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Why choose The Wellington NET Unit?
The Wellington NET Unit is one of the UK’s leading specialist centres for the diagnosis and treatment of neuroendocrine tumours (NETs). NETs are a rare and complex cancer that require highly specialised expertise.
Opened in 2013 at The Wellington Hospital, the unit was established in direct response to growing demand for specialist NET care, and has since built an international reputation for excellence. We treat patients from across the UK and around the world, including those with complex or advanced disease who may have received limited treatment options elsewhere.
What sets us apart is the depth and breadth of the multidisciplinary specialist expertise brought together under one roof. Your care draws on the combined knowledge of nuclear medicine physicians, specialist radiologists and experienced surgeons, all working alongside gastroenterologists, oncologists, endocrinologists and pathologists. This means every aspect of your diagnosis, staging and treatment is considered by an expert team.
The Wellington NET Unit is led by consultant Professor Martyn Caplin, who has vast experience in neuroendocrine tumours and an international reputation for the management of neuroendocrine tumour patients. His reputation includes leading pivotal clinical trials and leading the most sophisticated laboratory research into these cancers.
We offer specialist diagnostic investigations including nuclear medicine tests such as Gallium-68 PET-CT imaging is one of the most advanced tests available for diagnosing NETs, enabling us to precisely locate tumours anywhere in the body and assess their activity with exceptional accuracy. This imaging also identifies whether tumours express somatostatin receptors, which is central to both accurate staging and planning targeted treatments such as Peptide Receptor Radionuclide Therapy (PRRT).
From the moment you are referred to the unit, you will be assigned a named Clinical Nurse Specialist (CNS) who will be your consistent, dedicated point of contact throughout your care. Your CNS will help guide you through every stage, from diagnosis and treatment through to follow-up, coordinating your appointments, answering your questions and making sure you have the support you need, when you need it.
Your team of specialists
Delivering exceptional NET care requires a coordinated multidisciplinary approach. The depth and breadth of our expertise means we can draw on the knowledge and experience of some of the world’s leading NET specialists, to create and deliver your recommended treatment plan. At the Wellington NET Unit, your diagnosis is discussed by our specialist multidisciplinary team which brings together expertise from across the following specialties:
- Gastroenterology
- Specialist surgery
- Oncology
- Nuclear medicine
- Specialist radiology
- Endocrinology
- Pathology
- Thoracic medicine
- Cardiology and cardiothoracic surgery
- Specialist NET and oncology nursing
Together, this team ensures that all treatment options are fully considered and that your recommended care plan reflects the very latest evidence and expertise in NET management.
What is a neuroendocrine tumour?
Neuroendocrine tumours (NETs) are a rare group of tumours that develop from specialised endocrine cells found throughout the body. These cells share properties of both nerve cells and hormone-producing cells, and can release chemical messengers that help control how different organs function. This is why NETs can occur in many different parts of the body, but are most commonly diagnosed in the digestive system (including the stomach, small intestine, pancreas and rectum), the lungs and the appendix.
NETs grow when these specialised cells change and begin to divide uncontrollably, forming abnormal masses or tumours. Many NETs are slow growing, though a minority can behave more aggressively. Some NETs produce excess hormones, which can cause a wide range of symptoms including flushing, diarrhoea or low blood sugar and these are known as ‘functional NETs’, while others cause no symptoms at all and these are known as ‘non-functional’ NETs. Because of this, NETs can be difficult to diagnose and people often live with unexplained symptoms for some time before a diagnosis is made. If you have concerns, it’s important to get specialist advice as early as possible, it may not be anything to worry about but finding cancer at an earlier stage can make it easier to treat.
Your named Clinical Nurse Specialist (CNS)
Working closely with your consultant, you will have the dedicated support of a named Clinical Nurse Specialist (CNS). Your CNS is an expert nurse with specialist knowledge in NETs and cancer care, and they will be your main point of contact throughout your treatment and follow-up.
They will coordinate your care across the wider clinical team, keeping you informed at every stage. They can also refer you to other specialists who can support your wider needs, including physiotherapists, dietitians and psychologists when needed.
If you have questions between appointments, or simply need someone to talk to, your CNS is there for you.
How are neuroendocrine tumours treated?
We are dedicated to offering you the latest and most effective treatments available for NETs. Our depth of experience across nuclear medicine, specialist surgery and interventional radiology means we can deliver the full range of NET therapies, from established treatments to the latest and most advanced options, delivered by a team of specialists who are experts in treating this rare and complex cancer.
Depending on your diagnosis, your recommended treatment plan may include one or a combination of the following approaches. For some patients with slow growing NETs, active monitoring with regular tests may be the most appropriate approach at first, with treatment introduced if and when needed. Your consultant will talk through what is right for you and be able to answer any questions you may have.
For many patients with localised NETs, surgery offers the best chance of cure or long term control. Our surgeons are highly experienced in operating on NETs wherever they occur in the body, using both traditional and minimally invasive approaches including robotic surgery. We have particular expertise in complex procedures such as liver resection for metastatic disease.
Somatostatin analogues such as octreotide and lanreotide are a key treatment for many NETs. As well as controlling symptoms caused by excess hormone production (such as carcinoid syndrome), they have been shown to slow tumour growth. These are often the first treatment recommended and can also be used to help slow the growth of NETs that do not produce excess hormones.
PRRT is a targeted nuclear medicine treatment that uses a small radioactive molecule eg. Lutetium-177 DOTATATE, that is designed to seek out and attach to NET cells, delivering targeted radiation directly to the tumour. It is particularly effective for somatostatin receptor positive NETs and has been shown in clinical trials to help control tumour growth and reduce symptoms. Our nuclear medicine team has significant experience in delivering this treatment, which is not widely available across the UK. We also perform Selective Internal Radiation Therapy (SIRT) which involves injection of radioactive beads into the liver via the artery feeding the tumours in the liver. This blocks the artery and the radiation treatment stops the tumours growing.
Our interventional radiology team uses the very latest imaging guided techniques to treat NETs that have spread to the liver, including techniques that cut off blood supply to tumours or use heat to destroy them, known as trans-arterial chemoembolisation (TACE) and radiofrequency ablation. Ablation therapies can be used at other sites e.g. lungs or bones.These minimally invasive procedures can be used to control liver metastases and reduce symptoms, often with shorter recovery times than surgery. The very new technique of Histotripsy is now available at The Wellington Hospital.
For certain types of NETs, particularly pancreatic NETs, targeted drug therapies may be recommended to slow the growth or spread of the tumour. These molecular targeted agents e.g. everolimus, sunitinib and cabozantanib are discussed in our multidisciplinary tumour board. In higher grade, more aggressive NETs, chemotherapy may form part of the treatment plan. We have specific chemotherapy regimens depending on the type and grade of neuroendocrine tumour. We have dedicated NET medical oncologists specialising in these forms of treatment. Your consultant and MDT will discuss which systemic therapies are most appropriate for your specific tumour type and stage.
In selected cases, radiotherapy may be used to treat NETs, for example, to help manage symptoms if the cancer has spread to the bones or brain. Where radiotherapy is recommended, you will have access to the latest precision techniques, delivered by experienced clinical oncologists.
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