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Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on March 21st, 2024.
Key Takeaways
- Neuroendocrine tumors produce excess serotonin and other hormones, with 95% originating in the digestive tract—only 10% of patients develop the syndrome unless tumors metastasize to the liver.
- Facial flushing episodes last 2-5 minutes and affect 85% of patients, often triggered by alcohol, stress, or eating, while chronic watery diarrhea occurs in 80% of cases.
- Somatostatin analogs like octreotide reduce hormone production by 50-70%, requiring subcutaneous injections every 8 hours or monthly long-acting formulations.
- Dietary triggers include tyramine-rich foods (aged cheeses, wine, chocolate) and histamine-containing foods (fermented products, shellfish) that can precipitate severe flushing attacks.
- Carcinoid heart disease develops in 20-50% of patients with advanced syndrome, causing tricuspid valve fibrosis and right-sided heart failure if hormone levels remain uncontrolled.
Carcinoid syndrome is a group of symptoms that can occur in people with a type of cancer called carcinoid tumors. These tumors usually grow in the stomach and intestines but can also develop in the lungs, pancreas, testicles, or ovaries. When these tumors release certain chemicals into the bloodstream, it can lead to various symptoms that may be similar to other conditions like menopause or asthma.
Causes of Carcinoid Syndrome
Carcinoid tumors can produce chemicals like hormones, which can enter the bloodstream when the cancer has spread to the liver. These chemicals can then travel throughout the body, causing various symptoms. In some cases, the chemicals can directly enter the bloodstream if the tumors are located in the lungs, testes, or ovaries.
Symptoms of Carcinoid Syndrome
People with carcinoid syndrome may experience the following symptoms:
Skin that turns pink, red, or purple
Small, widened blood vessels on the face
Diarrhea
Shortness of breath or wheezing
Rapid heart rate
Sudden drops in blood pressure
Diagnosing Carcinoid Syndrome
If your doctor suspects you have carcinoid syndrome, they will perform a physical exam and may ask you questions about your symptoms. To confirm the diagnosis and locate the carcinoid tumor, you may need to undergo tests such as:
Urine test to check for high levels of hormones or their breakdown products
Blood test to detect chemicals released by the tumors
Imaging tests like CT scans, MRIs, or radionuclide scanning to locate the tumor
Treatment Options for Carcinoid Syndrome
Treatment for carcinoid syndrome focuses on addressing the underlying tumors. Your doctor may recommend one or a combination of the following treatments:
Surgery to remove the affected organ or part of the affected area
Chemotherapy to kill cancer cells or slow their growth
Radiation therapy to destroy cancer cells or prevent them from multiplying
Liver directed therapy to block the blood supply to liver tumors
Biologic drugs (immunotherapy) to strengthen the body's defenses against cancer cells
Drug therapy with lanreotide, octreotide, or telotristat ethyl to help with symptoms like skin flushing and diarrhea
Lifestyle Changes and Support
In addition to medical treatment, making lifestyle changes can help manage the symptoms of carcinoid syndrome. Avoiding certain foods and drinks that trigger symptoms, such as alcohol, nuts, cheese, chili peppers, and hot liquids, may be beneficial. Maintaining a healthy diet and taking vitamins or supplements as recommended by your doctor can also help address nutritional deficiencies caused by the condition.
Joining a support group can provide a valuable outlet for sharing your feelings with others who understand what you're going through. The Carcinoid Cancer Foundation offers information about carcinoid syndrome and carcinoid tumors, as well as resources for finding support groups in your area.
Remember, you don't have to face carcinoid syndrome alone. With the right treatment, lifestyle changes, and support, you can manage your symptoms and improve your quality of life. If you have any questions or concerns about your condition, don't hesitate to reach out to your healthcare provider or a trusted cancer organization for guidance and support.
For more information on carcinoid syndrome and related topics, visit:
The Bottom Line
Early detection and hormone control through somatostatin analogs can prevent serious complications like heart valve damage while significantly reducing debilitating symptoms. Avoiding dietary triggers and maintaining consistent medication schedules are essential for symptom management. If you're experiencing unexplained flushing episodes or chronic diarrhea, Doctronic can help you get proper evaluation and answers quickly.
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