The Endocrine System of the body is made up of the endocrine glands in different parts of the human body which produce different types of hormones. Endocrine cancer occurs when these glands develop tumours.
Endocrine Services in Belfast Trust are located in Belfast City Hospital and the Royal Victoria Hospital. This team consists of:
- Medical Oncologists
- Clinical Oncologists
- Endocrine Surgeons
- Clinical Nurse Specialists
- Allied Health Professionals
- Administration Staff
Please note that this section details services provided to adult patients of Belfast Trust. Please follow the link for information on Children’s Cancers.
Endocrine tumours are classified according to:
- The particular endocrine glands that are involved
- The type of cell from which the cancer develops
- The part of the body that is affected
If a GP suspects a patient of having endocrine cancer, the GP will conduct an examination and possibly arrange the patient to have further tests.
If the GP sees anything unusual they will refer the patient to a specialist in the Royal Victoria Hospital.
Patients will be contacted and given an appointment.
Investigations and diagnosis
This usually begins with a patient’s GP, who will ask about the symptoms a patient is experiencing and their general health before conducting an examination. The GP may also take some blood tests.
If the GP notices anything unusual when conducting an examination or from any tests conducted, they will refer a patient to the Royal Victoria Hospital or Belfast City Hospital.
Patients will be seen by a Consultant Endocrine Specialist or nurse who will conduct an examination and may order further investigations. These investigations may include:
The types of tests and scans conducted at the hospital will be depend upon a patient’s symptoms and the problematic areas.
Within a week of their investigations patients will be seen at clinic with an opportunity to discuss their results with one of the specialists.
There are two multi-disciplinary teams involved in the treatment of endocrine cancer, the Endocrine cancer team and the Neuro-Endocrince cancer team. The teams are well established groups of experts with a specialist interest in diagnosing and treating patients with endocrine tumours.
How the team works
The teams meet on a monthly basis to discuss patient diagnosis and treatment plans. These discussions are confidential and bring together all the relevant test results and scans that have been conducted. They are needed to ensure that patients receive the best treatment plan possible.
A copy of any discussions will be sent to the patient’s GP.
There are a range of cancer treatments for patients with endocrine tumours. The type of treatment given will depend on the the type and the size of the tumour or whether it has spread. Treatment plans are tailored to each person. Treatments include:
- Thyroid Hormone Replacement
- Radioactive Iodine Treatment
- Radionuclide Therapy
- Drug Treatment
- Biological Targeted Therapy
Before a patient can begin treatment, they must first give their consent. This is an important process to ensure that patients fully understand the nature of their treatment and the risks involved.
Very small cancers can often be treated with a simple surgical operation under local or general anesthetic, or with laser surgery, with no need to stay in hospital overnight.
If the cancer is larger, surgery will often involve a hospital stay and an operation under general anesthetic.
Thryoid Hormone Replacement
Once a patient has their thyroid gland removed by surgery their body no longer produces certain hormones. The hormones can be replaced by taking tablets. This is a life-long requirement as without these hormone tablets, patients would develop the signs and symptoms of hypothyroidism such as weight gain, tiredness, dry skin and hair, and physical and mental slowness.
Radioactive Iodine Treatment
This is mainly taken as capsules, but can be taken as a drink or injected into a vein in your arm (intravenously). It is a way of giving radiotherapy internally, rather than externally| as high-energy rays. It is common for an operation| for papillary or follicular thyroid cancer to be followed by treatment with radioactive iodine. The iodine treatment can destroy tiny amounts of normal thyroid tissue and any cancer cells that are sometimes left behind after an operation. The treatment is sometimes known as thyroid remnant ablation.
Some types of tumour may take up large amounts of particular chemicals such as MIBG. To treat these tumours, the chemical can be attached to a dose of a radioactive substance. As the cancer takes up the chemical, it also takes in the radioactivity.
To test whether or not the tumour takes up large quantities of these chemicals, a scan will first be done using a tiny amount of radioactivity. If the tumour takes up the radioactivity, the treatment will be given using a higher dose of the radioactive substance. Patients may need to be looked after in a contained room by themselves for a few days so that other people are not unnecessarily exposed to the radioactivity.
Some prolactin-secreting tumours can be treated with a drug treatment which reduces the production of prolactin. These drugs include bromocriptin and cabergoline.
If the whole pituitary gland is removed, drugs will have to be taken to replace the hormones that are normally produced (hormone replacement).
Biological Targeted Therapy
This is called Interferon and is used for carcinoid tumours and targeted therapy.
Following cancer treatment patients will be asked to return to the hospital to see one of the Endocrine Team. The frequency of these review appointments will differ for each patient. The review appointments allow the team to assess patient progress following treatment. The check-ups are also a good opportunity for patients to discuss any problems or worries they may have with medical staff.
Follow up appointments will take place at an outpatients department in one of the two hospitals of the Belfast Health and Social Care Trust; Belfast City Hospital or the Royal Victoria Hospital.
If patients notice any new symptoms, or have any worries, they should contact their Clinical Nurse Specialist, Consultant or local GP to discuss the symptoms as they may need additional treatment or rehabilitation services, such as a dietician or physiotherapy services.
A list of useful websites relating to Endocrine Tumours have been provided below for patients and their familes to read for additional information.
Please select one of the links below if you would like to read more: