CARCINOID SYNDROME

 Basic information

description

Carcinoid syndrome is a group of symptoms caused by a tumor (carcinoid). Carcinoids are called “cancers in slow motion” because of their slow growth. These tumors most often develop in the intestinal tract (e.g., small intestine, colon, or appendix) or lungs. The tumors produce certain hormones (e.g., serotonin). When the tumor is within the intestine, the hormones are removed from the body by the liver. If the tumor has spread to the liver, it can no longer remove them. The hormones then travel through the body and cause the carcinoid syndrome symptoms. If the tumors occur outside the intestinal tract (e.g., lungs), carcinoid syndrome can develop without spread to the liver. The syndrome more often affects older adults ages 50 to 70.

FREQUENT SIGNS & SYMPTOMS

• Because the tumors grow slowly, there may be no apparent symptoms.
• Symptoms may be triggered by physical or emotional stress, eating, and/or drinking hot liquids or alcohol.
• Flushing on the head, neck, and chest. It may last minutes or hours. Skin may turn bluish after flushing.
• Diarrhea with abdominal cramps.
• Breathing problems (similar to asthma) and wheezing.
• Heart palpitations or irregular heartbeat.
• May have high or low blood pressure.
• Swelling of the face, hands, or feet.
• Weight loss.
• Intestinal obstruction may cause fever along with stomach pain and tenderness.

causes

Unknown.

risk increases with

• Older adults.
• Family history of multiple endocrine neoplasia, type 1 (a hereditary disorder).

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

In some, it can be cured with surgery. In others, the problem may progress, recur, or relapse.

possible complications

• Low blood pressure. It can increase risk of falls and injury.
• Carcinoid heart disease.
• Intestinal obstruction.
• Carcinoid crisis (a severe episode of the symptoms).
• Renal failure.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms. Blood and urine studies are done to look for certain hormones and chemicals. Different imaging tests are done to locate the tumor and check for any disease spread.
• Treatment varies and depends on the location and size of the tumor, person's health, age, and preferences.
• Surgery can bring about a cure if the entire tumor may be removed. If the entire tumor cannot be removed, surgery can be done to remove a portion as large as possible. This helps relieve symptoms.
• Hepatic artery embolization may be used to cut off blood supply to the tumor. Radiofrequency ablation uses heat to kill the cancer cells. Other procedures may be done depending on any complications.
• Avoid emotional stress that can trigger symptoms.
• To learn more: American Cancer Society; (800) ACS-2345; website: www.cancer.org or National Cancer Institute; (800)4-CANCER; website: www.cancer.gov.

medications

• Your health care provider may prescribe:
  • Antidiarrheal drugs.
  • Anticancer drugs (chemotherapy).
  • Drugs to prevent serotonin production.
  • Biologic therapy to stimulate the immune system.
  • Drugs to prevent flushed skin.
  • Multivitamins and niacin supplements.

activity

Mild physical activity is usually not harmful. Avoid intense physical activity that can trigger symptoms.

diet

• Increased protein intake in the diet is often advised.
• Avoid alcohol and foods that trigger symptoms.

 notify our office if

• You or a family member has symptoms of carcinoid syndrome.
• Symptoms become worse or drugs used for treatment cause unexpected side effects.

Special Notes: