Materiały źródłowe

• #1 Gastrointestinal Carcinoid Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gastrointestinal-neuroendocrine/gastrointestinal-carcinoid-tumors

  Carcinoid tumors are the most common type of neuroendocrine tumor. An estimated 11,000 to 12,000 people are diagnosed with a carcinoid tumor each year in the United States. About two-thirds of all carcinoid tumors appear in the gastrointestinal system, particularly in the small intestine, rectum, stomach, colon, and liver. […] Carcinoid tumors usually grow slowly over many years. Neuroendocrine tumors that grow slowly are called low-grade tumors. However, even low-grade carcinoid tumors can begin to grow rapidly, for reasons that are not well understood. […] Patients with carcinoid syndrome who undergo surgery, anesthesia, or chemotherapy are at risk of experiencing a carcinoid crisis, which is a life-threatening condition caused by a sudden surge of serotonin into the bloodstream. Treatment with the hormone octreotide before any medical procedure can help prevent a carcinoid crisis from occurring.

• #2 Carcinoid Tumors – Center for Advanced Digestive Care | NewYork-Presbyterian Hospital

  https://www.nyp.org/cadc/neuroendocrine-tumors/carcinoid-tumors

  Neuroendocrine tumors arising outside the pancreas are most often carcinoid tumors, and represent the most common type of neuroendocrine cancer. […] Carcinoid tumors are considered a type of neuroendocrine tumor because they start in the hormone-producing cells of various organs primarily the digestive tract. […] Because carcinoid tumors generally grow slowly over many years, patients typically don’t experience symptoms such as diarrhea, skin flushing, and difficulty breathing until they are quite advanced. […] The symptoms a person develops from a gastrointestinal carcinoid tumor often depend on where it is located. […] In ten percent of patients, carcinoid tumors release enough hormone-like substances into the bloodstream to cause symptoms known as „carcinoid syndrome,” which is characterized by facial flushing, severe diarrhea, wheezing, and fast heartbeat.

• #3 Carcinoid Tumors: MedlinePlus

  https://medlineplus.gov/carcinoidtumors.html

  Carcinoid tumors are rare, slow-growing cancers. They usually start in the lining of the digestive tract or in the lungs. They grow slowly and don’t produce symptoms in the early stages. As a result, the average age of people diagnosed with digestive or lung carcinoids is about 60. […] In later stages the tumors sometimes produce hormones that can cause carcinoid syndrome. The syndrome causes flushing of the face and upper chest, diarrhea, and trouble breathing. […] Surgery is the main treatment for carcinoid tumors. If they haven’t spread to other parts of the body, surgery can cure the cancer.

• #4 Carcinoid Tumors – Center for Advanced Digestive Care | NewYork-Presbyterian Hospital

  https://www.nyp.org/cadc/neuroendocrine-tumors/carcinoid-tumors

  Neuroendocrine tumors arising outside the pancreas are most often carcinoid tumors, and represent the most common type of neuroendocrine cancer. […] Carcinoid tumors are considered a type of neuroendocrine tumor because they start in the hormone-producing cells of various organs primarily the digestive tract. […] Because carcinoid tumors generally grow slowly over many years, patients typically don’t experience symptoms such as diarrhea, skin flushing, and difficulty breathing until they are quite advanced. […] The symptoms a person develops from a gastrointestinal carcinoid tumor often depend on where it is located. […] In ten percent of patients, carcinoid tumors release enough hormone-like substances into the bloodstream to cause symptoms known as „carcinoid syndrome,” which is characterized by facial flushing, severe diarrhea, wheezing, and fast heartbeat.

• #5 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  A carcinoid tumour is a rare cancer of the neuroendocrine system the body system that produces hormones. […] Carcinoid syndrome is the collection of symptoms some people get when a carcinoid tumour usually one that has spread to the liver releases hormones such as serotonin into the bloodstream. […] Symptoms may result from both the tumour itself and from any hormones it releases into the bloodstream. […] Some people may also develop carcinoid heart disease, where the heart valves thicken and stop working properly. There is also a risk of developing a rare but serious reaction called a carcinoid crisis, which involves severe flushing, breathlessness and a drop in blood pressure. […] If the tumour cannot be removed, but its not growing or causing symptoms, you may not need treatment straight away it might just be carefully monitored.

