About carcinoid tumors

What is carcinoid tumors?

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 skin flushing.

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

What are the symptoms for carcinoid tumors?

In some cases, 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

Signs and symptoms of carcinoid lung tumors include:

  • Chest pain
  • Wheezing
  • Shortness of breath
  • Diarrhea
  • Redness or a feeling of warmth in your face and neck (skin flushing)
  • Weight gain, particularly around the midsection and upper back
  • Pink or purple marks on the skin that look like stretch marks

Carcinoid tumors in the digestive tract

Signs and symptoms of carcinoid tumors in the digestive tract include:

  • Abdominal pain
  • Diarrhea
  • Nausea, Vomiting and inability to pass stool due to intestinal blockage (bowel obstruction)
  • Rectal bleeding
  • Rectal pain
  • Redness or a feeling of warmth in your face and neck (skin flushing)

When to see a doctor

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

What are the causes for carcinoid tumors?

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

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

Doctors don't know what causes the mutations that can lead to carcinoid tumors. But they know that carcinoid tumors develop in neuroendocrine cells.

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

What are the treatments for carcinoid tumors?

Treatment for a carcinoid tumor depends on the tumor's location, whether cancer has spread to other areas of the body, the types of hormones the tumor secretes, your overall health and your own preferences.

Surgery

When detected early, a carcinoid tumor may be removed completely using surgery. If carcinoid tumors are advanced when discovered, complete removal may not be possible. In some cases, surgeons may try to remove as much of the tumor as possible, to help control signs and symptoms.

Medications

Medications used to treat carcinoid syndrome include:

  • Drugs that block cancer cells from secreting hormones. Using medications to block hormones secreted by the tumor may reduce the signs and symptoms of carcinoid syndrome and slow tumor growth.

    Octreotide (Sandostatin) and lanreotide (Somatuline Depot) are given as injections under the skin. Side effects from either medication may include abdominal pain, bloating and diarrhea.

  • Drugs to boost the immune system. An injectable medication called interferon alfa (Intron A, Pegasys, others), which stimulates the body's immune system to attack the tumor, is sometimes used to slow the growth of carcinoid tumors and to relieve symptoms. Interferon can cause significant side effects, including fatigue and flu-like symptoms.

Treatments for carcinoid tumors that have spread to the liver

Carcinoid tumors commonly spread (metastasize) to the liver. Options for treatment may 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.

What are the risk factors for carcinoid tumors?

Factors that increase the risk of carcinoid tumors include:

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

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