Carcinoid tumors are a type of slow-growing cancer that can arise in several places throughout your body. Carcinoid tumors, which are one subset of tumors called neuroendocrine tumors, usually begin in the digestive tract (stomach, appendix, small intestine, colon, rectum) or in the lungs.
Carcinoid tumors often don't cause signs and symptoms until late in the disease. Carcinoid tumors can produce and release hormones into your body that cause signs and symptoms such as diarrhea or skin flushing.
Treatment for carcinoid tumors usually includes surgery and may include medications.
Symptoms
Some carcinoid tumors don't cause any signs or symptoms. When they do occur, signs and symptoms are usually vague and depend on the location of the tumor.
Carcinoid tumors in the lungs
Signs and symptoms of carcinoid lung tumors include:
Chest pain
Wheezing
Shortness of breath
Diarrhea
Redness or a feeling of warmth in your face and neck (skin flushing)
Weight gain, particularly around the midsection and upper back
Pink or purple marks on the skin that look like stretch marks
Carcinoid tumors in the digestive tract
Signs and symptoms of carcinoid tumors in the digestive tract include:
Abdominal pain
Diarrhea
Nausea, vomiting and inability to pass stool due to intestinal blockage (bowel obstruction)
Rectal bleeding
Rectal pain
Redness or a feeling of warmth in your face and neck (skin flushing)
Treatment
Treatment for a carcinoid tumor depends on the tumor's location, whether cancer has spread to other areas of the body, the types of hormones the tumor secretes, your overall health and your own preferences.
Carcinoid tumor treatment options may include:
Surgery. When detected early, a carcinoid tumor may be removed completely using surgery. If carcinoid tumors are advanced when discovered, complete removal may not be possible. In some situations, surgeons may try to remove as much of the tumor as possible, to help control signs and symptoms.
Medications to control excess hormones. Using medications to block hormones secreted by the tumor may reduce the signs and symptoms of carcinoid syndrome and slow tumor growth.
Octreotide (Sandostatin, Bynfezia Pen) and lanreotide (Somatuline Depot) are given as injections under the skin. Side effects from either medication may include abdominal pain, bloating and diarrhea. Telotristat (Xermelo) is a pill that is sometimes used in combination with octreotide or lanreotide to further try to improve the symptoms of carcinoid syndrome.
Chemotherapy. Chemotherapy uses strong drugs to kill tumor cells. It can be given through a vein in your arm or taken as a pill. Chemotherapy is sometimes recommended for treating advanced carcinoid tumors that can't be removed with surgery.
Targeted drug therapy. Targeted drug treatments focus on specific abnormalities present within tumor cells. By blocking these abnormalities, targeted drug treatments can cause tumor cells to die. Targeted drug therapy is usually combined with chemotherapy for advanced carcinoid tumors.
Drugs that deliver radiation directly to the cancer cells. Peptide receptor radionuclide therapy (PRRT) combines a drug that seeks out cancer cells with a radioactive substance that kills them. In PRRT for carcinoid tumors, the drug is injected into your body, where it travels to the cancer cells, binds to the cells and delivers the radiation directly to them. This therapy may be an option for people with advanced carcinoid tumors.
Treatment for cancer that spreads to the liver. Carcinoid tumors commonly spread to the liver. Treatments may include surgery to remove part of the liver, blocking blood flow to the liver (hepatic artery embolization), and using heat and cold to kill cancer cells. Radiofrequency ablation delivers heat treatments that cause carcinoid tumor cells in the liver to die. Cryoablation uses cycles of freezing and thawing to kill cancer cells.
Diagnosis
Tests and procedures used to diagnose carcinoid tumors include:
Blood tests. If you have a carcinoid tumor, your blood may contain high levels of hormones secreted by a carcinoid tumor or byproducts created when those hormones are broken down by the body.
Urine tests. People with carcinoid tumors have excess levels of a chemical in their urine that's produced when the body breaks down hormones secreted by carcinoid tumors.
Imaging tests. Imaging tests, including a computerized tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET), X-ray and nuclear medicine scans, may help your doctor pinpoint the carcinoid tumor's location.
A scope or camera that sees inside your body. Your doctor may use a long, thin tube equipped with a lens or camera to examine areas inside your body.
An endoscopy, which involves passing a scope down your throat, may help your doctor see inside your gastrointestinal tract. A bronchoscopy, using a scope passed down your throat and into your lungs, can help find lung carcinoid tumors. Passing a scope through your rectum (colonoscopy) can help diagnose rectal carcinoid tumors.
To see inside your small intestine, your doctor may recommend a test using a pill-sized camera that you swallow (capsule endoscopy).
Removing tissue for laboratory testing. A sample of tissue from the tumor (biopsy) may be collected to confirm your diagnosis. What type of biopsy you'll undergo depends on where your tumor is located.
One way of collecting a tissue sample involves using a needle to draw cells out of the tumor. Another option may be through surgery. The tissue is sent to a laboratory for testing to determine the types of cells in the tumor and how aggressive those cells appear under the microscope.