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Chapter 4 Carcinoid Tumour |
Carcinoid is the most common type of neuroendocrine cancer. It occurs most often in the small bowel and appendix, followed by the large bowel, rectum, stomach and lung. It is typically a slow‐growing cancer. Carcinoid tumours are likely to spread to the liver. This often happens before your cancer is diagnosed.
Examples of Bowel Blockage
Tethered Bowel
Tumour Block
Carcinoid tumours of the bowel tend to produce a lot of scar tissue around the tumour. This may block the bowel because the scar tissue pushes directly on the wall of the bowel. This causes a bottleneck effect. The scarring may cause “tethering” or sticking down of the bowel or lining around the bowel. The scarring may also trap waste and narrow blood vessels.
What is carcinoid syndrome?
Carcinoid syndrome occurs when a carcinoid tumour makes or secretes large amounts of hormones and biologically active substances like peptides. When this happens, it causes:
- Flushing of the face and upper body
- Watery diarrhea
- Cramps
- Heart palpitations
High amounts of hormones may also cause memory problems and make it difficult to think clearly. Generally, carcinoid syndrome happens when tumour cells spread to the liver. Lung carcinoids can also cause the syndrome even if the cancer has not spread to the liver.
Carcinoid syndrome may be triggered by certain foods, alcohol, stress, exercise and surgery. It can also happen for no reason.
Over time, high hormone levels can damage the valves on the right side of the heart. High hormone levels may also thicken the lining of the heart muscle on the right side. This can lead to heart failure. It is important to lower hormone levels so that damage to the heart is delayed or prevented.
Carcinoid syndrome can be controlled with daily or monthly injections of a drug called Octreotide (awk‐tree‐oh‐tide). The amount and timing of the injections are based on hormone levels and the severity of symptoms. Some people will need an intravenous infusion (IV) to help control carcinoid syndrome.
What is carcinoid crisis?
A carcinoid crisis is a severe form of the carcinoid syndrome. It is a medical emergency. Sometimes it is called malignant carcinoid syndrome.
Carcinoid crisis causes low or high blood pressure, a fast or slow heartbeat, or the narrowing of the breathing passages. It should be treated with high doses of the drug Octreotide. This will quickly relieve these symptoms.
Why are 24‐hour urine samples collected?
People who have a carcinoid tumour need regular urine collections to measure their hormone levels. The 24‐hour urine sample measures the amount of a substance called 5‐hydroxyindoleacetic acid (5‐HIAA). This substance is a breakdown of the hormone serotonin, which is made by the tumour cells. The doctor uses the 5‐HIAA results to adjust your dose of Octreotide.
| << Patient Booklet Main Page >> | |
| << Chapter 3 Types of Neuroendocrine Tumours |
Chapter 5 >> Pancreatic Endocrine Tumours |