• #6 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Neuroendocrine tumors (NETs) are rare and often misdiagnosed. Some people with NETs develop carcinoid syndrome, which is most often marked by debilitating diarrhea and facial flushing. I believe it’s important for oncology nurses to encourage our patients to accurately describe their life-disrupting symptoms. Many of my patients with carcinoid syndrome are having diarrhea 10 times a day, or their face is so flushed it is like red leather, so I work closely with them to provide solutions to help improve their quality of life. The good news is that with proper diagnosis and treatment, these symptoms can be successfully managed and our patients’ lives can be significantly prolonged. […] Carcinoid syndrome is real. Sadly, many patients are referred to psychiatrists because their healthcare provider does not believe their symptoms are occurring. I always ask every patient whether they are experiencing any GI or flushing symptoms and whether their symptoms have persisted with no explanation.

• #7 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Neuroendocrine tumors (NETs) are rare and often misdiagnosed. Some people with NETs develop carcinoid syndrome, which is most often marked by debilitating diarrhea and facial flushing. I believe it’s important for oncology nurses to encourage our patients to accurately describe their life-disrupting symptoms. Many of my patients with carcinoid syndrome are having diarrhea 10 times a day, or their face is so flushed it is like red leather, so I work closely with them to provide solutions to help improve their quality of life. The good news is that with proper diagnosis and treatment, these symptoms can be successfully managed and our patients’ lives can be significantly prolonged. […] Carcinoid syndrome is real. Sadly, many patients are referred to psychiatrists because their healthcare provider does not believe their symptoms are occurring. I always ask every patient whether they are experiencing any GI or flushing symptoms and whether their symptoms have persisted with no explanation.

• #8 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Neuroendocrine tumors (NETs) are rare and often misdiagnosed. Some people with NETs develop carcinoid syndrome, which is most often marked by debilitating diarrhea and facial flushing. I believe it’s important for oncology nurses to encourage our patients to accurately describe their life-disrupting symptoms. Many of my patients with carcinoid syndrome are having diarrhea 10 times a day, or their face is so flushed it is like red leather, so I work closely with them to provide solutions to help improve their quality of life. The good news is that with proper diagnosis and treatment, these symptoms can be successfully managed and our patients’ lives can be significantly prolonged. […] Carcinoid syndrome is real. Sadly, many patients are referred to psychiatrists because their healthcare provider does not believe their symptoms are occurring. I always ask every patient whether they are experiencing any GI or flushing symptoms and whether their symptoms have persisted with no explanation.

• #9 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Neuroendocrine tumors (NETs) are rare and often misdiagnosed. Some people with NETs develop carcinoid syndrome, which is most often marked by debilitating diarrhea and facial flushing. I believe it’s important for oncology nurses to encourage our patients to accurately describe their life-disrupting symptoms. Many of my patients with carcinoid syndrome are having diarrhea 10 times a day, or their face is so flushed it is like red leather, so I work closely with them to provide solutions to help improve their quality of life. The good news is that with proper diagnosis and treatment, these symptoms can be successfully managed and our patients’ lives can be significantly prolonged. […] Carcinoid syndrome is real. Sadly, many patients are referred to psychiatrists because their healthcare provider does not believe their symptoms are occurring. I always ask every patient whether they are experiencing any GI or flushing symptoms and whether their symptoms have persisted with no explanation.

