Carcinoid Tumor Treatment in Delhi, India

A carcinoid tumor is a rare, slow-growing, malignancy that arises 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 stomach cancer, liver cancer, colon cancer, and rectum cancer.

Statistical data suggest that only about 4 in 100,000 adults suffer from a carcinoid tumor. It is even rarer in children.

Carcinoid Tumor Causes

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

Carcinoid Tumor Symptoms and Signs

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
• Cough
• Wheezing
• Chest pain
• Blood in the sputum
• Diarrhea
• 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.

Carcinoid Tumor Symptoms of GI Tract

• Diarrhea
• Nausea and vomiting
• Abdominal pain
• Constipation
• Rectal pain and bleeding
• Skin flushing (feeling of warmth in face and neck)

Carcinoid Tumor Diagnosis

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 (e.g. 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

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.

Stages of Carcinoid Tumor

Once a cancer diagnosis is established, staging is done to determine the size of the tumor / depth of invasion and its spread in the body. It helps to devise the best cancer 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 invasion
• 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.

Carcinoid Tumor Treatment

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

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 completely remove it.

Medications

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.

Chemotherapy

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

Targeted drug therapy treatment method uses drugs that specifically target some reports in cancer cells and kill it.

Radiation Therapy

Radiation therapy 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.

Risk Factors of Carcinoid Tumor

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.

Prognosis

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.

Frequently Asked Questions

1. What is a carcinoid tumour?

Carcinoid tumours are a type of neuroendocrine tumour that develops from specialised neuroendocrine cells. They can occur in various body parts, mainly the gastrointestinal tract and lungs.

2. Is carcinoid cancer serious?

Carcinoid cancer can be severe, especially if it has spread to other parts of the body. The severity of the cancer depends on several factors, including its location, size, and stage at diagnosis.

3. How is a carcinoid tumour diagnosed?

Carcinoid tumour is diagnosed through a combination of tests, including imaging studies such as CT scans or MRIs, blood tests to measure hormone levels, and a biopsy to examine a tumour sample under a microscope.

4. What is the most common cause of carcinoid?

The exact cause of carcinoid tumour is unknown, but it is believed to develop from certain neuroendocrine cells in the body. It may also develop due to certain genetic mutations and environmental factors, including exposure to toxins or infections.

5. What age do carcinoid tumours start?

Carcinoid tumours can occur at any age, but they are more common in people over the age of 60. They are rare in children and young adults, accounting for less than 5% of all paediatric tumours. They can occur in various body parts, but the most common locations are the gastrointestinal tract, lungs, and pancreas.

6. Can a blood test detect carcinoid tumours?

Yes, blood tests can sometimes detect carcinoid tumours by measuring levels of specific hormones or markers in the blood. However, additional tests, such as imaging studies and a tumour biopsy, are usually necessary for a definitive diagnosis.

7. When should you suspect a carcinoid?

Carcinoid tumours may be suspected when a person experiences symptoms such as flushing, diarrhea, abdominal pain, wheezing, or heart palpitations. These symptoms may occur due to the release of hormones from the tumour and can be intermittent or chronic.

8. How fast do carcinoid tumours spread?

The growth rate of carcinoid tumours varies widely. Some may remain small and slow-growing for many years, while others may grow rapidly and spread to other body parts. The rate of tumour growth and spread is determined by various factors, including the tumour's size and location and its genetic characteristics.

9. Are carcinoid tumours painful?

Carcinoid tumours may or may not cause pain, depending on their location and size. Some carcinoid tumours grow slowly and may not cause pain until they become large or spread to other organs.

10. Do you need chemo for carcinoid?

The treatment for carcinoid tumours depends on the type, location, and stage. In some cases, surgery may be the only treatment needed. Chemotherapy and other medications may treat more advanced or aggressive tumours. However, not all carcinoids require chemotherapy, and treatment plans are individualised for each patient.

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