A carcinoid tumor is a rare, slow-growing, malignancy that aries from neuroendocrine cells. Neuroendocrine cells are present throughout the body in different organs. They help in various body functions by receiving and sending messages through hormones.
Carcinoid tumors can arise in several body parts, the most common being lungs, appendix, and organs of the gastrointestinal tract such as the stomach, liver, colon, and rectum.
Statistical data suggest that only about 4 in 100,000 adults suffer from a carcinoid tumor. It is even rarer in children
The exact cause of carcinoid tumors is not known, but in general, cancers are caused due to genetic changes in the DNA of the cells called mutations. Due to these mutations, the cells do not die their natural death but keep on growing and dividing, and form a mass. This tumor interferes with the normal functions of the body
Factors that increase the risk of developing carcinoid tumor include:
Age: Carcinoid tumors are more prevalent in individuals in the older age group compared with younger people or children.
Sex: Carcinoid tumors are found more commonly in women than men.
Race: GI carcinoid tumors are more frequently found in African-Americans than in Caucasians.
Certain diseases: Patients suffering from multiple endocrine neoplasia type 1 (MEN1) are at higher risk of developing carcinoid tumors, and this is a genetic disease that is passed down through the families. Neurofibromatosis type 1 also increases the risk of carcinoid tumors
Signs and symptoms
Some carcinoid tumors may not cause any symptoms. Others might cause vague symptoms, depending upon their location.
Symptoms of carcinoid tumor involving the lungs are:
- Shortness of breath.
- Chest pain.
- Blood in the sputum.
- Skin flushing (feeling of warmth in face and neck).
- Weight gain, specifically around the upper back and midsection.
- Pinkish or purplish skin marks that resemble stretch marks.
Symptoms of carcinoid tumor of GI tract are:
- Nausea and vomiting.
- Abdominal pain.
- Rectal pain and bleeding.
- Skin flushing (feeling of warmth in face and neck)
Carcinoid tumors are diagnosed by performing the following tests and imaging:
Blood tests: High levels of certain hormones or their byproducts in the blood can be an indicator of a carcinoid tumor (eg. Metanephric /Nor metanephric)
Urine tests: Patients suffering from carcinoid tumors have high levels of breakdown products of hormones in the urine.
Endoscopy: Bronchoscopy, colonoscopy, or capsule endoscopy is used to look for the presence of a tumor in the lungs, colon, or rectum.
Biopsy: A tissue sample is collected from the tumor and is inspected under a microscope to confirm the presence of cancerous cells in the tumor.
Imaging techniques: A CT scan, MRI, PET scan, X-ray, or nuclear medicine imaging studies (Eg Dotanoc Scan) are used to identify the exact location of the tumor, its size, and extent of metastasis
Once a cancer diagnosis is established, staging is done to determine the size of the tumor / depath of invasion and its spread in the body. It helps to devise the best treatment strategy.
Cancer staging is done from Stage 0 to Stage IV, with 0 being the non invasive stage.
Further, it is classified according to the TNM system, (Varies according to locations) in which:
T denotes the size of the tumor / depth of invasio
N denotes if cancer has spread to lymph nodes; If so, to how many and where?
M denotes if cancer has metastasized (spread) to other organs too; if yes, where?
The stage of the cancer is determined by combining all this information
The treatment approach for carcinoid tumors depends upon various factors such as the location of the tumor, size of the tumor, whether it has spread to other organs, your overall health condition, prognosis, and your own decision.
Different treatment modalities used to treat carcinoid tumors include:
Surgery is the best treatment option for a carcinoid tumor if it has not yet reached an advanced stage. The tumor, along with some surrounding normal tissue, is removed surgically to completly remove it
Medications are given to block hormones secreted by the carcinoid tumor. This reduces the signs and symptoms of the disease, as well as restricts the growth of the tumor.
Drugs are given orally or intravenously to kill the cancer cells. Chemotherapy is usually given when surgery alone is not considered enough to control the disease.
Targeted drug therapy:
This treatment method uses drugs that specifically target some reports in cancer cells and kill it.
It uses high-energy X-rays to kill the tumor cells. Mostly, it is given externally on the affected body part, but sometimes radioactive seeds are implanted inside the body near the tumor, and radiation from these seeds kills the cancer cells
Prognosis means the chances of recovery or survival rates of disease. The prognosis of a carcinoid tumor depends on its location, stage, how much the tumor was resected by surgery, age, and the overall health condition of the patient.
The prognosis of carcinoid tumors is very good in children and younger people. In these individuals, the tumor can be resected surgically. Studies have reported that the 5-year survival rate for children and young individuals whose bronchial carcinoid tumor could be removed, is greater than 90%. The prognosis might be lower in old age patients or cases where the carcinoid tumor had spread to other body parts.
Your oncologist will be the best person to inform you about your prognosis.
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