately 200 new patients every year.

We offer comprehensive treatment, care and support to our patients with endocrine cancer making full use of the clinical expertise of the multi-disciplinary team and the state-of-the-art facilities available. Planning and delivering this treatment requires the expertise of dedicated surgeons, endocrinologists, oncologists, radiologists and nuclear medicine physicians, pathologists, geneticists and specialist endocrine and cancer nurses.

Endocrine Cancers and tumours

Endocrine cancers are relatively rare but our team diagnoses and treats approximately 200 new patients every year. We assess and treat many more non-cancerous endocrine tumours. We offer comprehensive treatment, care and support to our patients with endocrine tumours making full use of the clinical expertise of the multi-disciplinary team and the state of the art facilities available. Planning and delivering this treatment requires the expertise of dedicated surgeons, endocrinologists, oncologists, radiologists and nuclear medicine physicians, pathologists, geneticists and specialist endocrine and cancer nurses.

Types of endocrine cancer and treatments:

Thyroid

Differentiated thyroid cancer

There are two types of differentiated thyroid cancer: papillary and follicular. For the majority of patients with differentiated thyroid cancer, treatment will involve surgery and radioactive iodine therapy, together with long term support and follow up. Every year at our centre we administer approximately 100 doses of radioactive iodine for patients with differentiated thyroid cancer.

Medullary thyroid cancer

This is a very rare type of cancer. The most effective treatment is surgery which should be performed by a surgeon with experience operating on this type of cancer. Some patients will need radiotherapy, chemotherapy and radionuclide therapy. For some patients the cancer may be caused by a genetic mutation which can be inherited and this possibility will be considered.

Anaplastic thyroid cancer

Anaplastic thyroid cancer is another very rare type of thyroid cancer. Surgery, radiotherapy and insertion of a tracheostomy may all play a role for certain patients.

Parathyroid

Parathyroid glands are attached to the back of the thyroid gland which, in turn, sits at the front of the neck. Tumours of the parathyroid glands cause a high calcium which can lead to problems with the bones and kidneys. Most parathyroid tumours are not cancerous but do require thorough and careful evaluation and imaging. This is because they are very small glands and accurate localisation is essential to help guide effective/curative surgery. Occasionally the gland enlargement can be cancerous and treatment may, in addition to surgery, include radiotherapy and a new drug called cinacalcet.

Pituitary

The pituitary gland is a small gland at the base of the brain which is vital for controlling many of the hormones in the body. Tumours affecting the gland are usually benign (non-cancerous) and small. Most commonly the tumours make a hormone called prolactin and these tumours can be controlled with medication alone. Larger tumours can cause problems due to 1) local effects due to their size, particularly affecting vision, 2) overproduction of certain hormones (eg the conditions of acromegaly and Cushing's disease) or 3) under-production of certain hormones.

The Endocrine Cancer centre is one of only a few centres in the UK to have all the necessary tools for dealing with the larger more complex tumours on one site; these include complex endocrine studies, dedicated imaging, neurosurgery, radiotherapy and gamma knife radio-surgery. Our surgeons routinely perform pituitary surgery using an endoscopic approach and the gamma knife centre now treats complex pituitary tumours from around the country. Many patients have their initial assessments and surgery here with multi-disciplinary input into their care and prefer to have subsequent follow-up nearer to home.

Adrenal

Phaeochromocytoma and paragangliomas

These are rare tumours of the autonomic nervous system which usually arise in the adrenal glands but may occur at other sites in the body. The tumours may make the hormones adrenaline and noradrenaline which can cause many symptoms and elevated blood pressure. They are usually non-cancerous but can be malignant in approximately 10% of cases. A proportion of people may develop the tumours as part of an underlying genetic condition and careful assessment, localization and treatment prior to surgical removal are essential.

Adrenal cancer

Most other adrenal lumps are non-cancerous but need careful evaluation to make sure that they are not producing excessive amounts of steroid hormones and to ensure that their characteristics are benign.

Cancer of the adrenal cortex is a very rare condition and may, in some cases, be associated with excessive production of certain steroid hormones. Surgery, chemotherapy and radiotherapy may all be used for the treatment of this rare type of cancer. Patients with the possibility of this type of cancer will undergo extensive investigation and imaging in order to help guide treatment decisions.

Neuroendocrine tumours (NETs)

Neuroendocrine tumors (NETs) are a group of tumours that start in the cells of the neuroendocrine system (some of the tumours described above are examples). These tumours most commonly arise from cells in the lung, bowel or pancreas. They may make hormones which can cause problems such as diarrhoea. Treatment is aimed at controlling these symptoms in addition to the size and/or spread of the NET. Treatment may include surgery, radiofrequency ablation (heating of the tumour until it dies), hepatic embolisation (blocking blood supply to the liver), chemotherapy, radiotherapy and radio-nuclide therapy. In addition, treatments to control the hormone secretion may be necessary.

Late effects of cancer treatment

Recent evidence shows that some of the treatments used for cancer both in children and in adults can have late effects on various aspects of health including the Endocrine system. We offer a specialist joint clinic to evaluate and treat patients who have or may be at risk of these conditions.

Research and clinical trials

The department is routinely leading and participating in clinical and laboratory based studies and trials to further our understanding about Endocrine tumours and their treatment. Further information on the academic and research aspects of the department can be found via the Queen Mary University link below;

www.whri.qmul.ac.uk/research

For patients

Endocrine cancers are rare and require a team of specialists to diagnose the condition and to provide the right treatment. Patients who are treated for endocrine cancer will be seen by an endocrinologist and cancer experts who will provide the best possible treatment approach.

In addition to the general cancer links on this website, specific further information about endocrine cancers/tumours may be obtained via the links below;

Thyroid www.butterfly.org.uk/about.htm

Pituitary www.pituitary.org.uk

Multiple Endocrine Neoplasia www.amend.org.uk

NETs www.netpatientfoundation.com

General further information on Endocrine cancers www.macmillan.org.uk/Cancerinformation/Cancertypes/Endocrine/Livingwithandaftercancer.aspx

For clinicians

We consistently achieve national access targets for patients with suspected cancer and for treatment following diagnosis. Referral criteria and forms are all available on our website, please click here for referral forms.

For non-cancer endocrinology information, please visit our dedicated website for Barts and The London Endocrinology Centre www.bartsandthelondon.nhs.uk/endocrinology

For more information about our endocrine cancer service and the treatment of endocrine cancers please contact one of the endocrinologists listed below.

Sources for further information

For further information about our endocrinology services at Barts and The London please visit our dedicated website at www.bartsandthelondon.nhs.uk/endocrinology

Here you can also find links to other websites that provide useful information about endocrine cancers.

Information about thyroid cancer from Butterfly – the thyroid cancer trust
www.butterfly.org.uk/about.htm

Information about pituitary tumours
www.pituitary.org.uk

Information about multiple endocrine neoplasia
www.amend.org.uk

Information about neuroendocrine tumours
www.netpatientfoundation.com

Vicky Clement Jones Macmillan Cancer Information Centre at Barts, click here for more information

From the Macmillan, cancer support website

Endocrine
www.macmillan.org.uk/Cancerinformation/Cancertypes/Endocrine/Endocrinetumours.aspx

Thyroid
www.macmillan.org.uk/Cancerinformation/Cancertypes/Thyroid/Thyroidcancer.aspx