Carcinoid tumors are rare cancers that start in the neuroendocrine system, which produces hormones, and spread to other areas over time. About 2/3 of all carcinoid tumors start in the gastrointestinal tract, according to the American Society for Clinical Oncology (ASCO); another 10 percent form in the lungs. Carcinoid tumors often produce excess hormones that cause flushing, diarrhea and wheezing; the tumors themselves don't generally cause symptoms until the disease is very advanced.
Surgery
If carcinoid tumors are discovered before they've metastasized to other areas, they can be removed surgically. According to the Mayo Clinic, most tumors are advanced when found, so removing the whole tumor may not be possible. A section of the small intestine or colon may be removed if the tumors are found primarily there; a colostomy or ileostomy may then be necessary to divert waste products from the body.
A liver resection can remove parts of the liver affected by the tumors. Liver transplant is generally not considered because most carcinoid tumors in the liver have metastasized there from other areas. Part of the lung, a lobe, or even an entire lung may be removed if tumors are located there. Removing lymph nodes near the lungs may stop tumors from metastasizing to other areas.
Chemotherapy and Immunotherapy
Chemotherapy may be used to shrink carcinoid tumors that have metastasized or that are causing severe symptoms, but these tumors often don't respond well to chemotherapy alone, according to ASCO. Immunotherapy, which enhances the body's natural ability to fight off cancers and other diseases, is given intravenously and may stop the growth of carcinoid tumors. Ocreotide and alpha-interferon are two types of immunotherapy that may be used. Avastin, a drug that targets the tumor's blood supply, is also being used for treatment, according to the American Cancer Society.
Ablation and Embolization
Ablation and embolization are used to treat carcinoid tumors in the liver and other areas. Hepatic artery embolization cuts off the blood supply to cancer cells by closing off the main blood supply to the liver. Healthy cells receive nutrients from other blood vessels. Radiofrequency ablation (RFA) and cryoablation kill cancer cells by delivering either heat or extreme cold to the cells. RFA is sometimes used to treat rectal carcinoid tumors.
Radiation
Radiation therapy may be used to help shrink large tumors for pain control but generally isn't a cure for carcinoid tumors, since most have metastisized by the time they're discovered.
Medications
Ocreotide, also an immunotherapy, and Ianreotide are two injectable medications used to control the symptoms caused by the excess hormones produced by carcinoid tumors. The drugs are injected once a month.
