Carcinoid Treatment & Symptom
Carcinoid, also carcinoid tumour and carcinoid tumor, is a slow-growing but often malignant type of neuroendocrine tumour , originating in the cells of the neuroendocrine system . Carcinoid tumors occur most commonly in the gastrointestinal tract, including the stomach, small intestine, appendix, colon and rectum, or in the lungs. Carcinoid develops in some people with carcinoid tumors and is characterized by cutaneous flushing, abdominal cramps, and diarrhea. Right-sided valvular heart disease may develop after several years. The syndrome results from vasoactive substances (including serotonin, bradykinin, histamine, prostaglandins, polypeptide hormones) secreted by the tumor, which is typically a metastatic intestinal carcinoid. Diagnosis is clinical and by demonstrating increased urinary 5-hydroxyindoleacetic acid. Tumor localization may require a radionuclide scan or laparotomy. Treatment of symptoms is with somatostatin or octreotide, but surgical removal is performed where possible; chemotherapy may be used for malignant tumors.
A carcinoid tumour, sometimes referred to as simply 'carcinoid', is a tumour of the neuroendocrine system. The neuroendocrine system is a network of glands that produce particular hormones and send them into the bloodstream to affect the function of different organs in the body. The symptoms of the carcinoid syndrome vary depending on which hormones are released by the tumors. The common hormones released are serotonin, bradykinin (a molecule produced by enzymes at the site of an injury and then binds to receptors to cause pain), histamine, and chromogranin A (a general marker for neuroendocrine tumors). In rare circumstances, carcinoid tumors can develop in the ovaries. Because carcinoid tumors generally grow slowly, they typically don't cause signs and symptoms until quite advanced. You might discover you have carcinoid cancer through a test for an unrelated disease or condition. Treatment for carcinoid syndrome usually involves treating your cancer. However, because most carcinoid tumors don't cause carcinoid syndrome until they're very advanced, a cure may not be possible. In those cases, medications may relieve the signs and symptoms of carcinoid syndrome and make you more comfortable.
Causes of Carcinoid
Common Causes of Carcinoide :
- Have a gastrointestinal carcinoid tumor.
Symptoms of Carcinoid
Some common Symptoms of Carcinoid Syndrome :
- Difficulty breathing.
- Flushing.
- Vomiting.
- Wheezing.
- Weight loss.
- Tachycardia.
- Joint pain.
- Abdominal pain.
- Low blood pressure.
- Diarrhea.
- Nausea.
- Skin flushing.
Treatment of Carcinoid
- Surgical resection of tumor and chemotherapy (5-FU and doxorubicin).
- Octreotide (somatostatin analogue- neutralizes serotonin and decreases urinary 5-HIAA.
- Methysergide maleate (antiserotonin agent but not used because of serious side effect of retroperitoneal fibrosis) .
- Cyproheptadine ( antihistamine ).
- External radiotherapy is sometimes used for bone pain but is not very successful elsewhere for tumour destruction.
- To try and reduce tumour growth chemotherapy may be used. Regrettably only 10 to 30% of patients show major shrinkage of the tumours (that is <50%). The drugs streptozocin, 5-fluorouracil and doxorubicin may be used.
- Another agent which is used in those who do not respond to octreotide or do so poorly is alpha interferon. This is given by injection 3 times per week and is successful in half the patients where it is used but less than 10% show any slowing or shrinkage of the tumour. Alpha interferon has side effects which sometimes are such that they outweigh the benefit. The patients can feel as if they have permanent flu symptoms and chronic fatigue.
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