• #10 FF #137Carcinoid Syndrome: Symptom Management | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/carcinoid-syndrome-symptom-management/

  Background The carcinoid syndrome (CS) is a symptom complex resulting from hormone secretion in patients with carcinoid tumors. CS becomes manifested only when sufficient concentration of hormones reaches the systemic circulation, most commonly in the presence of liver metastases. This Fast Fact will focus on managing the symptoms of CS. […] Drugs that block the hormonal secretion can help to control the symptoms of carcinoid syndrome. […] Somatostatin Analogs These drugs are the treatment of choice for CS. 50-70% of patients experience a significant reduction of diarrhea and flushing episodes within seven days. […] Patients should be counseled to identify and eliminate stressors that reproducibly cause symptoms—this may include specific stressful situations, foods, or alcohol. […] Other treatments for refractory symptoms include systemic chemotherapy, hepatic artery embolization, hepatic chemoembolization, or debulking surgery of hepatic metastases.

• #11 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Complete surgical removal of all tumor tissues, when feasible, is the best treatment for carcinoid syndrome because it may result in a complete and permanent cure. […] Systemic medical therapy should be used to control humorally mediated symptoms when the cancer spreads elsewhere. […] Patients with severe diarrhea may develop dehydration, which usually manifests as dark brown or intensely yellow urine. Intravenous fluid infusion may be needed to keep up with the fluid loss from diarrhea. Replacement of essential dietary elements and vitamins may be necessary. Along with potassium, magnesium, and iron, supplemental niacin is especially important, as decreased ingestion and absorption can be compounded by increased serotonin production by the tumor, which depletes stores of tryptophan that would otherwise be used to generate niacin.

• #12 FF #137Carcinoid Syndrome: Symptom Management | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/carcinoid-syndrome-symptom-management/

  Background The carcinoid syndrome (CS) is a symptom complex resulting from hormone secretion in patients with carcinoid tumors. CS becomes manifested only when sufficient concentration of hormones reaches the systemic circulation, most commonly in the presence of liver metastases. This Fast Fact will focus on managing the symptoms of CS. […] Drugs that block the hormonal secretion can help to control the symptoms of carcinoid syndrome. […] Somatostatin Analogs These drugs are the treatment of choice for CS. 50-70% of patients experience a significant reduction of diarrhea and flushing episodes within seven days. […] Patients should be counseled to identify and eliminate stressors that reproducibly cause symptoms—this may include specific stressful situations, foods, or alcohol. […] Other treatments for refractory symptoms include systemic chemotherapy, hepatic artery embolization, hepatic chemoembolization, or debulking surgery of hepatic metastases.

• #13 Neuroendocrine Tumor | Ochsner Health

  https://www.ochsner.org/services/neuroendocrine-tumor-program

  Our multidisciplinary approach means you have an entire network of specialists to lean on. […] We provide our patients with specialized knowledge that can make all the difference in treatment, quality of life and recovery. […] The Ochsner Neuroendocrine Tumor Program offers advanced treatment options and technology for our patients. […] Treatment can reduce the number and size of neuroendocrine tumors. […] Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. […] Most localized NETs are successfully treated with surgery alone. […] When completely removing the tumor is not possible, „debulking surgery” is sometimes recommended. […] Treatments using medication are used to destroy cancer cells. […] Depending on the type of NET, medications that may be used include: Somatostatin analogs, Chemotherapy, Peptide receptor radionuclide therapy, Radiation, Liver-directed therapies.

• #14 Carcinoid Tumors Causes, Symptoms, and Treatments | UPMC

  https://www.upmc.com/services/endocrinology/conditions/carcinoid-tumors

  Surgery is the preferred treatment for carcinoid tumors when possible. […] To treat carcinoid syndrome, doctors treat the tumor. Removing the tumor will stop the carcinoid syndrome symptoms, too.

• #15 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Systemic therapy should be used to control humorally mediated symptoms when the cancer spreads elsewhere. […] Diarrhea generally responds to standard antidiarrheal medications, but serotonin antagonists should be administered, if necessary, to control diarrhea and malabsorption. […] In patients with symptoms specifically related to increased histamine production, such as angioedema, histamine blockers may also be useful. […] Surgery should always be considered in patients with large or extensive hepatic metastases involving surgically accessible areas of the liver. […] For lesions in the distal ileum, a right hemicolectomy is necessary to remove the lymphatic drainage adequately. […] For tumors located in the appendix that are smaller than 1.5 cm in diameter, appendectomy is suitable and curative in 100% of patients.

