Carcinoid Tumours: Symptoms, Risk Factors, Diagnosis, Treatment Options

Medically Reviewed by Dr. K. on May 19, 2021.

Carcinoid Tumours

Carcinoid tumours disease is a form of cancer, although unlike other types, it may occur in more than one area of the body. And depending on when you develop it, you may have a variety of symptoms, ranging from abdominal pain to a severe cough.

Carcinoid tumours damage cells that make hormones, regardless of when they appear. They’re a kind of cancer known as neuroendocrine tumours (NETs).

The majority of carcinoid tumours begin in one of two places: the lungs or the digestive system. The stomach, small intestine, colon, appendix, and rectum are all examples of this.

It’s less common, but tumours may start in your pancreas, testicles, or ovaries, depending on whether you’re a male or a female.

It’s important to keep in mind that these tumours seem to develop slowly. Doctors frequently discover them at an early stage, making them easier to treat.

Learn everything you can regarding this disease so you can collaborate with your doctor to find the right treatment option for you. Keep a channel of communication available for your friends and family so you can get the help and guidance you need to overcome obstacles with confidence and optimism.

Risks for Carcinoid Tumours

There are a few risk factors that can increase the chance of developing carcinoid tumours.

Genetic disease:

  • If you have multiple endocrine neoplasia type 1 (MEN1), you may develop carcinoid tumours. It’s a genetic disorder that runs through the family. MEN1 is responsible for around 10% of these tumours.
  • Neurofibromatosis type 1 is another disease that will increase the chances of having them.

Race: Carcinoid tumours in the gastrointestinal tract affect more African-Americans than Caucasians.

Gender: This form of cancer affects slightly more women than it does men.

Age: Carcinoid tumours are more often detected in adults in their 40s or 50s.

Conditions: If you have a condition like pernicious anaemia or Zollinger-Ellison syndrome, which affects the amount of acid the stomach produces, you’re more likely to develop a stomach tumour.

Symptoms

When carcinoid tumours grow on hormone-producing cells, they may begin to produce hormone-like substances of their own. Depending on where this is happening, this may result in a multitude of symptoms.

If you have tumours in your gastrointestinal tract, for example, you may notice symptoms like these:

  • Abdominal pain
  • Constipation
  • Diarrhea
  • Nausea
  • Vomiting
  • Difficulty breathing
  • Blood in the stool
  • Weight loss

If you have a lung carcinoid tumour, you may experience symptoms such as:

  • Coughing
  • Coughing up bloody mucus
  • Wheezing
  • Difficulty breathing

Carcinoid syndrome is a disorder that occurs when you have this form of cancer after a long time. It’s a set of symptoms that begin as tumours release hormones into your bloodstream.

You may experience face redness and warmth, as well as sweating. You may also encounter issues such as:

  • Diarrhea
  • Shortness of breath
  • Wheezing
  • Rapid heart rate
  • Weight loss
  • Weakness
  • Excessive hair growth on face and body

Diagnosis

They're commonly found by accident. Your doctor can notice them when doing a routine exam to rule out other diseases.

If you visit your doctor with symptoms of a carcinoid tumour, they can perform any of the following tests to see if you have one:

Biopsy: They take certain cells from the body and examine them under a microscope and see whether they are cancerous. To further refine the treatment, the tumour can be screened for certain genes or proteins.

Blood and urine tests: Your doctor will take samples of each and analyse them for hormones and other substances released by carcinoid tumours, such as serotonin and 5-HIAA.

Upper endoscopy: An endoscope is a thin, flexible tube that the doctor uses to visualise cancers in the oesophagus, stomach, and small intestine. To get a glimpse of your GI tract, they insert it into your mouth. When they're doing this, you'll be given medication to protect you from experiencing pain or discomfort. You can also be offered a sedative to ease discomfort during the procedure.

Colonoscopy: A thin, lighted tube is inserted into your back passage to give your doctor a glimpse of your rectum and colon. They can take samples of tissue to examine under a microscope for cancer. You'll be given pain medication, just as in an endoscopy. You can also be offered a sedative to ease discomfort during the procedure.

Capsule endoscopy: You take a pill with a small camera in it for this examination. This allows the doctor to examine the whole small intestine, which is where several carcinoid tumours start.

CT, or computed tomography: This strong X-ray creates clear images of the internal organs. It is capable of determining the extent of your tumour. You may even tell whether the cancer has advanced to the liver or lymph nodes, which are tiny glands that are part of the immune system's germ-fighting protection. To help show a better image of the tumour, you might be given a specific dye to drink or inject into a vein.

