The carcinoid syndrome

Description

The carcinoid syndrome occurs when a rare cancerous tumor called a carcinoid tumor secretes certain chemicals into the bloodstream, causing a variety of signs and symptoms. A carcinoid tumor, a type of neuroendocrine tumor, occurs most frequently in the gastrointestinal tract or the lungs.

The carcinoid syndrome typically occurs in people who have carcinoid tumors that are advanced. Treatment for carcinoid syndrome usually involves treating the cancer. However, because the most carcinoid tumors don't cause carcinoid syndrome until it is advanced, a cure may not be possible. They may recommend medications to relieve the carcinoid syndrome symptoms and make you feel more comfortable.

Symptoms

The signs and symptoms of car -cinoid syndrome depend on the chemicals that the carcinoid tumor secretes in your bloodstream.

The most common signs and symptoms include:

  • Redness of the skin.The skin of the face and upper chest feels hot, and changes color from pink to purple-red. Flushing episodes can last from a few minutes to a few hours or more. The flushing may occur for no apparent reason, although sometimes it can be triggered by stress, exercise, or alcohol consumption.
  • Facial skin lesions. Purplish areas of spiderlike veins can appear on the nose and the upper lip.
  • The diarrhea. Frequent, watery stools, sometimes accompanied by abdominal pain can occur in people who have carcinoid syndrome.
  • Difficulty breathing. Asthma-like signs and symptoms, such as wheezing and difficulty breathing, may occur at the same time that you experience redness of the skin.
  • A fast heartbeat. The periods of a fast heart rate could be a sign of carcinoid syndrome.

Redness of the skin. The skin of the face and upper chest feels hot, and changes color from pink to purple-red. Flushing episodes can last from a few minutes to a few hours or more.

The flushing may occur for no apparent reason, although sometimes it can be triggered by stress, exercise, or alcohol consumption.

When to see a doctor

Make an appointment with your doctor if you have signs and symptoms that worry you.

Causes

The carcinoid syndrome is caused by a carcinoid tumor that secretes serotonin and other chemicals in the bloodstream. Carcinoid tumors occur most often in the gastrointestinal tract, including the stomach, small intestine, appendix, colon and rectum.

Only a small percentage of these tumors secrete the chemicals that cause the carcinoid syndrome. When these tumors secrete chemical substances, the liver normally neutralizes the chemicals before they have the opportunity to travel to t -n to your body and cause symptoms.

However, when an advanced tumor that spreads (metastasizes) in the liver, it is possible that secrete chemical substances that are not neutralized before reaching the bloodstream. Most of the people suffering from carcinoid syndrome have an advanced cancer that has spread to the liver.

Some carcinoid tumors don't have to be advanced to cause the carcinoid syndrome. For example, carcinoid lung tumors that secrete chemicals into the blood to do so farther upstream from the liver, which then cannot process and remove the chemicals.

Carcinoid tumors of the gut, on the other hand, the secretion of chemicals in the blood that must first pass through the liver before reaching the rest of the body. The liver usually neutralizes the chemicals before they can be affectedct the rest of the body.

What causes carcinoid tumors is not clear.

Complications

Have carcinoid syndrome can cause the following complications:

  • Carcinoid heart disease.Some people with carcinoid syndrome develop heart disease carcinoid. The carcinoid syndrome causes problems with the heart valves, making it difficult for them to operate properly. As a result, the heart valves may leak. The signs and symptoms of heart disease carcinoid include fatigue and shortness of breath. Carcinoid heart disease may eventually lead to heart failure. The surgical repair of damaged heart valves may be an option.
  • Carcinoid crisis. Carcinoid crisis causes a severe episode of flushing, low blood pressure, confusion and difficulty breathing. Carcinoid crisis can occur in people with carcinoid tumors when they are exposed to certain triggers, including anesthesia during surgery. Carcinoid crisis can be fatal. Your doctor can give you medicines before the surgery to reduce the risk of crisis carcinoid.

Carcinoid heart disease. Some people with carcinoid syndrome develop heart disease carcinoid. The carcinoid syndrome causes problems with the heart valves, making it difficult for them to operate properly. As a result, the heart valves may leak.

The signs and symptoms of carcinoid heart disease include fatigue and shortness of breath. Carcinoid heart disease may eventually lead to heart failure. The surgical repair of damaged heart valves may be an option.

The carcinoid syndrome

Diagnosis

Your doctor will assess your signs and symptoms to rule out other causes of skin flushing and diarrhea. If there are no other causes are found, your doctor may suspect carcinoid syndrome.

To confirm a diagnosis, your doctor may recommend additional tests, including:

  • Urine test. The urine may contain a substance made when your body breaks down serotonin. An excessive amount of this substance could indicate that your body is processing extra serotonin, the chemical most commonly excreted by carcinoid tumors.
  • Blood test. Your blood may contain high levels of certain shazardous that are released by some carcinoid tumors.
  • Imaging tests. Imaging tests can be used to localize the tumor carcinoid primary and determine if it has spread. Your doctor may start with a ct scan of the abdomen, because most carcinoid tumors are found in the gastrointestinal tract. Other scans, such as magnetic resonance imaging or nuclear medicine scans, may be useful in certain situations.
  • A scope or camera to view the inside of your cuerpo.Su doctor may use a long, thin tube equipped with a lens or camera to examine areas in your body. An endoscopy, which involves passing a scope down your throat, which can help your doctor see the inside of the gastrointestinal tract. A bronchoscopy, which uses a scope passed through the throat and in the lungs, it can help you to find carcinoid lung tumors. Spend a scope through your rectum (colonoscopy) can help you to diagnose rectal carcinoids.
  • Removal of tissue for laboratory analysis. A sample of tumor tissue (biopsy) may be collected to confirm the diagnosis. What type of biopsy that I'm going to undergo depends on where the tumor is located.