• #16 Guidelines for the diagnosis and management of carcinoid tumours. Part 1: The gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1891174/

  Surgery is the only way to obtain a complete cure. Surgical resection of the primary tumour in midgut carcinoids and in cases with lymph node or liver involvement can improve survival. […] Octreotide administration is crucial before an invasive procedure. In patients whose symptoms are well controlled with the long-acting form, a supplemental dose should be given 12 hours before the procedure. […] Patients with carcinoid syndrome should have an echocardiogram at diagnosis. All patients should have an annual echocardiogram and follow-up with a cardiologist, particularly those with any cardiac changes or with elevated 5-hiaa.

• #17 Gastrointestinal Carcinoid Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gastrointestinal-neuroendocrine/gastrointestinal-carcinoid-tumors

  Carcinoid tumors are the most common type of neuroendocrine tumor. An estimated 11,000 to 12,000 people are diagnosed with a carcinoid tumor each year in the United States. About two-thirds of all carcinoid tumors appear in the gastrointestinal system, particularly in the small intestine, rectum, stomach, colon, and liver. […] Carcinoid tumors usually grow slowly over many years. Neuroendocrine tumors that grow slowly are called low-grade tumors. However, even low-grade carcinoid tumors can begin to grow rapidly, for reasons that are not well understood. […] Patients with carcinoid syndrome who undergo surgery, anesthesia, or chemotherapy are at risk of experiencing a carcinoid crisis, which is a life-threatening condition caused by a sudden surge of serotonin into the bloodstream. Treatment with the hormone octreotide before any medical procedure can help prevent a carcinoid crisis from occurring.

• #18 Neuroendocrine Tumors – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/surgery/general-and-gastrointestinal-surgery/services/neuroendocrine-tumors

  Carcinoid tumors are often found during tests or treatments for other conditions and sometimes a patient has no symptoms. […] You will receive a thorough diagnostic examination to evaluate if you have a neuroendocrine tumor and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced surgeon are important to successful outcomes for patients. […] The day of surgery, you will be cared for in the operating room by surgeons, anesthesiologists and nurses who specialize in neuroendocrine tumor surgery. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff. […] The Program of Neuroendocrine and Carcinoid Tumors at the Gastrointestinal Cancer Treatment Center at Dana-Farber Brigham Cancer Center provides advanced and innovative multidisciplinary care for patients with neuroendocrine tumors. Our treatment team includes surgeons, medical and radiation oncologists, pathologists, radiologists, anesthesiologists, gastroenterologists and nursing and research staff.

• #19 Management of carcinoid syndrome: a systematic review and meta-analysis in: Endocrine-Related Cancer Volume 26 Issue 3 (2019)

  https://erc.bioscientifica.com/view/journals/erc/26/3/ERC-18-0495.xml

  Carcinoid syndrome (CS) is a debilitating disease caused by functional neuroendocrine tumors. Several treatment options are available to alleviate the hormonal symptoms, but their relative efficacy is unknown. […] The somatostatin analogs octreotide and lanreotide induced symptomatic improvement in 65-72% and biochemical response in 45-46% of patients. An increase in dose or frequency or interclass switch led to a reduction of flushes and/or diarrhea in 72-84% of cases. […] The serotonin synthesis inhibitor telotristat ethyl reduced bowel movements in 40% of patients with diarrhea refractory to somatostatin analogs. Interferon-alpha controlled CS symptoms in 45-63% of cases. […] We conclude that several treatment lines can be offered to patients suffering from the carcinoid syndrome. Initiation of randomized controlled trials with a primary outcome on carcinoid syndrome symptoms is strongly recommended.

