Description

Carcinoid tumors are a type of slow-growing cancer that can arise in several places throughout your body. Carcinoid tumors, which are one subset of tumors called neuroendocrine tumors, usually begin in the digestive tract (stomach, appendix, small intestine, colon, rectum) or in the lungs.

Carcinoid tumors often don't cause signs and symptoms until late in the disease. Carcinoid tumors can produce and release hormones into your body that cause signs and symptoms such as diarrhea or flushing of the skin.

Treatment for carcinoid tumors usually includes surgery and may include medication.

Symptoms

Some carcinoid tumors don't cause any signs or symptoms. When they do occur, signs and symptoms are usually vague and depend on the location of the tumor.

Carcinoid tumors in the lungs

The signs and symptoms of tumors of the lung include:

  • Pain in the chest
  • Wheezing
  • Shortness of breath
  • Diarrhea
  • Redness or warmth of the face and neck (skin redness)
  • Weight gain, especially around the midsection and upper back
  • Pink or purple marks on the skin that seem to stretch marks

Carcinoid tumors of the digestive tract

The signs and symptoms of carcinoid tumors in the digestive tract are:

  • Abdominal Pain
  • Diarrhea
  • Nausea, vomiting and inability to pass stool due to bowel obstruction (intestinal obstruction)
  • Rectal Bleeding
  • Pain in the rectum
  • Redness or warmth of the face and neck (skin redness)

When to see a doctor

If you experience any of the signs and symptoms that bother you and are persistent, make an appointment with your doctor.

Causes

It is not clear what causes carcinoid tumors. In general, cancer occurs when a cell develops a mutation in its DNA. The mutations allow the cell to continue to grow and divide when healthy cells would normally die.

The accumulation of cells that form a tumor. Cancer cells can invade nearby healthy tissue and spread to other parts of the body.

Doctors do not know what causes the mutations that can lead to carcinoid tumors. But they know that the carcinoid tumors develop in the neuroendocrine cells.

The neuroendocrine cells are found in various organs throughout the body. To perform some of the functions of the nerve cells, and some hormone-producing endocrine cell functions. Some of the hormones that are produced by enteroendocrine cells are histamine, insulin, and serotonin.

Risk factors

The factors that increase the risk of carcinoid tumors are:

  • Advanced age. Older adults are more likely to be diagnosed with a carcinoid tumor of younger people or children.
  • Sex. Women are more likely than men to develop carcinoid tumors.
  • The history of the family. A family history of multiple endocrine neoplasia type 1 (MEN 1), increases the risk of carcinoid tumors. In people with MEN-1 multiple tumors that occur in the glands of the endocrine system.

Complications

The cells of carcinoid tumors can secrete hormones and other chemicals, causing a series of complications, including:

  • The carcinoid syndrome. The carcinoid syndrome causes redness or warmth of the face and neck (skin redness), chronic diarrhea, difficulty breathing, among other signs and symptoms.
  • Carcinoid heart disease. Carcinoid tumors can secrete hormones that can cause the thickening of the lining of the heart chambers, valves and blood vessels. This can lead to leakage of the heart valves and heart failure, which may require valve replacement surgery. Carcinoid heart disease can usually be controlled with medications.
  • Cushing's syndrome. A lung carcinoid tumor may produce an excess of a hormone that can cause your body produces too much of the hormone cortisol.

Diagnosis

Tests and procedures used to diagnose carcinoid tumors include:

  • Blood tests. If you have a carcinoid tumor, your blood may contain high levels of hormones secreted by a carcinoid tumor or byproducts created when those hormones are metabolized by the body.
  • Urine tests. People with carcinoid tumors have excess levels of a chemical in their urine that occurs when the body breaks down hormones secreted by carcinoid tumors.
  • Imaging tests. Imaging tests, including computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), x-ray and nuclear medicine scans can help your doctor identify the carcinoid tumor of the location.
  • A scope or a camera that sees in the interior 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, the use of a scope is passed down your throat and into 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 carcinoids. To see the inside of the small intestine, your doctor may recommend a test with a pill-sized camera that you swallow (capsule endoscopy).
  • Removal of tissue for laboratory analysis.A sample of tumor tissue (biopsy) may be collected to confirm the diagnosis. The type of biopsy you undergo depends on where the tumor is located. A way to collect a sample of tissue involves the use of a needle to remove cells from the tumor. Another option may be through surgery. The tissue is sent to a laboratory for analysis to determine the types of cells in the tumor is and how aggressive the cells appear under the microscope.

A scope or camera that looks at 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, which can help your doctor see the inside of the gastrointestinal tract. A bronchoscopy, the use of a scope is passed down your throat and into 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 carcinoids.

To see the inside of the small intestine, your doctor may recommend a test with a pill-sized camera that you swallow (capsule endoscopy).

Removal of tissue for laboratory analysis. A sample of tumor tissue (biopsy) may be collected to confirm the diagnosis. The type of biopsy you undergo depends on where the tumor is located.

A way to collect a sample of tissue involves the use of a needle to remove cells from the tumor. Another option may be through surgery. The tissue is sent to a laboratory for analysis to determine the types of cells in the tumor is and how aggressive the cells appear under the microscope.

