Learn About Carcinoid Syndrome

What is the definition of Carcinoid Syndrome?

Carcinoid syndrome is a group of symptoms associated with carcinoid tumors. These are tumors most often of the small intestine, colon, appendix, or bronchial tubes in the lungs.

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What are the alternative names for Carcinoid Syndrome?

Flush syndrome; Argentaffinoma syndrome

What are the causes of Carcinoid Syndrome?

Carcinoid syndrome is the pattern of symptoms sometimes seen in people with carcinoid tumors. These tumors are rare, and often slow growing. Most carcinoid tumors are found in the gastrointestinal tract and lungs.

Carcinoid syndrome occurs in very few people with carcinoid tumors, after the tumor has spread to the liver or lung.

These tumors release too much of the hormone serotonin, as well as several other chemicals. The hormones cause the blood vessels to open (dilate). This causes carcinoid syndrome.

What are the symptoms of Carcinoid Syndrome?

The carcinoid syndrome is made up of four main symptoms including:

  • Flushing (face, neck, or upper chest), or widened blood vessels seen on the skin (telangiectasias)
  • Difficulty breathing, such as wheezing
  • Diarrhea
  • Heart problems, such as leaking heart valves, slow heartbeat, low or high blood pressure

Symptoms are sometimes brought on by physical exertion, or eating or drinking things such as blue cheese, chocolate, or red wine.

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What are the current treatments for Carcinoid Syndrome?

Surgery to remove the tumor is usually the first treatment. It can permanently cure the condition if the tumor is completely removed.

If the tumor has spread to the liver, treatment involves either of the following:

  • Removing areas of liver that have tumor cells
  • Sending (infusing) medicine directly into the liver to destroy the tumors

When the entire tumor can't be removed, removing large portions of the tumor ("debulking") can help relieve the symptoms.

Octreotide (Sandostatin) or lanreotide (Somatuline) injections are given to people with advanced carcinoid tumors that can't be removed with surgery.

People with carcinoid syndrome should avoid alcohol, large meals, and foods high in tyramine (aged cheeses, avocado, many processed foods), because they may trigger symptoms.

Some common medicines, like selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil) and fluoxetine (Prozac), may make symptoms worse by increasing levels of serotonin. However, do not stop taking these medicines unless your provider tells you to do so.

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What are the support groups for Carcinoid Syndrome?

Learn more about carcinoid syndrome and get support from:

  • The Carcinoid Cancer Foundation -- www.carcinoid.org/resources/support-groups/directory/
  • Neuroendocrine Tumor Research Foundation -- netrf.org/for-patients/
What is the outlook (prognosis) for Carcinoid Syndrome?

The outlook in people with carcinoid syndrome is sometimes different from the outlook in people who have carcinoid tumors without the syndrome.

Prognosis also depends on the site of tumor. In people with the syndrome, the tumor has usually spread to the liver. This lowers the survival rate. People with carcinoid syndrome are also more likely to have a separate cancer (second primary tumor) at the same time. Overall, the prognosis is usually excellent.

What are the possible complications of Carcinoid Syndrome?

Complications of carcinoid tumors may include:

  • Increased risk of falls and injury (from low blood pressure)
  • Bowel obstruction (from tumor)
  • Gastrointestinal bleeding
  • Heart valve failure

A fatal form of carcinoid syndrome, carcinoid crisis, may occur as a side effect of surgery, anesthesia or chemotherapy.

When should I contact a medical professional for Carcinoid Syndrome?

Contact your provider for an appointment if you have symptoms of carcinoid syndrome.

How do I prevent Carcinoid Syndrome?

Treating the tumor reduces the risk of carcinoid syndrome.

Serotonin uptake
What are the latest Carcinoid Syndrome Clinical Trials?
Prospective Randomized Phase II Trial of Pazopanib (NSC # 737754) Versus Placebo in Patients With Progressive Carcinoid Tumors

Summary: This randomized phase II trial studies how well pazopanib hydrochloride works in treating patients with carcinoid tumors that are growing, spreading, or getting worse. Pazopanib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.

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Single Centre, Prospective, Single Arm Open Label Series of a Transcatheter Tricuspid Valved Stent Graft System for the Reduction of Tricuspid Regurgitation and Improved Patient Reported Outcomes in Patients With Carcinoid Heart Disease

Summary: The purpose of this investigation is to see if the TRICENTO Valved Stent Graft implant reduces tricuspid regurgitation (TR) and improves the symptoms and quality of life in 15 participants with carcinoid heart disease, and who are not able to have a new valve via a surgical procedure.

What are the Latest Advances for Carcinoid Syndrome?
Current Practice in Carcinoid Heart Disease and Burgeoning Opportunities.
Ablation of typical atrial flutter as therapeutic component in carcinoid heart disease: a case report.
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Transcatheter Pulmonary Valve Implantation in Carcinoid Heart Disease.
Who are the sources who wrote this article ?

Published Date: August 15, 2022
Published By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

National Cancer Institute website. Gastrointestinal carcinoid tumors treatment (Adult) (PDQ) - health professional version. www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq. Updated August 19, 2022. Accessed October 13, 2022.

Öberg K. Neuroendocrine tumors and related disorders. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 45.

Wolin EM, Jensen RT. Neuroendocrine tumors. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 219.