Hormonal crisis Archives

Tag: Hormonal crisis

In the simplest of terms and in the context of Neuroendocrine Tumours, it is a dangerous change in blood pressure, heart rate, and breathing (technical term – cardiopulmonary hemodynamic instability). On an operating table under anaesthetics or an invasive procedure such as liver embolization, this can actually be life threatening. Incidentally, this happens with many other types of conditions (hormones and peptides do exist in other illnesses). However, with a patient already oversecreting these hormones and peptides, it could be a life or death situation.

The most common type is currently known as Carcinoid Crisis but this can also happen with catecholamine secreting NETs known as Pheochromocytoma and Paraganglioma where there might need to be significant pre-operative preparation in addition to peri-operative measures and post surgical treatment and monitoring, to prevent ‘Intraoperative Hypertensive Crisis

22 Oct 2024

By Ronny Allan

6 Comments

Neuroendocrine Tumour (NET) – don’t let it be a Crisis

Awareness, Living with Neuroendocrine Cancer, Patient Advocacy, TreatmentAdrenal medulla, Adrenaline, Carcinoid crisis, Carcinoid syndrome, Carcinoid tumour, Cardiopulmonary hemodynamic instability, Catecholamines, Chromaffin cells, Cortisol, Epi pens, Epinephrine, Hormonal crisis, Hormones, Hypertension, Hypotension, Intraoperative hypertensive crisis, NET syndromes, Neuroendocrine tumour (NET), Norepinephrine, Pheochromocytoma, Pressor amines, Serotonin, Somatostatin analogues, The 5 E's, Thorson-Bioerck syndrome, Vasoactive amines, Vasoactive peptides

Update February 2026. Before you read this, please note: Why Practice Is Changing Faster Than the Guidelines Modern peri‑operative management for neuroendocrine tumours is evolving rapidly, and several factors explain why clinical practice in some expert centres has moved ahead of formal guidelines: 1. New evidence challenges long‑held assumptions Recent surgical series — most prominently from OHSU Portland USA — show that prophylactic octreotide does not reliably prevent carcinoid crisis and that crises behave more like distributive shock, responding better to vasopressors than to somatostatin analogues. This directly contradicts decades of dogma. 2. Guidelines update slowly by design Bodies such…

09 Oct 2024

By Ronny Allan

11 Comments

Neuroendocrine Cancer – Liver directed therapy

TreatmentAdvanced neuroendocrine cancer, Arterial embolization, Bland liver embolization, Carcinoid crisis, Cryoablation, Drug-Eluting Beads DEB-TACE, High-intensity focused ultrasound (HIFU), Hormonal crisis, Liver directed therapy, Liver embolization, Liver metastases, Metastatic Neuroendocrine Cancer, Radioembolization, Selective Internal Radiotherapy (SIRT), Trans arterial embolization (TAE), Transarterial chemo embolization (TACE), Transarterial radioembolization (TARE)

October 2024. Updated to include Drug-Eluting Beads TACE Neuroendocrine Neoplasms (NENs) present complex challenges to diagnosis and treatment. Even in metastatic cases spreading to the liver, there are some important differences compared to the more common types of gastrointestinal tumours and pancreatic adenocarcinomas, e.g. their sometimes-indolent nature and their ability to oversecrete hormones causing distinct clinical syndromes. Also, the tumours are known to be highly vascular which is a feature where growth inhibition and symptom relief may be achieved by specific 'blocking' agents - this is particularly the case with liver metastases in well-differentiated Neuroendocrine Tumours (NETs). Spread to the…

14 Dec 2016

By Ronny Allan

4 Comments

Neuroendocrine Tumours: a spotlight on Pheochromocytoma and Paraganglioma

A spotlight on NENs - Types, Awareness, Patient Advocacy, Spotlight on NENs - Types Series123I-Metaiodobenzylguanidine (mIBG), 131I-Metaiodobenzylguanidine (mIBG), 18F-FDG, 18F-FDOPA, 24-hour urinary catacholamines and metanephrines, Adrenal glands, Adrenal medulla, Adrenaline, Adrenocortical Carcinoma (ACC), Anxiety, AZEDRA, Catecholamines, EPAS1, Epinephrine, Familial NET, FH, Ga68 PET/CT, Genetics, Hormonal crisis, Hormones, Hyperadrenergic, Hypertension, Intraoperative hypertensive crisis, Iobenguane I 131, MDH2, MEN2 syndrome, MIBG scan, Multiple Endocrine Neoplasia (MEN), Nausea, Neuroendocrine, Neuroendocrine cancer, Neuroendocrine carcinoma (NEC), Neuroendocrine tumour (NET), NF1, Octreotide scan, Palpitation, Pheochromocytoma, RET, Scan, SDHA, SDHAF2(SDH5), SDHB, SDHC, SDHD, Somatostatin analogues, Surgery, Sweating, Tachycardia, The 5 E's, Vanillylmandelic acid (VMA), Von Hippel-Lindau (VHL) Syndrome

Updated 19th August 2025 I spend a lot of time talking about the most common forms of Neuroendocrine Tumours (NETs), but what about the less well-known types? As part of my commitment to all types of NETs, I'd like to shine a light on two less common tumour types known as Pheochromocytomas and Paragangliomas - with an incidence rate of approximately 8 per million per year. They are normally grouped together, and the definitions below will confirm why. If you think it's difficult to diagnose a mainstream NET, this particular sub-type is a real challenge. So, let's get definitions out…