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Carcinoid Syndrome: Causes, Symptoms, Diagnosis & Treatment

Carcinoid syndrome occurs when a carcinoid tumour, a rare cancerous tumour secretes certain chemicals into the bloodstream, causing an array of symptoms. The carcinoid tumours mostly appear in the lungs or gastrointestinal tract including your stomach, small intestine, colon, appendix, and rectum.

What Causes Carcinoid Syndrome? [1]

Carcinoid syndrome is caused when a carcinoid tumour releases hormonal chemical substances such as serotonin, bradykinins, tachykinins and prostaglandins into the bloodstream. Just a small percentage of carcinoid tumours secrete these chemicals, and the liver normally counteracts these chemicals before they have a chance to move throughout the body and cause symptoms.

However, when the tumour has advanced to the liver, the chemicals are released that aren't neutralized before reaching the bloodstream. People with carcinoid syndrome usually have an advanced carcinoid tumour.

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Symptoms Of Carcinoid Syndrome [2]

  • Skin turns pink, red, or purple colour
  • Diarrhoea
  • Rapid heartbeat
  • Shortness of breath or wheezing
  • Facial skin lesions
  • A sudden drop in blood pressure

Complications Of Carcinoid Syndrome [3]

  • Carcinoid heart disease - People with carcinoid syndrome can also develop carcinoid heart disease. It is caused due to the thickening of the heart valves, making it difficult for them to function properly resulting in the leakage of the heart valves. The symptoms of carcinoid heart disease are fatigue and shortness of breath.
  • Carcinoid crisis - It causes a severe episode of flushing, confusion, low blood pressure, and difficulty in breathing.
  • Bowel obstruction - It occurs when the cancer spreads to the lymph nodes next to the small intestine, causing narrowing of the intestine and leading to bowel obstruction.

Diagnosis Of Carcinoid Syndrome [4]

The doctor will conduct a physical examination and may ask about your symptoms. He/she will then recommend further tests to confirm the diagnosis such as:

  • Blood test - Your blood may contain certain substances, including the protein chromogranin A, which is released by some carcinoid tumours.
  • Urine test - When your body breaks down extra serotonin, it creates an excess amount of a substance in the urine that indicates the body is processing extra serotonin.
  • Imaging tests - Imaging tests like CT scan or MRI scan also detect the location of the primary carcinoid tumour and determine whether it has spread or not.

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Treatment Of Carcinoid Syndrome [5]

  • Medications

Medications in the form of injections are used to lower the signs and symptoms of carcinoid syndrome, including skin flushing and diarrhoea.

  • Surgery

If the entire organ is infected with a carcinoid tumour, such as the appendix or the bowel, doctors may perform surgery. Also depending on where the tumour is, surgeons may also use an electric current to burn it off or cryosurgery to freeze it.

  • Chemotherapy

Chemotherapy drugs are used for the treatment of carcinoid tumours to shrink it.

  • Biological therapy

Interferon alfa is an injectable medication which triggers the body's immune system to function better and slow down the growth of carcinoid tumours and relieves the symptoms.

  • Radiation therapy

This kind of treatment kills the cancer cells and prevents them from multiplying.

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View Article References
  1. [1] Creutzfeldt, W., & Stöckmann, F. (1987). Carcinoids and carcinoid syndrome.The American journal of medicine,82(5), 4-16.
  2. [2] Gelhorn, H. L., Kulke, M. H., O’Dorisio, T., Yang, Q. M., Jackson, J., Jackson, S., ... & Lapuerta, P. (2016). Patient-reported symptom experiences in patients with carcinoid syndrome after participation in a study of telotristat etiprate: a qualitative interview approach.Clinical therapeutics,38(4), 759-768.
  3. [3] Mota, J. M., Sousa, L. G., & Riechelmann, R. P. (2016). Complications from carcinoid syndrome: review of the current evidence.Ecancermedicalscience,10, 662.
  4. [4] Halperin, D. M., Shen, C., Dasari, A., Xu, Y., Chu, Y., Zhou, S., … Yao, J. C. (2017). Frequency of carcinoid syndrome at neuroendocrine tumour diagnosis: a population-based study.The Lancet. Oncology,18(4), 525–534.
  5. [5] Moertel, C. G. (1983). Treatment of the carcinoid tumor and the malignant carcinoid syndrome.Journal of Clinical Oncology,1(11), 727-740.

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