Carcinoid is a rare type of tumor in which certain chemicals secreted by the tumor is sent into the blood stream causing various problems affecting the lungs and gastrointestinal tract. Carcinoid syndrome is a kind of cancer that can cause symptoms like flushing of skin, skin lesions, and diarrhea. Often, this cancer becomes evident only in the later stage which makes treatment impossible. In other cases, the symptoms of this disease can be managed with chemotherapy, radiation and medications. Carcinoid tumors grow slowly and invade the neighboring cells spreading the cancer. They also secrete certain chemicals and hormones causing disturbance in the digestive system.
Symptoms :
Carcinoid tumor can cause signs of diarrhea and stomach pain if the chemicals affect the digestive system. It may cause shortness of breath, wheezing and heart palpitation if the tumor affects the lungs. It may also cause flushing of skin more on your face. The skin becomes hot and change in color for no reason. It can also cause skin lesions on your face. Intake of alcohol or too much of stress can trigger these symptoms. Taking certain foods like cottage cheese or salted meat can trigger signs of diarrhea easily.
How common is this problem?
Not all the people having carcinoid tumor would develop carcinoid syndrome. Less than 10% of people with this tumor may get this syndrome. Carcinoid tumors would secrete chemicals and certain hormones in blood but it may not affect the body totally in all cases. This is because the unwanted chemicals are filtered in the liver before being distributed to other parts of the body. Liver would dissolve most of the chemicals and hormones and hence may not cause any problem. Hence, carcinoid syndrome is a rare disorder.
Causes :
Excess of serotonin secreted by the carcinoid tumor would pass into the bloodstream. Carcinoid tumor also produces unwanted chemicals and hormones that are distributed in the blood. It may affect your lungs, GI tract and even the rectum. In most of the cases, liver would dissolve these chemicals and neutralize them before it is sent back into the blood. People with carcinoid syndrome will show signs only in the advanced stage where the cancer cells have spread to other organs. But what exactly causes this tumor is not known.
Complications :
In rare cases, carcinoid syndrome can cause heart problems like thickening of heart valves and leakage. This can cause heart failure demanding immediate surgical repair. Some of the chemicals produced by the tumor may affect the lymph nodes of the intestine leading to obstruction of bowel movement. It can cause severe abdominal cramps and vomiting. In extreme cases, carcinoid crisis can developing showing signs of skin flushing, reduced blood pressure, mental imbalance and shortness of breath.
Diagnosis :
Based on the symptoms, your doctor would order for blood culture and urine analysis to check the levels of serotonin and other proteins. He may also request for imaging tests like CT or MRI scan if he suspects problems in GI tract and intestine.
Treatment :
The worst part of carcinoid syndrome is the signs become evident only in the advanced stage of tumor. Hence it is difficult to treat this cancer. Surgery is done if the disease is detected in early stages in which the surgeon would remove tumor to reduce the intensity of symptoms. Drugs are given to block the secretion of chemicals affecting the organs. Drugs like sandostatin and octreotide are prescribed to manage symptoms of skin flush.
Embolizaiton is done to stop blood supply to liver tumors so that the remaining part of the liver would stay healthy. In other cases, chemotherapy can be done to shrink the tumor. Radiation and cryotherapy is also effective. Surgery is done only if the size of the tumor is large and the symptoms are very intense. Medications like alpha interferon are useful in treating carcinoid tumor.
Lifestyle Changes :
Discuss with your doctor about the diet and supplement you need to take. Avoid certain things that can trigger skin flushing. Control your emotions and stress by going to yoga or meditation classes.
Prognosis :
Once the presence of carcinoid syndrome indicates the tumor has advanced and spread to other organs. Hence the rate of survival is low for people with carcinoid syndrome. However if the tumor is detected in early stages and if it is slow growing modern treatments can be effective and extend your life.