Carcinoid Syndrome: A Silent and Serious Digestive Condition
Carcinoid syndrome is a cluster of symptoms—such as flushing, wheezing, and fast heart rate-associated with a rare, slow—growing tumor commonly found in the gastrointestinal tract. Symptoms occur when the tumors release too much of the hormone serotonin as well as other chemicals that cause varied symptoms, such as flushing, wheezing, fast heart rate, and diarrhea.
About two-thirds of carcinoid tumors occur in the GI tract. The rest occur in the lung.
The good news: carcinoid tumors are rare. The bad news: most carcinoid tumors have no symptoms, and they're usually not detected until they have spread to organs such as the liver or lung.
Symptoms of a Carcinoid Tumor
Most carcinoid tumors don't produce symptoms, allowing them to grow undetected until the cancer is in advanced stages and/or carcinoid syndrome is present (though not everyone with carcinoid tumors will develop carcinoid syndrome). If symptoms do occur, the National Institutes of Health (NIH) says they may include:
- Abdominal pain
- Bright red flushing of the face, neck, or upper chest
- Heart palpitations
- Low blood pressure
The NIH says these symptoms may also be brought on by physical exertion, or by eating or drinking things such as blue cheese, chocolate, or red wine. See your doctor if you experience any symptoms that cause discomfort or concern.
Carcinoid syndrome occurs in about 1 in 10 people affected with carcinoid tumors—usually after the cancer has spread to the liver or the lung.
When a carcinoid tumor is slowly growing in the GI tract, it releases chemicals (usually the hormone serotonin) into the bloodstream that flow into the liver where enzymes destroy them before symptoms can appear. If, however, the carcinoid tumor has spread to the liver, it is unable to neutralize the chemicals and symptoms begin to appear.
According to the Mayo Clinic, carcinoid tumors that develop in the lung may produce symptoms of carcinoid syndrome. That's because the chemicals secreted into the blood stream travel further to be filtered by the liver, and are not neutralized before they create symptoms.
Treatment for Carcinoid Syndrome
Since the presence of carcinoid syndrome usually indicates the cancer has spread to the liver and is advanced, the survival rate is low. However, there are treatment options that may help.
- Surgery: According to the NIH, the first line of treatment is to remove the tumor. If the tumor can be removed, carcinoid syndrome can be cured. If the entire tumor is unable to be removed, your doctor may remove a large portion of the tumor to help relieve symptoms.
- Octreotide (Sandostatin): If surgery is not an option, injections of octreotide work to slow the growth of the tumor and reduce symptoms of carcinoid syndrome. The medication helps control skin flushing and diarrhea in most patients, says the Mayo Clinic.
- Interferon: An injection of interferon (with or without octreotide) may also be given to help slow cancer growth and relieve symptoms.
- Hepatic artery embolization: If the tumor has spread to the liver, this procedure is an option to cut off the blood supply to the cancer cells.
- Ablation: Techniques include radiofrequency ablation (heating), cryotherapy (freezing), or percutaneous ethanol injection (concentrated alcohol). Heating or freezing the cancer cells may cause them to die. Viewed as generally safe procedures, the experts at Mayo Clinic say one of these might be an option if the tumors are small in quantity and size.
- Chemotherapy: As with other cancers, chemotherapy may reduce the size of the tumors.
Living With Carcinoid Syndrome
In addition to medical treatment, there are lifestyle changes to help manage the condition:
Track personal symptom triggers. Avoid consuming alcohol, large meals, and foods high in tyramine (aged cheeses, avocado, processed foods), which can trigger flushing. Keep track of your personal triggers to learn what to avoid.
Review medications with your doctor. The increased levels of serotonin from selective reuptake inhibitors (SSRIs), such as Paxil and Prozac, may also trigger symptoms. Talk to your doctor before you stop taking SSRIs.
Reduce stress. Stress can trigger flushing. Meditation, light exercise, or any activity you find relaxing (knitting, reading, crossword puzzles) can help keep stress in check.
Ask your doctor about taking a multi-vitamin. If you're experiencing chronic diarrhea, a multi-vitamin may help you get the vitamins and minerals you need.
"Newly Diagnosed: The Basics" The Carcinoid Cancer Foundation. Web.
Carcinoid Syndrome. Mayo Clinic. Web. 2010
Gastrointestinal Carcinoid Tumors. American Cancer Society. Web. 2011
Carcinoid Syndrome. Medline Plus. Web. 2010
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