What Is a Carcinoid Tumor?
Carcinoid tumors are slow-growing cancers that originate primarily in the lungs or the digestive tract, but can spread to other parts of the body. They are part of a larger group of cancers associated with the neuroendocrine cells. Found throughout the body, neuroendocrine cells support both the nervous and hormone-producing endocrine systems. Because carcinoid tumors develop in a variety of locations, they can be difficult to diagnose, with early symptoms that are similar to those of less-serious medical conditions. Though a malignant form of cancer, carcinoid tumors can be effectively treated; studies have documented a five-year survival rate in the range of 70 to 80 percent.
If you are concerned about the possibility of a carcinoid tumor, arrange to see your Baptist Health family physician or oncologist.
What Are the Symptoms of a Carcinoid Tumor?
Detecting carcinoid tumors isn’t easy. They are sometimes discovered accidentally, for example, during a surgical procedure for another condition. Depending on their location, however, there can be certain indicators.
- Digestive Tract Symptoms
- A tendency for skin to turn red or warm (called flushing)
- Nausea and vomiting
- Abdominal pain
- Constipation or difficult bowel movements
- Rectal pain or bleeding
- Purple or pink streaks on the skin
- Coughing and wheezing
- Chest pain and shortness of breath
- Unexpected weight gain, especially in the chest and midsection
Carcinoid tumors are not limited to the lungs or digestive tract. Less frequent sites include the liver, pancreas, and appendix.
What Causes a Carcinoid Tumor?
Like other cancers, carcinoid tumors result from DNA mutations that drive changes in cell behavior. Cancer cells live longer and reproduce more rapidly than healthy cells, leading to the buildup of cancerous masses or tumors that interrupt normal bodily functions. Cancer cells also metastasize or spread, extending the range and degree of disease. Medical researchers have yet to determine the exact cause or causes of the mutations.
There are several risk factors associated with carcinoid tumors:
- Age: Carcinoid tumors strike most frequently in middle age (people in their forties and fifties).
- Sex: Women have a higher incidence of carcinoid tumors than men.
- Race: African-Americans run a proportionately higher risk of GI-tract carcinomas than European-Americans.
- Other medical conditions: Certain forms of anemia and other medical conditions increase the possibility of carcinoid tumors.
- Genetic factors: There is evidence that genes plays a role in some carcinoid tumors. A heritable disorder, called MEN1 (for multiple endocrine neoplasia 1), is implicated in about one out of every ten carcinoid tumors.
How Is a Carcinoid Tumor Diagnosed?
The diagnosis of a carcinoid tumor typically requires a number of tests and procedures:
- Physical exam: Your doctor will examine you for evidence of cancer. He or she will document your symptoms and ask questions about your medical history and possible risk factors.
- Urine test: A urine test will provide evidence of a carcinoid tumor by identifying the chemical remnants of excessive hormone production.
- Blood test: If the bloodstream contains unusually high levels of certain hormones, they can be detected in blood-sample analyses.
- Medical imaging: X-rays, CT scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans can help your physician locate a carcinoid tumor.
- Endoscopy: Endoscopes are long, slender tubes with optical elements and cameras that physicians use for close inspection of possible tumor sites, including the lungs and digestive tract. A lung procedure is a bronchoscopy; a digestive-tract procedure, a colonoscopy.
- Biopsy: To confirm the presence of cancer, your physician will collect a tissue sample for analysis. This sample is called a biopsy. The sample will be removed either before or during surgery, and sent to a medical laboratory for analysis.
How Is a Carcinoid Tumor Treated?
How a carcinoid tumor is treated depends on a number of variables, including its size and location, whether it has spread to other parts of the body, and the role it’s playing in hormone production. The primary methods of treatment include:
- Surgery: The surgical removal of a carcinoid tumor can be effective in the early stages of the disease. Surgery may be combined with other forms of cancer treatment, including radiation, chemo, targeted, and immune-system therapies.
- Targeted-radiation medications: More serious cases might call for peptide receptor radionuclide therapy (PRRT), an anticancer medication that pairs a radioactive agent with a chemical that targets cancer cells. This a highly precise form of radiation delivery.
- Hormone-blocking medications: A third option is a hormone-blocking agent for controlling some carcinoid tumor symptoms. Drugs used in this capacity include the injectables octreotide and lanreotide, as well as telotristat, taken in pill form.
If the cancer has spread to the liver, surgery or a procedure for reducing the liver’s blood supply (called hepatic artery embolization) may be required.
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