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Home » What are Neuroendocrine Cancers?​ » Large Cell Neuroendocrine Carcinoma

Large Cell Neuroendocrine Carcinoma

Everything you need to know about LCNEC from survival rates to treatment options

In the realm of oncology, the journey through cancer can be a challenging one that demands a balance of expertise and support. For Australians facing a large cell neuroendocrine carcinoma (LCNEC) diagnosis, it’s crucial to arm oneself with information about your prognosis and treatment options.

Large cell neuroendocrine carcinomas (LCNEC) can occur in various organs and tissues in the body, but they are most commonly associated with the lungs. LCNEC of the lung is a type of lung cancer that has features of both neuroendocrine cells and large cell carcinoma. It is considered a subtype of non-small cell lung cancer (NSCLC) and is relatively rare, accounting for a small percentage of all lung cancer cases.

LCNEC can also occur in other organs such as the gastrointestinal tract, thymus, and other sites, but lung LCNEC is the most well-known and frequently encountered type. It is an aggressive cancer that tends to grow and spread quickly, making early detection and treatment crucial for better outcomes.

Understanding Large Cell Neuroendocrine Carcinoma

Large Cell Neuroendocrine Carcinoma (LCNEC) originate in the neuroendocrine cells. Neuroendocrine cells are responsible for producing hormones and regulating various bodily functions. 

When these cells undergo abnormal changes and start to proliferate uncontrollably, they can give rise to large cell neuroendocrine carcinoma. This type of cancer most commonly occurs in the lungs but can also affect other organs such as the gastrointestinal tract.

Due to its rarity and aggressive nature, LCNEC can be challenging to diagnose and treat effectively. Its symptoms are often nonspecific and can mimic other more common conditions, leading to delays in diagnosis.

What causes Large Cell Neuroendocrine Carcinoma?

Like many cancers, the exact causes of LCNEC are not fully understood. However, there are several known risk factors that may increase the likelihood of its development. 

Some of the potential causes and risk factors for LCNEC include:

Genetic factors

While specific genetic mutations have not been definitively linked to LCNEC, there is evidence that genetic factors may play a role in some cases. Individuals with a family history of lung cancer or certain genetic predispositions may be at a higher risk.

Immune suppression

People with weakened immune systems may have a higher risk of developing certain types of cancers, including LCNEC. This includes individuals who have undergone organ transplantation or who are living with HIV/AIDS.

Smoking

Smoking tobacco is a significant risk factor for LCNEC, and people who smoke have a much higher risk compared to non-smokers. The carcinogenic chemicals present in tobacco smoke can damage lung cells and increase the likelihood of cancer development.

Prior lung disease

People with a history of chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis, may have an increased risk of developing LCNEC.

Occupational hazards

Exposure to certain occupational carcinogens, such as asbestos, radon, and various industrial chemicals, can increase the risk of developing lung cancer, including LCNEC.

Radiation exposure

Exposure to high levels of ionising radiation, such as from previous radiation therapy for other medical conditions, may increase the risk of developing LCNEC.

Remember that LCNEC is relatively rare, and not everyone with these risk factors will develop the condition. If you have concerns about your risk of LCNEC or any other health-related matters, it’s best to consult with a healthcare professional.

What are the symptoms of Large Cell Neuroendocrine Carcinoma?

LCNEC may not be a household name, but recognising its symptoms can make all the difference in a patient’s journey toward diagnosis and treatment. This aggressive form of cancer originates in neuroendocrine cells, which typically produce hormones and influence various bodily functions. 

This influence can lead to a range of symptoms, including.

  • Respiratory distress: Breathlessness, a persistent cough, and chest pain often arise due to the tumour’s interference with normal lung function and airflow.
  • Fatigue: LCNEC can drain your energy reserves, leaving you persistently fatigued despite ample rest. This exhaustion can significantly impact your quality of life.
  • Altered bowel habits: LCNEC that develops in the gastrointestinal tract can lead to changes including persistent diarrhoea, constipation, or even rectal bleeding.
  • Unexpected weight loss: Rapid and unexplained weight loss can signal an underlying health issue, including large cell neuroendocrine cancer.
  • Skin flushing or paleness: Neuroendocrine cells are known for releasing hormones that can affect blood vessels, which may lead to skin flushing or paleness.
  • Hormonal imbalances: LCNEC can produce hormones that lead to imbalances. A tumour in the lungs might cause excessive sweating, palpitations, or even anxiety.
  • Abdominal pain: LCNEC affecting the gastrointestinal tract can cause persistent abdominal pain, discomfort, or a feeling of fullness.
  • Neurological symptoms: LCNEC may affect the nervous system, leading to symptoms such as headaches, seizures, or weakness in certain body parts.

