Nutrition and neuroendocrine tumors: An update of the literature

Bone Metabolism and Vitamin D Implication in Gastroenteropancreatic Neuroendocrine Tumors

“…Nevertheless, surgical treatment can influence nutritional status, causing diarrhea for several reasons. As previously discussed, the extent of the intestinal resection and the anatomical position of the resected region are the main factors with an impact on bowel transit time, vitamin B12 action, bile acid secretion, fat-soluble vitamins absorption and digestion [19,67,70].…”

“…Nutritional status in GEP-NET patients is deeply affected by the excessive production of gastrointestinal hormones, peptides, and amines, which could cause malabsorption, diarrhea, steatorrhea, and altered gastrointestinal motility. Furthermore, surgical resection of GEP-NET could change the anatomy of the gastrointestinal tract, and therapy with somatostatin analogs (SSAs) could modify the function of the gastrointestinal tract by inhibiting the secretion of pancreatic enzymes and hormones, impairing normal absorptive function (Figure 1) [19,67]. It has been recently demonstrated that GEP-NET patients have a dietary pattern with significantly lower adherence to the Mediterranean diet compared to a health-matched control group, less frequently consuming vegetables, fruits, wine, fish/seafood, and nuts, and more frequently red/processed meats, butter, cream, margarine, and soda drinks [20].…”

“…Thus, similarly to surgical treatment, a direct relationship between SSA treatment and bone has not been demonstrated. It could be possible that malabsorption of fat and fat-soluble vitamins may lead to reduced bone density due to vitamin D deficiency [19]. Nevertheless, this hypothesis has been contradicted.…”

“…It has been demonstrated that NET patients have a greater clinical burden of disease than matched control subjects, with increased risk of cardiovascular, hepatic, and gastrointestinal diseases, as well as osteopenia and osteoporosis [18]. Moreover, the tumor itself and the systemic therapy may have an impact on patients' nutritional status [19,20], leading to a deficiency of different vitamins, including vitamin D [21,22]. It is well demonstrated that vitamin D plays a key role in the process of bone formation [23].…”

Neuroendocrine neoplasms – think about it and choose the most appropriate diagnostic and therapeutic steps

“…If the decision is made to perform surgery on a patient with NEN, a multidisciplinary team should discuss the perioperative proceedings including an effective prophylaxis against an intraoperative carcinoid crisis, supportive therapy, and nutrition [7,8,22]. Psychosocial support, expert nursing, nutritional support and management of cancer related pain will be reviewed by the groups, Auernhammer and Spitzweg, as well as the group, Faggiano, Colao, Muscogiuri and colleagues [23,24].…”