Gastrointestinal Carcinoid Tumors Treatment (PDQ�)
General Information About Gastrointestinal Carcinoid Tumors
A gastrointestinal carcinoid tumor is cancer that forms in the lining of the gastrointestinal tract.
Gastrointestinal carcinoid tumors grow slowly. Most of them occur in the
Health history can affect the risk of developing gastrointestinal carcinoid tumors.
Having a family history of
multiple endocrine neoplasia type 1 (MEN1) syndrome.
Having certain conditions that affect the stomach's ability to produce stomach acid, such as atrophic
gastritis, pernicious anemia, or Zollinger-Ellison syndrome.
A gastrointestinal carcinoid tumor often has no signs in its early stages. Carcinoid syndrome may occur if the tumor spreads to the liver or other parts of the body.
The hormones produced by gastrointestinal carcinoid tumors are usually destroyed by
Redness or a feeling of warmth in the face and neck.
Shortness of breath, fast heartbeat, tiredness, or swelling of the feet and ankles.
Pain or a feeling of fullness in the
These symptoms and others may be caused by gastrointestinal carcinoid tumors or by other conditions. A doctor should be consulted if any of these symptoms occur.
Tests that examine the blood and urine are used to detect (find) and diagnose gastrointestinal carcinoid tumors.
The following tests and procedures may be used:
Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:
The number of
red blood cells, white blood cells, and platelets.
The amount of
hemoglobin(the protein that carries oxygen) in the red blood cells.
The portion of the sample made up of red blood cells.
Physical examand history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient?s health habits and past illnesses and treatments will also be taken. Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as hormones, released into the blood by organs and tissuesin the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it. The blood sample is checked to see if it contains a hormone produced by carcinoid tumors. This test is used to help diagnosecarcinoid syndrome.
urinetest: A test in which a urine sample is checked to measure the amounts of certain substances, such as hormones. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it. The urine sample is checked to see if it contains a hormone produced by carcinoid tumors. This test is used to help diagnose carcinoid syndrome.
Certain factors affect prognosis (chance of recovery) and treatment options.
cancercan be completely removed by surgery.
Whether the cancer has spread from the stomach and intestines to other parts of the body, such as the liver or lymph nodes.
The size of the tumor.
Where the tumor is in the gastrointestinal tract.
Whether the cancer is newly diagnosed or has
Treatment options also depend on whether the cancer is causing symptoms. Most gastrointestinal carcinoid tumors are slow-growing and can be treated and often cured. Even when not cured, many patients may live for a long time.
Stages of Gastrointestinal Carcinoid Tumors
After a gastrointestinal carcinoid tumor has been diagnosed, tests are done to find out if cancer cells have spread within the stomach and intestines or to other parts of the body.
endoscopy: A procedure to look inside the gastrointestinal tractfor abnormalareas or cancer. An endoscope(a thin, lighted tube) is inserted through the mouth and esophagusinto the stomachand first part of the small intestine. Also, a colonoscope(a thin, lighted tube) is inserted through the rectuminto the colon(large intestine); this is called a colonoscopy. CT scan(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-raymachine. A dye may be injectedinto a vein or swallowed to help the organsor tissuesshow up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
receptorscintigraphy (SRS): A type of radionuclide scanused to find carcinoid tumors. In SRS, radioactive octreotide, a drug similar to somatostatin, is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to carcinoid tumor cellsthat have somatostatin receptors. A radiation-measuring device detects the radioactive material, showing where the carcinoid tumor cells are in the body. This procedure is also called an octreotide scan. Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Tissue samples may be taken during endoscopy and colonoscopy. Angiogram: A procedure to look at blood vesselsand the flow of blood. A contrast dye is injected into the blood vessel. As the contrast dye moves through the blood vessel, x-rays are taken to see if there are any blockages. PET scan(positron emission tomography scan): A procedure to find malignanttumor cells in the body. A small amount of radionuclide glucose(sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells.
X-ray of the
abdomen: An x-ray of the organs and tissues inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
tissue. Cancer invadesthe surrounding normal tissue.
lymph system. Cancer invades the lymph system and travels through the lymph vesselsto other places in the body.
blood. Cancer invades the veinsand capillariesand travels through the blood to other places in the body.
Gastrointestinal carcinoid tumors are grouped for treatment based on where they are in the body.
Cancer is found in the
Cancer has spread from the appendix, colon, rectum, stomach, and/or small intestine to nearby tissues or
Cancer has spread to other parts of the body.
Recurrent Gastrointestinal Carcinoid Tumors
Treatment Option Overview
There are different types of treatment for patients with gastrointestinal carcinoid tumors.
