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Carcinoid Tumors: When Surgery Isn't an Option

By Ellen Greenlaw
WebMD Feature

When carcinoid tumors are at a more advanced stage, surgery may not be possible. However, other treatments can help manage these neuroendocrine tumors. Although these treatments don't cure the cancer, they can help slow or stop the growth of the tumor and ease symptoms.

Using a Variety of Treatments for Carcinoid Tumor

Depending on the location of the tumor and how far it has spread, doctors may use a variety of treatments. Even if surgery can't be used to cure the tumor, it may be used to remove part of the tumor, called debulking.

"I've found the best way to approach carcinoid tumors is to treat them aggressively," says Richard Warner, MD, professor of medicine at the Mount Sinai School of Medicine and medical director of the Carcinoid Cancer Foundation. "We often use a few types of treatments one right after the other. For example, we may use debulking surgery, then radiation, and then chemotherapy. This helps us stay ahead of tumor growth."

Medications to Slow Carcinoid Tumors

Medications can help slow the growth of tumors and ease the symptoms of carcinoid syndrome. Carcinoid syndrome is a set of symptoms -- including flushing of the skin, wheezing, and diarrhea -- that can occur if the tumor produces excess hormones such as serotonin or histamine.

  • Octreotide. The drug most commonly used to treat carcinoid tumors is octreotide (Sandostatin). This drug is similar to a hormone that occurs naturally in the body. It can help relieve the flushing and diarrhea caused by carcinoid syndrome, and slow tumor growth.
  • Interferons. Interferon drugs can help reduce the symptoms of carcinoid syndrome and may help slow the growth of carcinoid tumors. But interferons can have severe side effects, so they may not be helpful for all people. 
  • Antihistamines. Some antihistamine drugs can help ease the symptoms of carcinoid syndrome, but they do not stop tumor growth.

Researchers are also looking at other drugs to help slow or stop the growth of carcinoid tumors. "There are a few drugs currently going through clinical trials or awaiting FDA approval," says James Yao MD, associate professor and deputy chair of the Department of Oncology at the University of Texas MD Anderson Cancer Center in Houston. "So we are hoping to have more options for drug treatment in the future."

Ablation to Shrink Carcinoid Tumors

Ablation is a way to destroy or shrink the tumor by injecting it directly with a substance that will kill it. It is often used for tumors that have spread to the liver, when surgery isn't possible because of their size, location, or number of tumors. There are a few different kinds of ablation.

  • Cryotherapy (cryoablation). This method involves injecting liquid nitrogen into the tumor to kill the cells by freezing them.
  • Percutaneous ethanol injection. This method uses concentrated alcohol to kill the tumor.
  • Radiofrequency ablation. This method uses high-energy radio waves to destroy the tumor.

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