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Carcinoid tumors, also called neuroendocrine tumors, are a slow-growing cancer that grow from neuroendocrine cells. Neuroendocrine cells are found throughout the body. Carcinoid tumors most often begin in the digestive tract, particularly in the stomach, appendix, small intestine, colon or rectum or even in the lungs. During the initial stage of the disease there are no signs or symptoms, however tumors have the ability to produce and secrete hormones in the body, which causes symptoms like diarrhea or flushing of skin. Surgery and medications are the treatment options for carcinoid tumors.
Symptoms
Carcinoid tumor are usually undetectable by sign and symptoms. However, sign and symptoms depends on type of hormone released by tumor and the location tumor cells have grown.
Symptoms of Carcinoid tumors in the lungs
- Chest pain
- Dyspnea (shortness of breath), wheezing
- Diarrhea
- Skin flushing on your face and neck
- Weight gain
- Appearance of purple or pink marks on the skin
Symptoms of Carcinoid tumors in the digestive tract
- Abdominal pain
- Diarrhea
- Nausea, vomiting and unable to defecate because of the bowel obstruction
- Rectal bleeding
- Rectal pain
- Facial flushing
In case of experiencing any persistent symptoms that may be concerning, consulting a doctor is recommended.
Causes
The causes of carcinoid tumors are unclear. Cancers in general arise from the development of cell mutations in its DNA. The mutations lead to cell growth and division when normal cells die. A buildup of the cells causes a tumor to form. Cancer cells attack healthy tissues surrounding the area, spreading to other parts of the body.
Carcinoid tumors arise in neuroendocrine cells found in multiple organs, responsible for producing hormones and control the secretions of digestive juices.
Risk factors
- Aging: Elderly are more prone to develop carcinoid tumors.
- Gender: Females are at a higher chance of developing the disease.
- Family history: Family history of multiple endocrine neoplasia type 1 (MEN 1) raises the risk of carcinoid tumors. Patients with this disease tend to have numerous tumors growing in endocrine glands.
Diagnosis
- Blood tests will reveal high levels of certain hormones produced by carcinoid tumors.
- Urine tests will reveal high levels of chemicals exist in the urine. The chemicals are created when carcinoid tumors release hormones and the body breaks them down.
- Imaging tests will help the doctors to precisely locate the carcinoid tumors.
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- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
- X-ray
- Nuclear medicine scans
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- A scope or camera may be used to examine the areas inside the body.
- Endoscopy. A thin tube with a camera attached at the tip is passed through the throat to view the inside of the patient’s gastrointestinal tract.
- Bronchoscopy. A scope inserted to the lungs to discover if tumors exist.
- Colonoscopy. To detect rectal carcinoid tumors.
- Capsule endoscopy. This procedure involves the swallowing of a pill-sized camera. It is carried out when the small intestine needs to be examined.
- Biopsy or the process of taking a tissue sample from the tumor for further laboratory tests. This step will confirm the diagnosis. There are different types of biopsies; the most suitable type will be determined by the location of the tumor.
- Needle biopsy is a way to collect the tissue by drawing cells out of the tumor. An alternative option would be through surgical procedure. Laboratory test will evaluate the types of cells exist in the tumor and severity.
Treatment
The treatment depends the location of the tumor (whether the cancer is metastasized), the type of hormones the tumor releases, and the patients’ clinical health.
- Surgery will be done to completely remove the tumor if carcinoid tumor is found early on. In an advanced stage, complete tumor removal may not be possible.
- Medications block the hormones releasing by the tumor may subside the symptoms of the disease and slow the growth rate of the tumor. The kind of medications given are octreotide, lanreotide and telotristat.
- Chemotherapy kills the cell in the cancerous tumors. Chemotherapy comes in both intravenous injections and oral medications. Advanced carcinoid tumors may be treated with chemotherapy as in some cases, the entire tumors may not be removed with surgical procedure.
- Targeted therapy usually combined with chemotherapy for advanced carcinoid tumors. It works by attacking particular abnormalities that exist in the tumor cells. Targeted therapy can kill the cells in the tumor by blocking these abnormalities.
- Peptide receptor radionuclide therapy (PRRT) combines a medication that focus on destroying cancer cells with a radioactive substance. The drug is injected into the body then it goes to the cancer cells and delivers radiation to them. Advanced carcinoid tumors are usually treated with this treatment option.
- Treatment option for cancer that spreads to the liver. Surgery may be done to remove some portion of the liver, to block blood flow to the liver (hepatic artery embolization), and to utilize heat and cold to destroy the cancer cells.