Treatment

The treatment of a carcinoid tumor depends on the location of the tumor, whether the cancer has spread to other areas of the body, the types of hormones that the tumor secretes, your general state of health and your own preferences.

Carcinoid Tumor treatment options may include:

  • Surgery. When detected early, a carcinoid tumor can be completely removed with surgery. If carcinoid tumors are advanced when discovered, the complete removal may not be possible. In some situations, surgeons may try to remove as much of the tumor as possible, to help control the signs and symptoms.
  • Medications to control the excess of hormones.The use of drugs to block the hormones secreted by the tumor can reduce the signs and symptoms of carcinoid syndrome and the slow growth of the tumor. Octreotide (Sandostatin, Bynfezia Pen) and lanreotide (Somatuline Depot) are given as injections under the skin. The side effects of both medicines may include abdominal pain, abdominal distension, and diarrhea. Telotristat (Xermelo) is a pill that is sometimes used in combination with octreotide or lanreotide more to try and improve the symptoms of carcinoid syndrome.
  • Chemotherapy. Chemotherapy uses strong drugs to kill tumor cells. It can be given through a vein in the arm or take it in pill form. Chemotherapy is sometimes recommended for the treatment of advanced carcinoid tumors that cannot be removed with surgery.
  • Targeted drug therapy. Targeted drug treatments focus on specific abnormalities present in tumor cells. By blocking these abnormalities, targeted drug treatments can cause tumor cells to die. Targeted drug therapy is usually combined with chemotherapy for advanced carcinoid tumors.
  • 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 the cells and provides the radiation directly to them. This therapy may be an option for people with advanced carcinoid tumors.
  • The treatment for the cancer that spreads to the liver. Carcinoid tumors commonly spread to the liver. The treatments may include surgery to remove part of the liver, blocking the flow of blood to the liver (hepatic artery embolization), and the use of heat and cold to kill cancer cells. Radiofrequency ablation offers heat treatments that cause the carcinoid tumor cells in the liver to die. Cryoablation uses cycles of freezing and thawing to kill the cancer cells.

Medications to control the excess of hormones. The use of drugs to block the hormones secreted by the tumor can reduce the signs and symptoms of carcinoid syndrome and the slow growth of the tumor.

Octreotide (Sandostatin, Bynfezia Pen) and lanreotide (Somatuline Depot) are given as injections under the skin. The side effects of both medicines may include abdominal pain, abdominal distension, and diarrhea. Telotristat (Xermelo) is a pill that is sometimes used in combination with octreotide or lanreotide more to try and improve the symptoms of carcinoid syndrome.

Coping and support

Each person with cancer to develop their own way of coping. But you don't have to do it alone. If you have questions or want guidance, talk to a member of your health care team. Also, consider the following steps to help you deal with your diagnosis:

  • To find out enough about the carcinoid tumors 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.
  • Talk with other people with cancer. Support groups for people with cancer can put you in touch with others who have faced the same problems that we are facing. Ask your doctor about groups in your area. Or contact your local chapter of the American Cancer Society, or the Carcinoid Cancer Foundation. Try the online chat rooms, and message boards at the American Cancer Society's Cancer Survivors Network.
  • Control what you can about your health.A cancer diagnosis can make you feel as if you don't have control over their health. But you can take measures to maintain a healthy lifestyle so that you will know better how to deal with your cancer treatment. Choose healthy foods with plenty of fruits and vegetables. When you feel up to it, work light exercise into your daily routine. Cut out the stress when it is possible. Get enough sleep to feel rested upon waking.

Control what you can about your health. A cancer diagnosis can make you feel as if you don't have control over their health. But you can take measures to maintain a healthy lifestyle so that you will know better how to deal with your cancer treatment.

Choose healthy foods with plenty of fruits and vegetables. When you feel up to it, work light exercise into your daily routine. Cut out the stress when it is possible. Get enough sleep to feel rested upon waking.

Preparing for your appointment

Make an appointment with your primary care physician or family doctor if you have signs and symptoms that worry you. If your doctor suspects a carcinoid tumor, you may be referred to a:

  • A doctor who specializes in problems in the digestive system (gastroenterologist)
  • A doctor who specializes in problems of the lungs (pulmonologist)
  • Doctor who treats cancer (oncologist)

Because appointments can be brief, and because there is often a large amount of information to discuss, it is a good idea to be prepared. Here's some information to help you prepare, and 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 any symptoms you're 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 medications, vitamins or supplements you are taking.
  • Consider taking along 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 you missed 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. Some basic questions to ask your doctor include:

  • What is likely causing my symptoms?
  • There are other possible causes of the symptoms?
  • What kinds of tests do I need? Do these tests require any special preparation?
  • What treatments are available and which do you recommend?
  • What are the risks and side effects I can expect for each treatment?
  • What is my prognosis, if I undergo treatment?
  • Does the treatment affect my ability to work or do normal daily activities?
  • I have these other health conditions. How can I best manage these conditions?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • How often will I need follow-up visits?

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may allow more time to cover the 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 the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Carcinoid tumors