• #20 Management of carcinoid syndrome: a systematic review and meta-analysis in: Endocrine-Related Cancer Volume 26 Issue 3 (2019)

  https://erc.bioscientifica.com/view/journals/erc/26/3/ERC-18-0495.xml

  Treatment of individual patients should consider the patients performance status and severity of complaints as well as tumor grade, stage and primary location. […] The international guidelines recommend SSAs as first-line therapy in CS in stage IV NET patients. […] These strategies resulted in a reduction of diarrhea in 116 out of 161 (72%) subjects and of flushes in 107 out of 127 (84%) patients. […] Despite the impressive response rates, the retrospective nature of 21 out of 22 studies renders a serious risk for reporting bias of successful cases. […] Following the pathophysiological relevance of serotonin in CS, several interventions in the serotonin pathway have been investigated. […] The favorable efficacy-to-toxicity profile of the SSAs octreotide and lanreotide secure them as first-line treatment of CS patients with an unresectable NET.

• #21 Carcinoid Tumors – Center for Advanced Digestive Care | NewYork-Presbyterian Hospital

  https://www.nyp.org/cadc/neuroendocrine-tumors/carcinoid-tumors

  Hormone therapy may be given to help stop the tumor from growing, or to relieve symptoms caused by the tumor by lowering the levels of hormones in the body. […] Patients with gastrointestinal carcinoid tumors that cannot be surgically removed may benefit from injections of a synthetic hormone which controls hormone-related symptoms and may have the potential to slow tumor growth. […] Systemic chemotherapy, delivered through the bloodstream, employs drugs to kill cancer cells. […] For patients with gastrointestinal carcinoid tumors, chemotherapy is usually reserved for patients whose tumors begin to grow during treatment with a synthetic hormone. […] Embolization is a localized approach to destroying liver tumors that may be used to treat gastrointestinal carcinoid tumors that spread to the liver.

• #22 Gastrointestinal Carcinoid Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gastrointestinal-neuroendocrine/gastrointestinal-carcinoid-tumors

  Many gastrointestinal carcinoid tumors are found through imaging studies performed for other health issues. […] There are several treatment options for patients with a gastrointestinal carcinoid tumor. Patients may receive one or more treatments such as surgery, minimally invasive therapy, hormone therapy, chemotherapy, and radiolabeled therapy. […] Surgical removal of the tumor is usually the first treatment for gastrointestinal carcinoid tumors. […] Patients with gastrointestinal carcinoid tumors that cannot be surgically removed may benefit from monthly injections of a synthetic hormone, octreotide, which controls hormone-related symptoms and may have the potential to slow tumor growth. […] Chemotherapy is usually reserved for patients whose carcinoid tumors begin to grow during treatment with octreotide. […] PRRT is a new nuclear medicine therapy. This treatment uses a radioactive drug called lutetium Lu 177 dotatate (Lutathera), which is given through an IV. The drug is effective against gastrointestinal and pancreatic carcinoid tumors that have proteins called somatostatin receptors.

• #23 Carcinoid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/carcinoid-tumors/diagnosis-treatment/drc-20351044

  Our caring team of Mayo Clinic experts can help you with your carcinoid tumors-related health concerns […] Treatment for a carcinoid tumor depends on the tumor’s location, whether cancer has spread to other areas of the body, the types of hormones the tumor secretes, your overall health and your own preferences. […] Carcinoid tumor treatment options may include: […] When detected early, a carcinoid tumor may be removed completely using surgery. […] Using medications to block hormones secreted by the tumor may reduce the signs and symptoms of carcinoid syndrome and slow tumor growth. […] Chemotherapy uses strong drugs to kill tumor cells. […] Targeted drug treatments focus on specific abnormalities present within tumor cells. […] Peptide receptor radionuclide therapy (PRRT) combines a drug that seeks out cancer cells with a radioactive substance that kills them.

