First off, to better understand whether smoking tobacco and alcohol consumption increases the risk of cancer or neuroendocrine tumors in the small intestine, we must better understand these tumors and the effects of these compounds on the body and bodily cells altogether.
Neuroendocrine tumors are rare malignancies that develop in the neuroendocrine system’s cells. NET cancers are rare, and earlier, they were often overlooked. However, with the advancements in cancer testing and diagnostic methods, experts can discover these diseases faster and offer faster and more effective neuroendocrine tumor treatment earlier.
In this article, Dr. Omar Rashid and his expert team will discuss the nature of these malignancies and try to shed more light on whether alcohol and tobacco use increases the risk of these cancers.
What Are NETs or Neuroendocrine Tumors?
As stated above, these are uncommon diseases that develop in the cells of the neuroendocrine system. The cells share traits of hormone-producing cells and nerve cells, linking the endocrine system to the nervous system, and they are scattered throughout the human body.
There are several types of these tumors, and many show symptoms similar to other, often less severe medical conditions.
Once considered especially rare, nowadays, diseases are being diagnosed in more and more patients, not necessarily because of the rising NET rates but because of improved diagnostics, which also increases the successful outcome of neuroendocrine tumor treatment.
Types of Neuroendocrine Tumors
Typically, these malignancies are classified as either primary or secondary, with the first being cancers that haven’t spread yet. Secondary tumors are those that have managed to metastasize, usually to the nearest lymph nodes, liver, or bones.
These tumors may also be classified based on their location. Here are the most common tumor types regarding the location of occurrence:
- GI or gastrointestinal tract: They are most common in the large intestine, small intestine, and appendix.
- Lung: This organ is the second most common place where these tumors may develop. Around 30% of NETs develop in the bronchial system.
- Pancreas: Around 7% of these tumors develop here. They were previously called islet tumors.
Symptoms
The signs of neuroendocrine tumors will usually vary depending on their location. On that end, carcinoid syndrome is often the most prevalent group of symptoms that patients produce.
Carcinoid syndrome occurs when the tumors affect normal hormone production. Only around 10% of patients with these conditions develop the syndrome, and the most common symptoms may include the following:
- Head and neck flushing
- Diarrhea and cramps in the abdomen
- Gassiness
- Edema
- Wheezing
- Decreased libido and erectile dysfunction
- Jaundice
The Causes Behind Neuroendocrine Tumors
Whether they develop in the lungs or the small intestine, researchers aren’t exactly sure what triggers these cell mutations. However, the medical community has linked these diseases to a few inherited syndromes, such as:
- MEN1, or multiple endocrine neoplasia type 1, which causes the adrenal thyroid, and parathyroid glands to form tumors or become overactive.
- MEN2, or multiple endocrine neoplasia type 2, which affects the pancreas, parathyroid, or pituitary gland to become overactive or form tumors.
- Tuberous sclerosis complex, with symptoms such as autism, skin birthmarks, and developmental delay in early childhood.
- Von-Hippel-Lindau syndrome, in which tumors may develop in various areas of the body.
- Neurofibromatosis type1, in which tumors grow on the nerves and the skin.
Do Smoking Tobacco and Drinking Alcohol Increase the Risk of NETs?
As of now, researchers aren’t exactly sure whether these two compounds can directly trigger the development of these malignancies. According to state-wide scientific research conducted in Utah between 1996 and 2014, smoking tobacco and alcohol use may be risk factors for neuroendocrine tumors of the small intestine, independent of family history. Still, when looking at the findings overall, experts stated that other yet-to-defined exposures might be more prevalent risk factors. On that end, the scientific consensus is that tobacco and alcohol present a modest risk of cancer when it comes to small intestine NET, specifically.
More About the Effects of Alcohol and Tobacco
The scientific community strongly agrees that alcohol consumption can contribute to the development of several malignancies.
According to evidence, the more a person drinks, over time, regularly, the higher the chances of developing an alcohol-related malignancy.
Clear patterns show that prolonged and regular alcohol consumption may lead to the development of the following cancers:
- Head and neck tumors
- Colorectal cancer
- Esophageal cancer
- Liver cancer
- Breast cancer
Apart from that, current research results suggest that alcohol consumption may increase the risks of other cancers, such as pancreatic, prostate, kideny cancers, and melanoma.
Tobacco, on the other hand, may increase cancer risk almost everywhere in the body. Even though lung cancer comes first to mind, in reality, smoking can increase malignancy development almost everywhere in the body, including the following:
- Cervix
- Throat and mouth
- Stomach
- Larynx
- Bladder
- Rectum and colon
- Esophagus
- Renal pelvis and kidney
- Liver
- Lungs
- Bronchi
- Trachea
- Blood (in the form of acute myeloid leukemia)
- Esophagus
- Pancreas
Just like in the case of alcohol, quitting can reduce the risk of cancer development. However, both of them may be hard to stop because of their addictive characteristics. Fortunately, several organizations and programs aim to help kick these unhealthy habits.
Lastly, epidemiologic research suggests that individuals who use both substances are at a higher risk of developing oral, throat, and esophagus cancers than those who either drink or smoke. While doing only one of these can somewhat lower the risks, individuals should consider quitting both to help decrease the risk of medical issues in general.
How Are NETs Diagnosed?
Now that we’ve established the possible links between neuroendocrine tumors and alcohol and tobacco use, we should highlight the most prevalent methods to diagnose these tumors.
The typical tests may include:
- Biopsy
- Urinalysis
- Coren needle biopsy
- CT scans
- MRI scans
- Biochemical tests
- PET scans
During the diagnostic process, healthcare experts will also grade the tumors to create an effective treatment plan.
Doctors usually grade these tumors in the following way:
- Grade 1 is a low-grade tumor where the cells multiply slowly, and cancer grows slowly.
- Grade 2 is an intermediate-grade tumor where the cells divide faster.
- Grade 3 tumors grow quickly, and the patient needs swift medical assistance.
Experts may also classify and evaluate the tumors by the degree of differentiation.
In the case of well-differentiated tumors, the cells look very similar to healthy cells. On the other hand, in poorly-differentiated NETs, the cells resemble typical cancerous cells more.
Treating Neuroendocrine Tumors
Typically, these malignancies are treated with surgery, but if the cancer is large or has spread, experts may also opt for:
- Chemotherapy as it uses different drugs to kill malignant cells.
- Somatostatin analogs inhibit excess hormone production, which may slow down tumor growth.
- Targeted therapy uses drugs that target specific proteins and genes to eliminate cancer cells.
Learn More
Knowing the most prominent cancer risk and cancer-causing substances can help you quit harmful habits and promote healthy lifestyle changes, which can minimize the chances of disease. If you’d like to learn more about the possible links between alcohol, tobacco, and small intestine neuroendocrine tumors, feel free to schedule an appointment with Dr. Rashid.