Multiple endocrine neoplasia type 1 medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Management
- Because the type of pancreatic endocrine cancer associated with MEN1 can be difficult to recognize, difficult to treat, and slow to progress, doctors have different views about the value of surgery in managing these tumors.
- One approach is to "watch and wait," using medical, or nonsurgical, treatments. According to this school of thought, pancreatic surgery has serious complications, so it should not be attempted unless it will cure a tumor or cure a hormone excess state.
- Another school advocates early surgery, perhaps when a tumor grows to a certain size, to prevent or treat pancreatic endocrine cancer—even if the tumor does not over secrete a hormone-before the cancer spreads. No clear evidence exists, however, that surgery to prevent pancreatic endocrine cancer from spreading actually leads to longer survival for patients with MEN1.
- Excessive release of certain hormones-mainly gastrin-from pancreatic endocrine cancer in MEN1 needs to be treated, and medications are often effective in blocking the effects of these hormones.