• #24 Gastrointestinal Carcinoid Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gastrointestinal-neuroendocrine/gastrointestinal-carcinoid-tumors

  Many gastrointestinal carcinoid tumors are found through imaging studies performed for other health issues. […] There are several treatment options for patients with a gastrointestinal carcinoid tumor. Patients may receive one or more treatments such as surgery, minimally invasive therapy, hormone therapy, chemotherapy, and radiolabeled therapy. […] Surgical removal of the tumor is usually the first treatment for gastrointestinal carcinoid tumors. […] Patients with gastrointestinal carcinoid tumors that cannot be surgically removed may benefit from monthly injections of a synthetic hormone, octreotide, which controls hormone-related symptoms and may have the potential to slow tumor growth. […] Chemotherapy is usually reserved for patients whose carcinoid tumors begin to grow during treatment with octreotide. […] PRRT is a new nuclear medicine therapy. This treatment uses a radioactive drug called lutetium Lu 177 dotatate (Lutathera), which is given through an IV. The drug is effective against gastrointestinal and pancreatic carcinoid tumors that have proteins called somatostatin receptors.

• #25 Carcinoid Tumors – Center for Advanced Digestive Care | NewYork-Presbyterian Hospital

  https://www.nyp.org/cadc/neuroendocrine-tumors/carcinoid-tumors

  Hormone therapy may be given to help stop the tumor from growing, or to relieve symptoms caused by the tumor by lowering the levels of hormones in the body. […] Patients with gastrointestinal carcinoid tumors that cannot be surgically removed may benefit from injections of a synthetic hormone which controls hormone-related symptoms and may have the potential to slow tumor growth. […] Systemic chemotherapy, delivered through the bloodstream, employs drugs to kill cancer cells. […] For patients with gastrointestinal carcinoid tumors, chemotherapy is usually reserved for patients whose tumors begin to grow during treatment with a synthetic hormone. […] Embolization is a localized approach to destroying liver tumors that may be used to treat gastrointestinal carcinoid tumors that spread to the liver.

• #26 Carcinoid Tumors – Center for Advanced Digestive Care | NewYork-Presbyterian Hospital

  https://www.nyp.org/cadc/neuroendocrine-tumors/carcinoid-tumors

  Some patients with neuroendocrine tumors benefit from radiation therapy, which uses a type of energy called ionizing radiation to kill cancer cells and shrink tumors. […] Immunotherapy is designed to boost the body’s natural defenses to fight the cancer. […] This treatment targets faulty genes or proteins that contribute to cancer growth and development.

• #27 FF #137Carcinoid Syndrome: Symptom Management | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/carcinoid-syndrome-symptom-management/

  Background The carcinoid syndrome (CS) is a symptom complex resulting from hormone secretion in patients with carcinoid tumors. CS becomes manifested only when sufficient concentration of hormones reaches the systemic circulation, most commonly in the presence of liver metastases. This Fast Fact will focus on managing the symptoms of CS. […] Drugs that block the hormonal secretion can help to control the symptoms of carcinoid syndrome. […] Somatostatin Analogs These drugs are the treatment of choice for CS. 50-70% of patients experience a significant reduction of diarrhea and flushing episodes within seven days. […] Patients should be counseled to identify and eliminate stressors that reproducibly cause symptoms—this may include specific stressful situations, foods, or alcohol. […] Other treatments for refractory symptoms include systemic chemotherapy, hepatic artery embolization, hepatic chemoembolization, or debulking surgery of hepatic metastases.

• #28 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Neuroendocrine tumors (NETs) are rare and often misdiagnosed. Some people with NETs develop carcinoid syndrome, which is most often marked by debilitating diarrhea and facial flushing. I believe it’s important for oncology nurses to encourage our patients to accurately describe their life-disrupting symptoms. Many of my patients with carcinoid syndrome are having diarrhea 10 times a day, or their face is so flushed it is like red leather, so I work closely with them to provide solutions to help improve their quality of life. The good news is that with proper diagnosis and treatment, these symptoms can be successfully managed and our patients’ lives can be significantly prolonged. […] Carcinoid syndrome is real. Sadly, many patients are referred to psychiatrists because their healthcare provider does not believe their symptoms are occurring. I always ask every patient whether they are experiencing any GI or flushing symptoms and whether their symptoms have persisted with no explanation.