Different types of treatment are available for patients with
Seven types of standard treatment are used:
Treatment of gastrointestinal carcinoid tumors usually includes
Appendectomy: Removal of the
appendix. Fulguration: Use of an electric current to burn away the tumor using a special tool. Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy. The doctor may use ultrasound to guide the instrument. Resection: Surgery to remove part or all of the organthat contains cancer. Resection of the tumor and a small amount of normal tissue around it is called a local excision. Bowelresection and anastomosis: Removal of the bowel tumor and a small section of healthy bowel on each side. The healthy parts of the bowel are then sewn together (anastomosis). Lymph nodesare removed and checked by a pathologistto see if they contain cancer. Radiofrequency ablation: The use of a special probe with tiny electrodes that release high-energy radio waves (similar to microwaves) that kill cancer cells. The probe may be inserted through the skin or through an incision(cut) in the abdomen. Hepaticresection: Surgery to remove part or all of the liver. Hepatic artery ligationor embolization: A procedure to ligate (tie off) or embolize (block) the hepatic artery, the main blood vesselthat brings bloodinto the liver. Blocking the flow of blood to the liver helps kill cancer cells growing there.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Percutaneous ethanol injection
Other drug therapy
MIBG (metaiodobenzylguanidine) is sometimes used, with or without
New types of treatment are being tested in clinical trials.
Treatments being studied in clinical trials for gastrointestinal carcinoid tumors include new combinations of chemotherapy. Information about clinical trials is available from the NCI Web site.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from
Follow-up tests may be needed.
Some of the tests that were done to
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has
Treatment Options for Gastrointestinal Carcinoid Tumors
A link to a list of current
Localized Gastrointestinal Carcinoid Tumors
Carcinoid tumors in the appendix
bowel resectionwith anastomosis, and removal of lymph nodes.
Rectal carcinoid tumors
Treatment of localized gastrointestinal carcinoid tumors in the
Small bowel carcinoid tumors
Treatment of localized gastrointestinal carcinoid tumors in the
Resection with removal of nearby lymph nodes.
Gastric, colon, and pancreatic carcinoid tumors
Treatment of localized gastrointestinal carcinoid tumors in the
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Regional Gastrointestinal Carcinoid Tumors
Treatment is usually surgery to remove all the
If the tumor cannot be completely removed by surgery, treatment is usually
cryosurgery, or radiofrequency ablationto remove as much of the tumor as possible. Chemoembolizationto shrink tumors in the liver.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with regional gastrointestinal carcinoid tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Metastatic Gastrointestinal Carcinoid Tumors
bypassor remove part of a tumor blocking the small intestine. Chemotherapy, which may include chemoembolization. Radiation therapy, sometimes with radioisotopessuch as radioactive iodine (I131).
MIBG (metaiodobenzylguanidine) therapy.
Biologic therapyand/or hormone therapy. Clinical trialsof new treatments.
Treatment of metastatic gastrointestinal carcinoid tumors that are causing
Resection, cryosurgery, radiofrequency ablation, or
percutaneous ethanol injectionfor tumors in the liver. Hepatic artery ligationor embolization, with or without regionalor systemic chemotherapy.
Biologic therapy with or without chemotherapy.
Clinical trials of new combinations of chemotherapy.
A heart valve replacement may be done for some patients with carcinoid syndrome.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with metastatic gastrointestinal carcinoid tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Recurrent Gastrointestinal Carcinoid Tumors
Surgery to remove part or all of the tumor.
A clinical trial.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent gastrointestinal carcinoid tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
To Learn More About Gastrointestinal Carcinoid Tumors
For more information from the
Gastrointestinal Carcinoid Tumors Home Page
Smoking and Cancer Home Page (Includes help with quitting)
Biological Therapies for Cancer: Questions and Answers
Cryosurgery in Cancer Treatment: Questions and Answers
What You Need to Know About? Cancer
Understanding Cancer Series: Cancer
Chemotherapy and You: Support for People With Cancer
Radiation Therapy and You: Support for People With Cancer
Coping with Cancer: Supportive and Palliative Care
Information For Survivors/Caregivers/Advocates
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Changes to This Summary (06/13/2008)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Several enhancements have been made to this summary to better explain certain medical concepts and to help readers find information about
Text describing the way cancer spreads in the body was added to the Stages section.
Information about patients taking part in clinical trials and about follow-up tests was added to the Treatment Option Overview section.
Links to ongoing clinical trials listed in NCI?s PDQ Cancer Clinical Trials Registry were added to the Treatment Options section.
A new section called ?To Learn More? was added. It includes links to more information about this type of cancer and about cancer in general.
The ?Get More Information from NCI? section (originally called ?To Learn More?) was revised.
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PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).