Understanding carcinoid tumors, carcinoid syndrome, and treatments for carcinoid when surgery is not an option are the focus of three feature articles by Ellen Greenlaw on WebMD.com this month. For these articles, Ms. Greenlaw sought the expertise of carcinoid/NET cancer specialists Richard R.P. Warner, MD, Professor of Medicine at Mount Sinai School of Medicine in New York City and Medical Director of the Carcinoid Cancer Foundation, and James C. Yao, MD, Associate Professor and Deputy Chair of the Department of Oncology at the University of Texas, MD Anderson Cancer Center in Houston.
In Understanding Carcinoid Tumor, the signs and symptoms of carcinoid, risk factors, diagnostic tests and prognosis are described. According to Dr. Warner, “The biggest obstacle in diagnosing carcinoid tumors is not thinking of them.” He explained that because these tumors are not common, “doctors may not think of them as a possibility when they see these symptoms.” Dr. Yao noted that carcinoid tumors are often found by accident. “We may find them during a screening colonoscopy or endoscopy or because of abnormal results on a liver function test.” Regarding prognosis, the sooner treatment is begun, the better the outcome. “ . . . Surgery and other treatments work much better when done early,” says Dr. Warner. “Early, aggressive treatment of carcinoid tumors leads to a much better outcome for patients.”
The feature What Is Carcinoid Syndrome presents information about the symptoms of the syndrome, including diarrhea, flushing, heart palpitations, stomach cramps, shortness of breath, and wheezing, and what exacerbates the symptoms such as stress, physical exertion, drinking alcohol, and certain foods. Dr. Yao describes the facial flushing of carcinoid syndrome as “usually a dry flushing, and not associated with sweating like other kinds of flushing.” Approximately 10% of those with carcinoid tumors also have carcinoid syndrome. Medications, such as octreotide and alpha-interferon drugs, can help relieve the symptoms of carcinoid syndrome. New drugs for carcinoid syndrome may be on the horizon; a number of these, says Dr. Warner are “undergoing clinical studies or awaiting FDA approval.” Some of these drugs are already available in Europe.
When Surgery Isn’t an Option outlines treatments for carcinoid tumors including medication to slow tumor growth, ablation to shrink tumors, chemotherapy, radiation therapy for cancer pain, and the rare option, a liver transplant when carcinoid has spread to the liver. New treatments such as targeted drug therapies and radiopharmaceuticals are also options. Treating tumors aggressively is Dr. Warner’s approach: “We often use a few types of treatments one right after the other. For example, we may use debulking surgery, then radiation, and then chemotherapy. This helps us stay ahead of tumor growth.”
To read the complete articles, click on each title below:
Thank you to WebMD.com and Ellen Greenlaw for helping to bring about greater awareness of carcinoid through these feature articles.