Carcinoid Cancer
Introduction
Carcinoid cancer originates from certain hormone producing cells that line several organ systems. It most frequently occurs in the gastrointestinal tract. The exact cause of carcinoid cancer is unknown. It may or may not produce symptoms depending on where in the body it is located. Carcinoid cancer is a slow growing cancer. Carcinoid cancer that is removed before it has spread to other parts of the body is associated with good outcomes.
Anatomy
Carcinoid tumors can originate in the gastrointestinal tract, respiratory tract, hepatobiliary system, and the reproductive glands. Your gastrointestinal tract consists of your esophagus, stomach, small intestine, and colon. Your respiratory tract is composed of your trachea, bronchi, and lungs. The pancreas, gallbladder, and liver are parts of the hepatobiliary system. The testes in males and the ovaries in females are reproductive glands.
Causes
Symptoms
The symptoms of carcinoid cancer vary depending on where the cancer is located, which hormones are produced by the tumor, and if the cancer has spread from its original site. Cancer that has spread from its original place of development is termed metastasized. Carcinoid cancer in the gastrointestinal tract may not cause symptoms. In some cases, these tumors may cause bowel obstruction resulting in pain, weight loss, constipation, diarrhea, or bleeding.
Carcinoid cancer located in areas other than the gastrointestinal tract or that has metastasized may produce symptoms. Carcinoid cancer may not produce symptoms until it has spread to the liver. A cluster of symptoms, termed carcinoid syndrome, can occur as the tumors overproduce hormones.
Carcinoid syndrome causes a variety of symptoms. It can cause an intense blush or flushing of the face, neck, trunk, back, or legs. The flushing may be accompanied by a rapid heartbeat. Excessive flushing can lead to telangiectasia, reddish spots or veins on the face, chest, or arms. Following flushing, some people experience cyanosis, bluish skin areas caused by a lack of oxygen.
The majority of people with carcinoid syndrome experience diarrhea. Diarrhea may be severe and cause dehydration. You may also experience painful cramping that prevents normal bowel movements. Carcinoid syndrome can cause intestinal blockage, a condition that should be brought to the attention of your doctor, if you are having severe nausea and vomiting along with the inability to have a bowel movement.
Heart valvular lesions are a serious condition that can be caused by carcinoid syndrome. Over 50% of people with carcinoid syndrome experience heart valvular lesions. The efxcess hormones produced by the carcinoid cancer affects the way the heart functions and can lead to carcinoid heart disease. Additionally, heart dysfunction can cause peripheral edema. This condition causes swelling in the ankles, legs, hands, arms, neck, and face. You should contact your doctor if you experience peripheral edema.
Carcinoid syndrome can cause several other symptoms. It can cause your airway passages to constrict and result in wheezing when you breathe. People with carcinoid syndrome tend to develop arthritis more frequently than the general population. Additionally, you may develop pellagra, a skin rash, because of a lack of niacin.
Diagnosis
A variety of imaging tests may be used to identify the location of carcinoid cancer and determine if it has spread. The most commonly used test is an OctreoScan. Images are taken after the body absorbs a harmless radioactive octreotide. The octreotide is attracted to these types of cancer tumors. The images show where the substance collects and indicates where cancer is located.
Your doctor may order more tests or imaging scans depending on your results and the location of your carcinoid cancer. Your doctor may perform a biopsy. A biopsy entails obtaining a tissue sample to test for cancerous or abnormal cells. In some cases, an exploratory surgery is necessary to locate a carcinoid tumor and determine its size.
If you have carcinoid cancer, your doctor will assign your cancer a classification stage based on the results of all of your tests. Staging describes the cancer and how it has metastasized. Carcinoid cancer can spread to nearby tissues, such as fat, ligaments, muscles, or lymph nodes. It may also spread to distant sites including the liver, bones, and lungs. Staging is helpful for treatment planning and recovery prediction.
Treatment
Carcinoid tumors in the appendix may require appendectomy and surgical bowel resection. Carcinoid tumors in the rectum may be treated with electric fulguration (cauterizing or "burning"), local excision, or resection. Surgical resection may be required for carcinoid tumors in the stomach, colon, and pancreas. Small intestine tumors may be removed with local excision and resection. Depending on the condition, it may be necessary to remove nearby lymph nodes. Minimally invasive laparoscopic surgeries are used when possible. Minimally invasive surgeries are associated with quicker recovery times. In rare cases, liver transplantation may be used for select individuals with metastasized liver cancer.
Prevention
Am I at Risk
Risk factors may increase your likelihood of developing carcinoid cancer, although some people that experience this cancer may not have any risk factors. People with all of the risk factors may never develop carcinoid cancer; however, the likelihood increases with the more risk factors you have. You should tell your doctor about your risk factors and discuss your concerns.
Risk factors for carcinoid cancer:
_____ People with multiple endocrine neoplasia type 1 (MEN1) may have an increased risk for developing carcinoid cancer. Researchers believe there is a link between this genetic disorder and carcinoid cancer.
_____ People with gastrointestinal conditions, including peptic ulcer disease, pernicious anemia, atrophic gastritis, and Zollinger-Ellison syndrome, have an increased risk for developing carcinoid cancer in the gastrointestinal tract.
_____ Women develop carcinoid cancer at slightly higher rates than men do.
_____ Carcinoid cancer most frequently develops in people that are over the age of 50.
_____ Some studies show that smoking increases the risk of carcinoid cancer in the small intestine. However, carcinoid cancer in the lungs is not linked to smoking.
Complications
Advancements
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.
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