A scope or camera to view the inside of your body. Your doctor may use a long, thin tube equipped with a lens or camera to examine areas in your body.

An endoscopy, which involves passing a scope down your throat, you can help your doctor see the inside of the gastrointestinal tract. A bronchoscopy, which uses a scope passed through the throat and in the lungs, it can help you to find carcinoid tumors of the lung. Spend a scope through your rectum (colonoscopy) can help you to diagnose rectal carcinoid tumors.

Treatment

The treatment of the carcinoid syndrome involves the treatment of your cancer and may also involve the use of medications for the control of their specific signs and symptoms.

Treatments may include:

  • Surgery. The surgery to remove the cancer or the majority of your cancer may be an option.
  • Drugs to block the cancer cells from secreting chemical substances. The injections of drugs octreotide (Sandostatin) and lanreotide (Somatuline Depot) can reduce the signs and symptoms orf carcinoid syndrome, including redness of the skin, and diarrhea. A medicine called telotristat (Xermelo) can be combined with these drugs for the control of diarrhea caused by the carcinoid syndrome.
  • Drugs that deliver radiation directly to the cancer cells. Peptide receptor radionuclide therapy (PRRT) combines a drug that look for cancer cells with a radioactive substance that kills them. In PRRT for carcinoid tumors, the drug is injected into the body, where it travels to the cancer cells, binds to cells and provides the radiation directly to them. This therapy is used in people who have advanced cancer that has not responded to other treatments.
  • To stop the supply of blood to the liver tumors. In a procedure called embolization of the hepatic artery, a doctor inserts a catheter through a needle near the groin and threads to the main artery that carries blood to the liver (hepatic artery). The doctor injects particles designed to obstruct the hepatic artery, cutting off the blood supply to the cancer cells that have spread to the liver. The healthy liver cells to survive by relying on the blood of other blood vessels.
  • Kill cancer cells in the liver with the heat or the cold. Radiofrequency ablation provides heat through a needle to the cancer cells in the liver, causing the cells to die. Cryotherapy is similar, but works by freezing of the tumor.
  • Chemotherapy. Chemotherapy uses strong drugs to kill cancer cells. Chemotherapy drugs can be given through a vein (intravenously) or in pill form, or both methods may be used.

Self-care

Talk with your doctor about measures of self-care that you can improve your signs and symptoms. Self-care is not a substitute for treatment, but it can complement it. Ask your doctor if you should:

  • Avoid the things that cause redness of the skin. Certain chemicals or situations, such as alcohol or large meals, can cause redness. Keep track of what makes her blush, and try to avoid your triggers.
  • Consider taking a multivitamin. Chronic diarrhea makes it difficult for your body to process the vitamins and nutrients in the foods you eat. Ask your doctor if you should take a multivitamin supplement may be a good idea for you.

Coping and support

You can be relieved to finally find an answer to what has been the cause of your signs and symptoms, but a diagnosis of a rare disease, such as the carcinoid syndrome, can be stressful. As you develop your own way of dealing with a cancer diagnosis, talk with your health care team about how you feel and consider trying to:

  • To find out enough about the carcinoid syndrome to make decisions about your care.Ask your doctor about your condition. Ask members of your healthcare team to recommend resources where you can get more information. Know about your condition may be allowed to participate in decisions about your care.
  • Talk with other people with the carcinoid syndrome.Support groups of people with carcinoid syndrome was put in contact with those who have faced the same problems you are facing. Ask your doctor about groups in your area. The carcinoid syndrome is rare, though, so you may need to connect with people outside of his immensediate area or online.
  • Take care of yourself. Do what you can to maintain a healthy lifestyle. Eat a diet full of fruits and vegetables. When you feel up to it, are the light of exercise in your daily routine. Cut the stress out of your life whenever possible. Get a lot of sleep to feel rested upon waking. Take care of your body and mind, so that it is better to be able to continue with your cancer treatment plan.

To find out enough about the carcinoid syndrome to make decisions about your care. Ask your doctor questions about your condition. Ask members of your healthcare team to recommend resources where you can get more information.

Know about your condition may be allowed to participate in decisions about your care.

Talk with other people who suffer from this syndrome. Support groups for people with carcinoid syndrome was put in contact with those who have faced the same problems you are facing.

Ask your doctor about groups in your area. The carcinoid syndrome is rare, though, so you may need to connect with people outside of your immediate area or online.

Preparing for your appointment

You can start by seeing your family doctor if you have signs and symptoms of carcinoid syndrome. Depending on what your doctor finds, you may be referred to a doctor who specializes in the treatment of cancer (oncologist), a specialist in disorders of the endocrine system (endocrine) or a surgeon.

Because appointments can be brief, and because there's often a lot to discuss, it is a good idea to be prepared. Here's some information to help you prepare and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down the symptoms you are experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all the medicines, vitamins or supplements you may be taking.
  • Consider the possibility of a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that has been lost or forgot.
  • Write questions to ask their doctor.

Your time with your doctor is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For the car -cinoid syndrome, some basic questions to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • Other that the most likely cause, what are other possible causes for my symptoms or condition?
  • What kinds of tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • What is going to determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask a series of questions. Be ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • The symptoms been continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Carcinoid syndrome