hormonal and metabolic disorders
Carcinoid Tumors and Carcinoid Syndrome
Treatment
Surgery to remove the tumor Octreotideand other drugs to relieve flushing and other symptoms When a carcinoid tumor is restricted to a specific area, such as the appendix, small intestine, rectum, or lungs, surgical removal may cure the disease. If the tumor has spread to the liver, surgery rarely cures the disease but may help relieve symptoms. Other treatments, such as embolization, in which substances are injected into the tumor through blood vessels in the liver, also can help liver tumors. Carcinoid tumors grow so slowly that even people whose tumors have spread often survive for 10 to 15 years. Several newer drugs such aseverolimusalso may be helpful. Chemotherapy is usually not helpful, but certain regimens (streptozocinwithfluorouracilandcyclophosphamide) are often tried in people whose disease has spread. Radiation therapy is not useful. The drugsoctreotideandlanreotidecan relieve flushing symptoms. Some forms of these drugs can be given only once a month. Other treatments for flushing include phenothiazines (such asprochlorperazine) and histamine-blocking drugs such asfamotidine. Rarely, phentolamine is used to control flushing in people with carcinoid syndrome.Prednisoneis sometimes given to people with carcinoid tumors of the lungs who have episodes of severe flushing. Diarrhea may be controlled withloperamide,codeine, tincture of opium, diphenoxylate, orcyproheptadine. Pellagra may be prevented by ensuring adequate protein in the diet and by takingniacin. Drugs that block the production ofserotonin, such asmethyldopa, also help prevent pellagra. 