Treatment options for Large Cell Neuroendocrine Carcinoma

When it comes to treating LCNEC, a multidisciplinary approach involving oncologists, surgeons, radiation therapists, and other specialists is essential. The treatment plan will be tailored to the individual’s unique circumstances, including the cancer’s stage, location, and the patient’s overall health.

Surgery

Surgical intervention is often considered for localised LCNEC. Surgeons may aim to remove the tumour and any affected nearby tissues. In cases where surgery is not feasible due to the tumour’s size or location, alternative treatments are explored.

Chemotherapy

Chemotherapy is a systemic treatment that uses medications to kill cancer cells or slow their growth. It’s commonly used in LCNEC cases, particularly when the cancer has spread beyond its initial site.

Radiation therapy

Radiation therapy involves using high-energy rays to target and destroy cancer cells. It’s sometimes used as a standalone treatment or in combination with surgery or chemotherapy, depending on the case.

Targeted therapy

This approach focuses on targeting specific molecules or pathways involved in cancer growth. While targeted therapies have shown promise in other types of cancer, their effectiveness in LCNEC is an area of ongoing research.

Immunotherapy

Immunotherapy works by enhancing the body’s immune system to recognise and attack cancer cells. While it has shown remarkable success in certain cancers, its role in LCNEC treatment is still being explored.

Survival rates and prognosis for Large Cell Neuroendocrine Carcinoma

Understanding survival rates is an essential aspect of coping with a cancer diagnosis. However, it’s crucial to remember that survival rates are statistical estimates and may not accurately predict an individual’s outcome. In Australia, the survival rate for LCNEC varies depending on several factors, including the stage at diagnosis, the patient’s overall health, and the treatments received.

Lung LCNEC

When LCNEC occurs in the lung, survival rates are often reported alongside other types of non-small cell lung cancer (NSCLC). The overall five-year survival rate for lung LCNEC tends to be lower than that for some other NSCLC subtypes.

Gastrointestinal (GI) Tract LCNEC

LCNEC can also occur in the gastrointestinal tract, including the oesophagus, stomach, small intestine, and colon. Survival rates for GI tract LCNEC may vary depending on the specific location and stage of the tumour.

Other Sites

LCNEC can occur in other sites like the thymus, bladder, or cervix. Survival rates for LCNEC in these locations can vary widely, and specific data may not be as readily available as for lung or GI tract LCNEC.

What to do after receiving an LCNEC diagnosis

A diagnosis of Large Cell Neuroendocrine Carcinoma (LCNEC) can be an overwhelming experience. It’s often a complex journey filled with medical decisions and emotional challenges. Approach the road ahead with a combination of empowerment and support, and follow these steps:.

  1. Seek expert advice from a Specialist NET oncologist. They can provide you with an understanding of your diagnosis, the stage of the cancer, and the treatments available.
  2. Understand your treatment options and take the time to discuss a multifaceted approach of surgery, chemo, radiation, targeted therapies, and/or immunotherapy. 
  3. Maintaining open communication with your medical team is essential. Ask questions, express your concerns, and clarify any doubts you may have.
  4. Advocate for yourself and take an active role in your treatment plan by sharing your preferences and concerns with your medical team.
  5. Focus on wellbeing by maintaining a healthy diet, engaging in regular physical activity if possible, practising relaxation techniques, and getting sufficient rest.
  6. Stay informed about advancements in LCNEC treatment and research. New therapies, treatments, and clinical trials may become available that could be relevant.

Accessing support for LCNEC

A cancer diagnosis, especially of a rare and aggressive form like LCNEC, can be emotionally overwhelming. Alongside medical treatment, emotional and psychological support plays a vital role in a patient’s journey.

As Australia’s foremost neuroendocrine cancer non-profit organisation, NeuroEndocrine Cancer Australia is here to help. If you’ve been recently diagnosed with LCNEC, we recommend giving our NET nurse a call. This free confidential telephone information line can answer any questions you have, while giving you emotional support.

Through your healthcare team, you have access to a network of resources to help you and your family navigate this challenging path with resilience and hope. Be sure to discuss these support options with your treatment team to figure out which course of action is right for you.

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