MRI, or magnetic resonance imaging: It creates images of organs and tissues within the body using strong magnets and radio waves. An MRI may be used to determine the tumour's size. You would need a special dye, just as with the CT scan, to get a clearer image.

X-ray: It uses low-dose radiation to enable your doctor to see through your body structures. It will check the lungs for tumours. Before this procedure, you will be asked to drink a substance containing a chemical called barium, which helps the specialist see the tumour more clearly.

Radionuclide scanning: A tiny quantity of a radioactive agent would be injected into one of the veins prior to the procedure. Carcinoid tumours are drawn to this drug. The examination will reveal where the tumour has spread in your body.

Often patients with carcinoid syndrome suffer from cardiac problems. Your doctor may recommend that you see a cardiologist or have a heart scan every 2-3 years to keep an eye on your heart.

Treatment Options

You will begin creating a treatment plan after your doctor determines what kind of carcinoid tumour you have and where it is located in your body.

You may need surgery to resect the whole tumour or only a portion of it. The type of surgery you receive is determined by the location of your cancer.

GI carcinoid tumours: The surgeon will incise a hole in the skin to resect the tumour, as well as any surrounding tissue. If the tumour is in the rectum, they can try to heat and kill it with an electric current. This is referred to as fulguration or electrocautery.

An endoscope should be used to remove certain minor carcinoid tumours in the stomach, duodenum, and rectum. The surgeon can even resect any of the stomach, colon, or rectum, as well as surrounding lymph nodes, if the tumour is huge.

Lung carcinoid tumours: The tumour and sections of the airway above and below it may be removed by your surgeon. A sleeve resection is the medical term for this procedure. After the treatment, the airway is reconnected. A larger tumour could require the removal of a portion or all of your lung. To prevent the tumour from spreading, they may also remove certain lymph nodes.

Carcinoid tumours in the liver: If your cancer has spread towards these places, your surgeon may remove the tumours. The procedure is known as liver resection.

Be sure your surgeon is aware whether you have carcinoid syndrome before the surgery, as your tumour can produce a harmful amount of hormones during the procedure. You'll be sent medication ahead of time to prevent this from occurring.

In addition to surgery, the doctor can try several other treatments to help it function better. If you are unable to have surgery, they will recommend them. Any of these options include:

Radiation: It kills cancer cells with high-energy X-rays. The majority of the time, this comes from a machine outside of your own. Alternatively, the doctor will insert radioactive seeds around the tumour within the body. Fatigue and redness in the affected region are possible side effects. You may have a sore throat, cough, or shortness of breath if you get radiation to your neck or throat.

Chemotherapy: It utilizes medicines to halt the growth of cancer cells. You may take these as tablets or get them injected directly into your vein. If the disease has spread, your doctor may use this drug. Chemotherapy may cause nausea, fatigue, hair loss, a loss of appetite, and an increased risk of infection.

Chemoembolization: It's a treatment for a carcinoid tumour in the liver that has spread. Chemotherapy medications are administered directly to the liver by a catheter, which a doctor inserts through an artery. The treatment blocks the tumour's blood supply.

Hormone therapy: It prevents the tumour from producing excess hormones. GI carcinoid tumours are treated with the antibiotics octreotide and lanreotide. You get them via shot.

Immunotherapy: It boosts the immune system's ability to fight cancer. You may be given a prescription called alpha-interferon.

Radioembolization: This is another treatment for liver cancer. Tiny nuclear beads are injected near your liver through your bloodstream. They will get trapped in the vessels around the tumour and emit radiation for many days, killing cancer cells.

Targeted therapy: It utilizes medications that target genes, proteins, and other substances that are specific to the cancer and assist in its progression. Some drugs inhibit the formation of new blood vessels, which aid in the survival of carcinoid tumours.

Consult a doctor on the right care option for you. Often, don't forget to take care of the emotional needs when all of this is going on. When you take care of your fitness, depend on your network of friends and family for help. Check or see whether there is a local community network where you can speak to those who have been through treatment and recovery.

Source:

Referenced on 2/5/2021

  1. American Cancer Society: “Can gastrointestinal carcinoid Tumors be found early?" “Surgery for gastrointestinal carcinoid Tumors." “What are the risk factors for gastrointestinal carcinoid Tumors?" “Embolization therapy for liver cancer."
  2. American Society of Clinical Oncology: “Carcinoid Tumor: Diagnosis." “Carcinoid Tumor: Overview." “Carcinoid Tumor: Risk Factors." “Carcinoid Tumor: Symptoms and Signs." “Carcinoid Tumor: Treatment Options."
  3. National Cancer Institute: “Gastrointestinal Carcinoid Tumors Treatment (PDQ)."
  4. https://www.webmd.com/cancer/carcinoid-Tumours

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