What Are Metastatic Carcinoid Tumors?
Carcinoid tumors also referred to as neuroendocrine tumors, originate in hormone producing cells of organs. Although they can originate in any location in the body, the primary points of origin are the gastrointestinal tract and the lungs. Metastatic carcinoid tumors are carcinoid tumors that have metastasized, or spread, to nearby muscle tissue and lymph nodes, or distant organs such as the liver and bones.
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Diagnosis
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Carcinoid tumors are very slow growing and can be present for many years without causing symptoms. Most tumors are found accidentally during unrelated procedures. As a result, metastasis has typically already occurred, making it difficult to determine the point of origin. Laboratory tests, biopsies, upper endoscopies, endoscopic ultrasounds, bone scans, X-rays, CAT scans, MRIs, OctreoScans and PET scans are procedures used to diagnose tumors, determine if metastasis has occurred and to establish a course of treatment.
Statistics
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The number of people diagnosed with a carcinoid tumor each year in the United States is estimated to be between 11,000 and 12,000, according to American Society of Clinical Oncology. The average five-year survival rate is estimated to be between 70 percent and 80 percent. The five-year survival rate for localized carcinoid disease is estimated to be about 93 percent. Advanced distant metastasis drastically reduces the overall five-year survival rate to between 20 percent and 30 percent.
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Risk Factors
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Researchers have not been able to link carcinoid tumors with any definitive causes or avoidable risk factors. A few factors that appear to impact a person's chance of developing a carcinoid tumor include family history of multiple endocrine neoplasia, race and gender (African American men are at greater risk), age (average diagnosis age is 40 to 65) and other stomach conditions that damage the stomach and reduce acid production.
Symptoms
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Symptoms of a carcinoid tumor typically appear only after the tumor has metastasized. Gastrointestinal carcinoid tumor symptoms may include facial flushing, diarrhea, abdominal pain, asthma, rash, heart disease, intestinal bleeding, pellagra and melena. Lung carcinoid tumor symptoms may include coughing, wheezing and post-obstructive pneumonia. All these symptoms can attributed to non-cancerous medical conditions, always consult your doctor about any problems you are experiencing.
Complications
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People who have had a carcinoid tumor for a long period of time may develop Carcinoid syndrome, which is characterized by facial flushing, sweating, diarrhea, shortness of breath, wheezing or asthma-like symptoms, fast heartbeat, heart murmur, unexplained weight gain, weakness, secondary diabetes, increased body and facial hair, high blood pressure and neurosis. Carcinoid crisis occurs when all these symptoms happen at the same time, and is life threatening. Associated with stress, chemotherapy and anesthesia, it is treatable and can even be prevented with octreotide, a medication to raise low blood pressure and control the production of hormones.
Treatment
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Factors that determine the course of treatment for a carcinoid tumor include tumor size and location, degree of metastasis and the overall health of the patient. Based on these factors, a doctor will determine the most effective course of action. Treatment options may include surgery, radiation therapy, chemotherapy, immunotherapy and targeted therapies.
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