Carcinoid Syndrome: Causes, Symptoms, Diagnosis, Treatment, Complications, Outlook

Medically Reviewed by Dr. K. on May 18, 2021.

What Is Carcinoid Syndrome?

Carcinoid syndrome is a collection of symptoms associated with carcinoid tumours, a form of cancer. These tumours begin in cells that produce certain chemicals and release more of those chemicals into your bloodstream.

Symptoms can resemble those of other illnesses such as menopause or asthma. For example, the face may become red and warm, you may have difficulty breathing, or your heart may beat rapidly.

Carcinoid tumours are most often seen in the stomach and intestines, although they may also grow in the lungs, pancreas, testicles, or ovaries. Carcinoid syndrome indicates that the cancer has advanced, most often to the lungs or liver.

If the doctor detects a tumour early enough, it might be possible to resect it. Carcinoid tumours may also be cured, but not often. Treatments will extend your life and improve your quality of life. You should also take measures to alleviate the effects and improve your overall comfort.

Carcinoid Syndrome Causes

Carcinoid syndrome develops as tumours produce chemicals similar to hormones. These chemicals will enter your bloodstream if your cancer has spread to your liver. They will then travel around the body, causing symptoms. If you have cancers in your lungs, testes, or ovaries, the chemicals will enter the bloodstream directly.

Carcinoid Syndrome Symptoms

  • Skin flushing: Your face and upper chest skin is hot and changes colour, varying from pink to purple. Flushing attacks will last anywhere from a few minutes to several hours or more. Flushing may occur for no apparent cause, but it can also be caused by fatigue, exercise, or alcohol consumption.
  • Facial skin lesions: Purple coloured areas of spider-like veins may appear on your nose and upper lip.
  • Diarrhea: Carcinoid syndrome patients can experience frequent, watery stools that are often followed by abdominal cramps.
  • Difficulty breathing: Wheezing and shortness of breath, which are asthma-like signs and symptoms, can appear around the same time as skin flushing.
  • Rapid heartbeat: Carcinoid syndrome may be identified by periods of rapid heart rate.
  • Sudden drops in blood pressure

Carcinoid Syndrome Complications

Carcinoid syndrome can cause a variety of complications, including:

  • Carcinoid heart disease: Your heart valves can thicken and leak as a result of this. Medicine may aid, though surgery could be required in certain situations.
  • Bowel obstruction or blockage: Your digestion can be obstructed by a tumour in the lymph nodes near the small intestine. Which results in extreme stomach pain and vomiting. You may require surgery.
  • Carcinoid crisis: You may experience severe flushing, difficulty breathing, and confusion on rare occasions. This is a life-threatening emergency, so get immediate assistance right away.

Carcinoid Syndrome Diagnosis

If the doctor suspects you have carcinoid syndrome, he or she will do a physical exam and ask you questions such as:

  • Have you ever noticed your skin turning red and feeling warm or burning?
  • If you get diarrhoea on a regular basis?
  • Have you been out of breath recently?
  • Do you have a tendency to wheeze now and then?

You can also include testing to rule out the presence of a carcinoid tumour.

Urine test: Over the course of a 24-hour cycle, you collect the urine in containers. High amounts of hormones, or by-products (what's left when the body breaks them down), will be tested in a lab.

Blood test: This may also reveal the chemicals released by tumours.

Imaging tests:

  • CT: A CT scan is a sequence of X-rays that shows the interior of the body in great detail.
  • MRI: Solid magnets and radio waves are used in an MRI to create images of the organs.
  • Radionuclide scanning: Your doctor will inject you with a tiny dose of toxic waste, which will be absorbed by your organs through radionuclide scanning. A specific camera will detect the substance and provide images that will aid the specialist in locating a tumour.

Questions for Your Doctor

  • What are the cancers triggering my carcinoid syndrome?
  • What sort of tests would I require?
  • What treatment would you suggest?
  • Is there anything I should stop eating?
  • What should I do to keep my skin flushing under control?
  • Any other signs and symptoms should I be aware of?

Carcinoid Syndrome Treatment

Your doctor would continue to treat your tumours in order to treat carcinoid syndrome. You can receive either one treatment or a variety of treatments.

Surgery

Doctors can resect an entire tumor-bearing organ, such as your appendix, or only a portion of a tumor-bearing tissue, such as a segment of your intestine.

Your doctor can also use an electric current to cauterise (melt it off) or cryosurgery to freeze it, depending on where the tumour is located. Radiofrequency ablation is another alternative. To destroy cancer cells, it employs a device that brings electrical energy through the tumour.

Chemotherapy

Strong drugs may also destroy or delay the development of cancer cells. Some of these medications should be taken orally, while some must be injected into a vein.

Radiation

This procedure will either kill or stop cancer cells from spreading. Radiation can be delivered by a device outside of your body, or the doctor may inject a tiny dose of radioactive material into your body, either in or around the tumour.

Liver directed therapy

By cutting off the blood flow of cancer cells in the liver, this procedure destroys them. A catheter is inserted by the doctor into one of the arteries that provide blood to the liver. Then they inject ions into the liver tumours that obstruct blood supply.

Biologic drugs

Immunotherapy is a form of medication that enhances the body's natural defences. Doctors administer medications that aid the immune system in the destruction of cancer cells.

Drug therapy

Skin flushing can be helped by injectable medications including lanreotide (Somatuline) and octreotide (Sandostatin). They might have a minor impact on tumour growth as well. The combination of telotristat ethyl (Xermelo) and lanreotide or octreotide may help relieve diarrhoea.

Lanreotide and octreotide bind to carcinoid cells and prevent them from producing too many chemicals. Nausea, gallstones, and inflammation or bruising when you administer it are also possible side effects.

To improve your body's reaction, doctors can combine octreotide with a medicine called interferon alfa.

Lifestyle Changes

You may reduce the symptoms of carcinoid syndrome by making minor improvements. Avoid foods and beverages that may exacerbate effects, such as:

  • Alcohol
  • Nuts
  • Cheese
  • Chili peppers
  • Hot liquids

It can take some trial and error to figure out what the causes are.

Your intestines can have difficulty consuming nutrients, resulting in weight loss, fatigue, and other issues. Make an effort to follow a nutritious diet, and see the doctor to see whether you need any vitamins or nutrients.

Carcinoid Syndrome Outlook

The tumours can disappear as a result of treatment. However, the disease will not be entirely gone, and it may relapse. To maintain things under control for as long as possible, you will need regular therapy on a daily basis.

Even if the treatment fails, you should concentrate on keeping yourself as comfortable as possible. Palliative care is the term for this.

Getting Support

You don't have to go through this on your own. Consider attending a community network where you can talk about your emotions with others who care.

On the Carcinoid Cancer Foundation's webpage, you can learn more about carcinoid syndrome and carcinoid tumours. It also contains material about how to join local support groups.

Source:

Referenceed on 2/5/2021

  1. American Cancer Society: “Octreotide."
  2. American Family Physician: “Carcinoid Tumors."
  3. Carcinoid Cancer Foundation.
  4. National Organization for Rare Disorders: “Carcinoid Syndrome."
  5. Caring for Carcinoid Foundation: “Carcinoid Syndrome."
  6. Cleveland Clinic: “Radionuclide Scanning (Nuclear Medicine Imaging)."
  7. UpToDate: “Treatment of the carcinoid syndrome."
  8. Mayo Clinic: “Carcinoid syndrome.”
  9. https://www.webmd.com/cancer/carcinoid-syndrome

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