Summary: Carcinoid cancer is a slow-growing cancer that can develop in several places in the body. Carcinoid tumors, which are only one subset of tumors called neuroendocrine tumors, usually begin in the digestive tract or lungs. In the digestive tract, these tumors could grow in the stomach, small intestine, colon, rectum, or even your appendix. There can be complications with this type of cancer. Here we discuss the possible complications, methods of diagnosis, and common treatment for carcinoid cancer.
Carcinoid cancer is a slow-growing cancer that can develop in several places in the body. Carcinoid tumors, which are only one subset of tumors called neuroendocrine tumors, usually begin in the digestive tract or lungs. In the digestive tract, these tumors could grow in the stomach, small intestine, colon, rectum, or even your appendix. There can be complications with this type of cancer, and some of these happen because the tumors can secrete hormones and other chemicals, which cause these complications. The possible complications are:
- Carcinoid syndrome. Carcinoid syndrome causes redness or a feeling of warmth in your face and neck, which is also called skin flushing, chronic diarrhea, and difficulty breathing, among other signs and symptoms.
- Carcinoid heart disease. Carcinoid tumors may secrete hormones that can cause thickening of the lining of heart chambers, valves and blood vessels. This can lead to leaky heart valves and heart failure that may require valve-replacement surgery. Carcinoid heart disease can usually be controlled with medications.
- Cushing syndrome. A lung carcinoid tumor can produce an excess of a hormone that can cause your body to produce too much of the hormone cortisol.
Diagnosis of Carcinoid Cancer
If your doctor suspects you may have carcinoid cancer, they may order any of these tests to find out if you do indeed have cancer.
- Urine analysis. Those who have carcinoid tumors have higher levels of the hormones secreted by the tumors or the byproducts created, and thusly broken down, in their blood.
- Imaging Tests. Computerized scans and imaging tests like CT scans, MRI scans, x-rays or PET scans can help your doctor determine the exact location of the tumor to aid in direct treatment and a firm plan on action.
- Blood Tests. With a carcinoid tumor, your blood will have higher levels of those hormones produced by the body.
- Endoscope or camera procedure that sees inside of your body. Your specialists will use a long, thin tube equipped with a lens or camera to examine areas inside your body.
- An endoscopy, which involves passing a scope down your throat, may help your doctor see inside your gastrointestinal tract. A bronchoscopy, using a scope passed down your throat and into your lungs, can help find lung carcinoid tumors. Passing a scope through your rectum, which is called a colonoscopy, can help diagnose rectal carcinoid tumors. To see inside your small intestine, your doctor may recommend a test using a pill-sized camera that you swallow, which is also called a capsule endoscopy.
- Biopsy of tissue for lab testing. Your doctor will take a sample of your tissue for help in proper diagnosis. Depending on the location of your tumor will depend on how the biopsy is done. Either way, allowing your doctor to see the cancer cells under the microscope helps to confirm your diagnosis and treatment plan.
Common Treatments for Carcinoid Cancer
The treatment for carcinoid cancer varies by patient and is dependent on the tumor’s location, if the cancer has spread to other areas in the body, the types and levels of hormones the tumor is secreting, and your overall health. These are the most common treatment methods for carcinoid tumors:
- Surgery. If detected early, the carcinoid tumor can be removed with surgery. If the tumors are advanced when found, full removal may not be possible, although you doctor may remove what they can to help decrease the amount of cancerous tissue in your body.
- Medications. Using medications to block hormones secreted by the tumor may reduce the signs and symptoms of carcinoid syndrome and slow tumor growth.
- These medications block the cancer cells from secreting hormones. Octreotide and lanreotide are given as injections under the skin. Side effects from either medication may include abdominal pain, bloating and diarrhea. Telotristat is a pill that is sometimes used in combination with octreotide or lanreotide to further try to improve the symptoms of carcinoid syndrome.
- These medications deliver radiation directly to the cancer cells. Peptide receptor radionuclide therapy combines a drug that seeks out cancer cells with a radioactive substance that kills them. In PRRT for carcinoid tumors, the drug is injected into your body, where it travels to the cancer cells, binds to the cells and delivers the radiation directly to them. This therapy is used in people who have advanced cancer that has grown despite the use of octreotide or lanreotide.
- Specialized treatment for carcinoid cancer that has metastasized to the liver. Carcinoid tumors usually spread or metastasize to the liver. Options for treatment could include:
- Liver surgery. Surgery to remove part of the liver (hepatic resection) may control signs and symptoms caused by liver tumors.
- Stopping blood supply to liver tumors. In a procedure called hepatic artery embolization, a doctor clogs the liver’s main artery (hepatic artery), cutting off the blood supply to cancer cells that have spread to the liver. Healthy liver cells survive by relying on blood from other blood vessels.
- Killing cancer cells with heat or cold. Radiofrequency ablation delivers heat treatments that cause carcinoid tumor cells in the liver to die. Cryoablation uses cycles of freezing and thawing to kill cancer cells.
Coping & Support with Carcinoid Cancer
Every cancer patient develops their own methods and plans for coping. If you feel stuck, or need guidance, speak with a member of your medical care team. Think about these steps to help you work through to a healthy platform for coping:
- Speak with others about cancer. Support groups for patients with cancer can help connect you with others going through the same things you are and allows you to openly discuss the challenges and chaos of living with cancer. If you’re interested in support groups in your area, just ask your doctor.
- Controlling what you can with your health. While your cancer diagnosis can feel as if you have no control over your life, you must remember that you do! You can choose to live a healthier lifestyle, or to eat a diet that starves cancer cells. You can work and exercise when you feel up to it and do nice things for others. You can work on lessening the stressors in your life and get plenty of sleep each night to help your body be strong for treatment.
- Educate yourself about carcinoid tumors to help yourself make better decisions about your health care. Ask questions. Read books and factual articles. Arm yourself with as much information as you can.
If you suspect that you have carcinoid cancer, do not hesitate to make an appointment with your medical care team to begin testing today. Earlier detection proves time and time again to be one of the best methods of removing cancer from your life!
Resources Used:
ACS
NIH