• #29 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Complete surgical removal of all tumor tissues, when feasible, is the best treatment for carcinoid syndrome because it may result in a complete and permanent cure. […] Systemic medical therapy should be used to control humorally mediated symptoms when the cancer spreads elsewhere. […] Patients with severe diarrhea may develop dehydration, which usually manifests as dark brown or intensely yellow urine. Intravenous fluid infusion may be needed to keep up with the fluid loss from diarrhea. Replacement of essential dietary elements and vitamins may be necessary. Along with potassium, magnesium, and iron, supplemental niacin is especially important, as decreased ingestion and absorption can be compounded by increased serotonin production by the tumor, which depletes stores of tryptophan that would otherwise be used to generate niacin.

• #30 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Patients benefit from specific drugs that either suppress production of vasoactive amines or block the peripheral effects. […] Patients with malignant carcinoid syndrome, diarrhea and weight loss are severe problems that need to be controlled. […] The major nutrients are absorbed easily and do not exacerbate the diarrhea, while most vegetables are very irritating. […] Patients with severe diarrhea should be careful to avoid dehydration or vitamin deficiency. Nicotinamide and niacin supplements are very useful and must be prescribed, along with potassium, magnesium, iron, and essential elements. […] Mild (not stressful) physical activity is not harmful and is possible if desired. No intense physical activities are allowed. […] In patients with malignant carcinoid syndrome who are cured with surgery, follow-up care does not need to be intensive. For patients with advanced disease, follow-up care should be scheduled on a regular basis.

• #31 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  If its causing symptoms, you may be offered one of the following treatments: injections of medicines called somatostatin analogues, such as octreotide and lanreotide, which can slow down the growth of the tumour. […] Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. […] Generally, you should avoid triggers of flushing, such as: alcohol, large meals, spicy foods, foods containing the substance tyramine, such as aged cheese and salted or pickled meats, stress. […] If you have diarrhoea, its important to keep drinking little and often to avoid dehydration. […] Overall, people with carcinoid tumours have a good life expectancy compared to many other cancers. Many people remain relatively well and lead active lives, with only occasional symptoms. […] However, treatment can still control your symptoms and slow down the spread of cancer.

• #32 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  If its causing symptoms, you may be offered one of the following treatments: injections of medicines called somatostatin analogues, such as octreotide and lanreotide, which can slow down the growth of the tumour. […] Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. […] Generally, you should avoid triggers of flushing, such as: alcohol, large meals, spicy foods, foods containing the substance tyramine, such as aged cheese and salted or pickled meats, stress. […] If you have diarrhoea, its important to keep drinking little and often to avoid dehydration. […] Overall, people with carcinoid tumours have a good life expectancy compared to many other cancers. Many people remain relatively well and lead active lives, with only occasional symptoms. […] However, treatment can still control your symptoms and slow down the spread of cancer.

• #33 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Systemic therapy should be used to control humorally mediated symptoms when the cancer spreads elsewhere. […] Diarrhea generally responds to standard antidiarrheal medications, but serotonin antagonists should be administered, if necessary, to control diarrhea and malabsorption. […] In patients with symptoms specifically related to increased histamine production, such as angioedema, histamine blockers may also be useful. […] Surgery should always be considered in patients with large or extensive hepatic metastases involving surgically accessible areas of the liver. […] For lesions in the distal ileum, a right hemicolectomy is necessary to remove the lymphatic drainage adequately. […] For tumors located in the appendix that are smaller than 1.5 cm in diameter, appendectomy is suitable and curative in 100% of patients.

