Is subcutaneous rescue octreotide indicated for dentistry?
In general all carcinoid syndrome patients should be given a booster dose of regular octreotide just prior to any anesthesia, surgery or dentistry.…READ MORE
How does Sandostatin work in conjunction with chemotherapy?
Sandostatin when given in large doses (if OctreoScan is positive) along with alpha interferon (with which it works synergistically) causes tumor regression in 2/3 of the cases.…READ MORE
What are the side effects of streptozotocin?
The main toxic side effect of streptozotocin is on the kidney and the 8th cranial nerve, the nerve that transmits hearing and the equilibrium function of the inner ear. Kidney damage is the more common side effect and is related to the dose and total amount…READ MORE
What is recommended for bone metastases?
Radiotherapy is helpful for painful bone lesions.…READ MORE
Do you know why there is a “mushrooming effect” once the primary is removed?
Sometimes, not always, when a primary NET (neuroendocrine tumor) is removed and metastastatic tumors are already present, their growth is accelerated. However, sometimes the opposite occurs and their growth is related. These effects are thought …READ MORE
When is local irradiation used?
In general, radiotherapy for carcinoid tumor arising from the foregut is utilized only to treat painful metastatic bone metastases (in which instances it is usually effective), brain metastases, unresectable carcinoid of the larynx, unresectable…READ MORE
Are there any chemotherapy agents more than 30% effective in carcinoid of the large and small bowel?
In atypical carcinoid VP16 and Cisplatin is 67% effective. In typical carcinoid DTIC as a single agent has been reported effective in greater than 50%. Dr. Kjell Oberg (as well as myself through observation) reports greater than 60% effectiveness from…READ MORE
You, Dr. Warner, and Dr. Woltering prescribe different dosages of Sandostatin – what the pros and cons of each approach?
Dr. Woltering stands somewhat alone in his use of huge doses of Sandostatin. Based on his research observations he feels that very large doses inhibit carcinoid tumor cell growth whereas conventional doses inhibit hormone production, release and effect…READ MORE
What is DTIC?
DTIC is an anticancer drug also known as dacarbazine. Like many other anticancer drugs, its mode of action is not known, but it may act via one of the following three hypotheses:
1. Inhibiting DNA synthesis by acting as a purine analog.
2. Acting as an alkylating…
Which anesthetics and painkillers are okay to use if you have carcinoid?
Morphine is okay for carcinoid patients but epinephrine is not since it can provoke carcinoid crisis. Epinephrine is sometimes used with local anesthesia to prolong the anesthesia by causing vasoconstriction. Novocain and other local anesthesia …READ MORE