What are the treatments for carcinoid syndrome? continued...
Surgery. Surgery is usually the first choice of treatment for carcinoid tumors, especially when they are found early and confined to a small area. The type of surgery used depends on the location of the tumor and its size. Many small tumors can be completely removed. "Even when the tumor has spread to a few surrounding lymph nodes, we can often cure the cancer by removing the original tumor and a few local lymph nodes," says Warner.
When tumors are larger, or when there are several tumors in one location, doctors may use more extensive surgery. In some cases, they may remove a piece of the organ where the tumor is located. If the tumor is too large or has spread too far, removing all of the tumor may not be an option.
Medications. When the tumor cannot be removed through surgery, medications can help relieve the symptoms of carcinoid syndrome. The drug most commonly used to treat carcinoid syndrome is octreotide (Sandostatin). When used to treat the flushing and diarrhea associated with carcinoid syndrome, octreotide helps relieved symptoms in at least 75% to 80% of patients. Octreotide may also help slow the growth of these tumors.
Alpha-Interferon drugs may also help reduce the symptoms of carcinoid syndrome, and can be used with octreotide to help reduce the size of tumors. Drugs that reduce levels of serotonin or histamine in the body may also help manage symptoms.
"There are a number of [other] drugs undergoing clinical studies or awaiting FDA approval," says Warner. Some of these new drugs are already being used in Europe.
Ablation. Ablation uses liquid nitrogen, high-energy radio waves, or concentrated alcohol injected into cancerous tissue to destroy it. Ablation is often used when a carcinoid tumor has spread to the liver and can't be removed with surgery.
Chemotherapy. Chemotherapy may also be used to treat tumors that can't be removed by surgery. These drugs are taken by mouth or injected into a vein to help kill cancer cells. "Although chemotherapy is not very effective for many carcinoid tumors, it can be effective for certain tumors, especially those located in the pancreas," says Yao.