CARCINOID TUMORs
Carcinoid tumors are rare, slow-growing cancers that may develop in different areas of the body.
- Carcinoid tumors are a type of neuroendocrine tumors that usually begins in the digestive tracts (stomach, small intestine, rectum, colon, and appendix) and the lungs.
- They can be seen in other organs, including the liver, pancreas, ovaries, and kidneys.
- Carcinoid tumors do not produce symptoms in the early stages and diagnosis may not be made until late into the disease.
- As a result, the average age of people diagnosed with carcinoid tumors especially of the lung and the digestive system is around 60 years of age.
- Although they are slow growing, they have a high potential for metastasis.
- In the late stage, carcinoid tumors sometimes produce and release hormones in the body that can cause carcinoid syndromes.
- The syndrome causes flushing of the face and chest and diarrhea.
CAUSES
The exact cause of the condition is not known. What is known, however, is that carcinoid tumors develop in the neuroendocrine cells.
In general, cancer occurs when something triggers a genetic mutation within the cells in the body. These causes normal cell in the body to become abnormal and multiply rapidly and continue to accumulate, forming a tumor or mass.
Certain factors that may predispose an individual to a higher risk of carcinoid tumors are:
- A family history of multiple endocrine neoplasia types 1 (MEN 1), neurofibromatosis type 1 (NF1).
- Older age
- Stomach conditions that damage the stomach and reduce the production of stomach acids such as pernicious anemia.
SYMPTOMS
Symptoms mostly depend on the location of the tumors.
LUNGS
- Shortness of breath
- Diarrhea
- Wheezing
- Chest pain
- Weight gain
- Pinky or purplish marks that resemble stretch marks
DIGESTIVE TRACTS
- Abdominal pain
- Diarrhea
- rectal pain and rectal bleeding
- bowel obstruction
When the tumors release hormones in your bloodstream, you may get:
- skin flushing (redness and warmth in the face and neck)
- weakness
- hair growth on the body and face
- weight loss
- rapid heartbeat
DIAGNOSIS AND TREATMENT
Sometimes they are found by chance while your doctor is doing an exam to look for other diseases.
In cases where the doctor may suspect the condition, certain tests and procedure may be carried out.
These tests include:
- Blood and urine tests to check for an elevated level of hormone secreted by carcinoid tumors or byproducts created when your body breaks down the hormones.
- Imaging tests such as CT scan, MRI scan, positron emission tomography (PET) to help detect the location of the tumors.
- Upper endoscopy where a thin flexible tube is put through the mouth into the gastrointestinal tracts (GI tracts) to help your doctor see tumors in the stomach, small intestine and esophagus.
- Bronchoscopy involves passing a scope through the through the throat into the lungs to help detect lung carcinoid tumors
- Colonoscopy involves passing a scope through the rectum to help detect rectal carcinoid tumors
- Capsule endoscopy
- Biopsy where tissue samples are collected for analysis in the lab.
TREATMENT
Treatment options depend on the location of the tumor, your overall health, preference, the type of hormones the tumor has secreted and whether cancer has metastasized.
Surgery may be used to completely remove tumors that are diagnosed early. If the tumors are discovered late, removing them completely with surgery may be impossible. Your doctor may try to remove as much of the tumor as possible.
Carcinoid syndrome may be treated with medications such as:
- Drugs that block cancer cells from secreting hormones such as octreotide and lanreotide given as injections.
- Drug to boost the immune system
If the tumor has spread to the liver,
Surgery may be done to remove part of the liver (hepatic resection).
A procedure called hepatic artery embolization where the hepatic artery is clogged, cutting blood flow to the tumors that have spread into the liver may also be carried out. Without blood and nutrients, the tumors cannot continue to grow.
Radiofrequency ablation where heat is used to kill tumors in the liver or cryoablation where cycles of freezing or thawing are delivered to the tumors to kill them may also be helpful.