Carcinoid tumours are the type of tumours that form in the neuroendocrine system. The neuroendocrine system comprises a series of glands that are responsible for the production of hormones, which have crucial bodily functions to perform.
Carcinoid tumours are usually slow-growing and do not have any signs or symptoms until the later stages. A large percentage of carcinoid tumours are formed in the appendix and small intestines. However, they can also form in the GI tract, stomach, colon, rectum, lungs, pancreas and ovaries or testicles. Wherever they arise, carcinoid tumours affect the cells that produce hormones.
There are three types of carcinoid tumours:
Carcinoid tumours are slow-growing in most cases and show signs and symptoms in later stages. The symptoms associated with this disease are specific to the organ that it forms in. Following are some of the common symptoms associated with carcinoid tumours:
Symptoms could be organ-specific, i.e., tumours formed in the GI tract may cause blood in stool, diarrhoea, rectal pain and bleeding. Carcinoid tumours formed in the lungs, on the other hand, may cause chest pain, shortness of breath, wheezing, weight gain in the midsection and upper back, etc.
As mentioned before, carcinoid tumours produce hormones and other chemicals, which lead to a range of health complications:
To conclude, any symptom that persists for more than two weeks should not be ignored and brought to the notice of the physician as early as possible.
Although the exact cause for the carcinoid tumour is unknown. Researchers have identified a few factors that increase the risk of developing this disease. Carcinoid tumour formation may be associated with one or more factors listed below:
Multiple tests are available for the detection and definitive diagnosis of carcinoid tumours.
a. Blood and Urine Tests: Hormone-secreting carcinoids may lead to excess levels of certain hormones in the body. Abnormal levels of these hormones and the by-products that are formed when these hormones break down can be detected through blood tests and urine tests.
b. Imaging Tests: Imaging tests, namely PET/CT scan, MRI scan, octreotide scan and X-ray, help pinpoint the tumour location. The results from these tests also support treatment planning.
c. Endoscopy: An endoscope may be inserted through the throat (bronchoscope) or rectum (colonoscope) to diagnose carcinoid tumours in various parts of the body. To detect carcinoid tumours of the small intestine, capsule endoscopy may be recommended where the patient is asked to swallow a pill-sized camera before the inspection.
d. Radionuclide scanning: This is a special diagnostic method where the patient is administered a small amount of radioactive tracer that goes and binds to the carcinoid tumours once it enters the bloodstream. This test helps in determining the regions where the tumours are present.
e. Biopsy: Biopsy involves the removal of a small portion of the tissue from the tumour and examining it under the microscope to study the aggressiveness and grade of the tumour. The tissue sample may be collected by inserting a fine needle, or it may be excised during surgery.
The treatment options available for carcinoid tumours are surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy and hormone therapy. The treatment plans for the carcinoid tumours are made after considering multiple factors such as the type of the tumour, its location and size, the stage, the grade and most importantly, the overall condition of the patient.
a. Surgery: Surgery is the main line of treatment for carcinoid tumours. Multiple surgical methods are available to operate the tumours based on their location:
b. Radiation Therapy: Radiation therapy uses high-energy radiation beams to destroy cancer cells. Radiation may either be delivered externally (through linear accelerator) or internally (brachytherapy).
c. Systemic therapy: Systemic therapies are those that find and attack tumours throughout the body, including the ones that are too small to detect.
Carcinoid tumours can be both benign and malignant. In a few cases, carcinoid tumours are fast-growing and more readily spread to other organs or cause complications such as carcinoid syndrome by producing certain hormones in excess levels.
Yes, carcinoid tumours are treatable. There are multiple treatment options available for carcinoid tumours today.
Since carcinoid tumours are slow-growing in most cases, early detection and timely treatment are usually feasible.
Yes, a blood test helps detect carcinoid tumours. The abnormal levels of certain hormones, such as serotonin, cortisol, etc., caused due to carcinoid tumours can be easily detected through blood tests. However, additional tests are required for a conclusive diagnosis.
Each case of carcinoid tumour is different, and therefore, the prognosis will be different too. The disease prognosis for any patient is made based on several factors, such as:
For more accurate information on your disease prognosis, you should have a detailed discussion with your doctor.