CARCINOID SYNDROME

CARCINOID SYNDROME 

Carcinoid syndrome is a mix of syndromes generated by hormones and other chemical substances discharged by the tumors toward the bloodstream. These tumors mostly appear in the gastrointestinal tract or lungs. Around ten percent of the people with carcinoid tumors will develop carcinoid syndrome. The manifestation of the carcinoid syndrome differs depending on which hormones are discharged by the tumors. Serotonin, histamine, bradykinin, and chromogranin are the prevalent hormones released.

The primary nature of carcinoid syndrome consists of flushing, diarrhea, recurring abdominal pain, cough (wheezing), low blood pressure and heart palpitations.

SYMPTOMS

Manifestations of carcinoid syndrome may be non-hormonal, secondary to tumor bulk extent and therefore, depend on location.

Symptoms include episodes of:

  • Asthmatic-like wheezing
  • Weight loss of gain
  • Malnutrition
  • Dehydration
  • Weakness
  • Warmth and redness of the upper face and chest
  • Diarrhea
  • Marked changes in blood pressure
  • Muscle and joint aching
  • Peptic ulcer

In the next stages, it may damage the heart valves, resulting in the manifestation of congestive heart failure. It may also be accompanied by stomach pain, blockage of the arteries in the liver, heart palpitations and excessive peptide excretion in the urine. Diarrhea may be so serious that vital nutrients of the body such as potassium and water are depleted, creating a life-threatening imbalance of the electrolytes.

DIAGNOSIS

An examination is best obtained with a multimodality approach along with biochemical investigation examination, nuclear and radiological imaging, and final histological confirmation where viable.

  • Imaging tests – Used to detect the dominant carcinoid tumor and check whether it has spread.
  • Urine Test – Urine may contain stuff made when your body breaks down serotonin. An excess amount of substance could mean that your body is processing additional serotonin, a chemical frequently excreted by carcinoid tumors.
  • Blood test – Blood may consist of high levels of certain substances like protein chromogranin A, which is discharged by any carcinoid tumors.

 

TREATMENT

Treatments may consist of:

  • Examinations– Some patients with unresectable carcinoid tumors may have no local manifestation nor carcinoid syndrome. These patients can be attended without surgery or medications because carcinoid tumors are slow-growing, and patients may not develop symptoms for a lengthened period.
  • Chemotherapy drugs may decrease carcinoid tumors. The side effects experienced during this process depends on which chemotherapy drugs are used.
  • Surgery to eliminate cancer. Surgery is also used to alleviate symptoms such as small intestinal obstruction or internal bleeding; for curative resection; and to reduce the size of tumors that are not effectively resectable. This action is called tumor debulking.
  • Medications to deter cancer cells from secreting chemicals. Injections of octreotide (sandostain) and lanreotide (somatuline depot) may lessen the signs and symptoms, including skin flushing and diarrhea. Ocreotide may also hinder the growth of carcinoid tumors.
  • Biological therapy is a medication through injection called interferon alfa. Itprompts the body’s immune system to work better. However, this treatment can cause serious side effects, including fatigue and flu-like manifestations.
  • Radiation therapy uses high-energy X-rays or other types of radiation to wipe-out tumor cells.
  • Cyrosurgery or cryotherapy is a process wherein doctors use cold temperatures to kill abnormal cells or small tumors. Liquid nitrogen or argon gas is where the cold comes from.

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