Symptoms
The most common symptoms of carcinoid syndrome include:
Skin flushing: Sudden reddening of the face, neck, and upper chest. Flushing episodes can last from a few minutes to several hours.
Diarrhea: Frequent, watery bowel movements, sometimes with abdominal cramping.
Wheezing: Difficulty breathing, shortness of breath, and a whistling sound during breathing.
Heart problems: Carcinoid heart disease can occur over time, damaging the heart valves and leading to heart failure. Symptoms include fatigue, shortness of breath, and swelling in the legs and ankles.
Abdominal pain: Cramping or discomfort in the abdomen.
Weight loss: Unexplained weight loss due to diarrhea and malabsorption.
Causes
Carcinoid syndrome is caused by carcinoid tumors that release hormones, most commonly serotonin, into the bloodstream. These tumors often originate in the gastrointestinal tract or lungs. The syndrome typically develops when the tumor has spread to the liver. A tumor in the lung can cause carcinoid syndrome even without liver metastases, because hormones produced in the lung enter directly into systemic circulation and bypass the liver.
Medicine Used
Medications used to manage carcinoid syndrome symptoms include:
Somatostatin analogs: These drugs, such as octreotide (Sandostatin) and lanreotide (Somatuline Depot), help reduce the production and release of hormones from the carcinoid tumor.
Telotristat ethyl (Xermelo): This medication reduces the amount of serotonin the body makes and is used to treat diarrhea.
Bronchodilators: Inhalers containing bronchodilators can help relieve wheezing and shortness of breath.
Anti-diarrheal medications: Medications like loperamide (Imodium) can help control diarrhea.
Interferon alfa: An injectable medication that can slow tumor growth and reduce symptoms.
Chemotherapy: Might be used for more advanced carcinoid tumors.
Targeted therapies: Certain targeted therapies may be used to block specific molecules involved in tumor growth.
Is Communicable
No, carcinoid syndrome is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent carcinoid syndrome itself, as it is a consequence of a carcinoid tumor. However, the following can be considered:
Early detection: If you experience symptoms suggestive of carcinoid syndrome, seek medical attention promptly for diagnosis and treatment.
Avoid triggers: Certain foods, alcohol, stress, or exercise may trigger flushing episodes in some individuals. Identifying and avoiding these triggers can help manage symptoms.
Medical management: Adhering to prescribed medications and follow-up appointments is crucial for managing the syndrome effectively.
How long does an outbreak last?
Carcinoid syndrome doesn't have "outbreaks" in the traditional sense of an infectious disease. Symptoms are chronic and persistent as long as the carcinoid tumor continues to release hormones. The duration of symptoms can vary greatly depending on the size and location of the tumor, the extent of metastasis, and the effectiveness of treatment. Individual flushing episodes may last minutes to hours.
How is it diagnosed?
Diagnosis of carcinoid syndrome typically involves:
Physical examination: A doctor will assess your symptoms and medical history.
Urine test: Measuring 5-hydroxyindoleacetic acid (5-HIAA), a breakdown product of serotonin, in a 24-hour urine sample. Elevated levels suggest carcinoid syndrome.
Blood test: Measuring serotonin levels and other substances released by carcinoid tumors in the blood.
Imaging tests: CT scans, MRI scans, or octreotide scans (scintigraphy) to locate the carcinoid tumor and assess its spread.
Biopsy: A tissue sample from the suspected tumor can confirm the diagnosis and determine the tumor's characteristics.
Timeline of Symptoms
The timeline of carcinoid syndrome symptoms is variable.
Early stages: Symptoms may be mild and intermittent, such as occasional flushing or diarrhea.
Progression: As the tumor grows or spreads, symptoms may become more frequent and severe. Heart valve problems, wheezing, and abdominal pain may develop over time.
Late stages: In advanced cases, carcinoid heart disease can lead to heart failure. Malnutrition and weight loss may become significant problems. It’s important to note that due to these being slow growing tumors, there may not be any signs or symptoms for years
Important Considerations
Rare disease: Carcinoid syndrome is a rare condition, so awareness is essential for timely diagnosis.
Individual variability: The severity and combination of symptoms can vary widely among individuals with carcinoid syndrome.
Treatment goals: Treatment focuses on controlling symptoms, slowing tumor growth, and improving quality of life.
Multidisciplinary care: Management often involves a team of specialists, including oncologists, gastroenterologists, cardiologists, and endocrinologists.
Long-term monitoring: Regular follow-up appointments and monitoring are crucial to assess treatment effectiveness and detect any complications.