• #34 Gastrointestinal Carcinoid Tumors | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gastrointestinal-neuroendocrine/gastrointestinal-carcinoid-tumors

  Carcinoid tumors are the most common type of neuroendocrine tumor. An estimated 11,000 to 12,000 people are diagnosed with a carcinoid tumor each year in the United States. About two-thirds of all carcinoid tumors appear in the gastrointestinal system, particularly in the small intestine, rectum, stomach, colon, and liver. […] Carcinoid tumors usually grow slowly over many years. Neuroendocrine tumors that grow slowly are called low-grade tumors. However, even low-grade carcinoid tumors can begin to grow rapidly, for reasons that are not well understood. […] Patients with carcinoid syndrome who undergo surgery, anesthesia, or chemotherapy are at risk of experiencing a carcinoid crisis, which is a life-threatening condition caused by a sudden surge of serotonin into the bloodstream. Treatment with the hormone octreotide before any medical procedure can help prevent a carcinoid crisis from occurring.

• #35 Carcinoid Syndrome • LITFL • CCC Endocrine

  https://litfl.com/carcinoid-syndrome/

  Carcinoid tumors are neuroendocrine malignancies typically located in the GI tract; most commonly in the terminal ilium and appendix. […] tumor resection […] anti-histamines […] octreotide infusion […] treat vasodilatory shock (e.g. noradrenaline infusion) […] treat right-sided heart failure (e.g., inotropes, diuretics, vasopressors, pulmonary vasodilators).

• #36 Carcinoid Crisis in the Intensive Care Unit | SpringerLink

  https://link.springer.com/10.1007/978-3-319-74698-2_82-1

  Carcinoid tumors are slow-growing, usually asymptomatic neuroendocrine tumors of enterochromaffin cell origin. […] The aim of the treatment of carcinoid crisis is to block the secretion and effect of mediators released by the tumor and control the symptoms. The cornerstone of this treatment is somatostatin analogs. Other drugs used in the treatment of carcinoid crisis are methylene blue, ketanserin, and H1 and H2 receptor antagonists.

• #37 Guidelines for the diagnosis and management of carcinoid tumours. Part 1: The gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1891174/

  Surgery is the only way to obtain a complete cure. Surgical resection of the primary tumour in midgut carcinoids and in cases with lymph node or liver involvement can improve survival. […] Octreotide administration is crucial before an invasive procedure. In patients whose symptoms are well controlled with the long-acting form, a supplemental dose should be given 12 hours before the procedure. […] Patients with carcinoid syndrome should have an echocardiogram at diagnosis. All patients should have an annual echocardiogram and follow-up with a cardiologist, particularly those with any cardiac changes or with elevated 5-hiaa.

• #38 Carcinoid Tumours: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/carcinoid-tumours

  Carcinoid tumours are rare, slow-growing tumours that originate in cells of the diffuse neuroendocrine system. […] Carcinoid tumours are often indolent asymptomatic tumours. However, a small but significant proportion are malignant and difficult to manage. […] Carcinoid tumours may secrete various bioactive compounds, including serotonin and bradykinin, which cause carcinoid syndrome, which includes bronchospasm, diarrhoea, skin flushing and right-sided valvular heart lesions. […] Treatment is usually based on the size of the tumour. Surgical resection (local resection with node clearance) when possible is the treatment of choice. […] Options for nonresectable disease include somatostatin analogues – eg, octreotide (which blocks 5-HT release), biotherapy, targeted radionuclide therapy, radiofrequency ablation therapy and chemotherapy. […] For patients with carcinoid valvular heart disease, surgical intervention can lead to improved prognosis and reduce the symptoms of heart failure.

• #39 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Patients benefit from specific drugs that either suppress production of vasoactive amines or block the peripheral effects. […] Patients with malignant carcinoid syndrome, diarrhea and weight loss are severe problems that need to be controlled. […] The major nutrients are absorbed easily and do not exacerbate the diarrhea, while most vegetables are very irritating. […] Patients with severe diarrhea should be careful to avoid dehydration or vitamin deficiency. Nicotinamide and niacin supplements are very useful and must be prescribed, along with potassium, magnesium, iron, and essential elements. […] Mild (not stressful) physical activity is not harmful and is possible if desired. No intense physical activities are allowed. […] In patients with malignant carcinoid syndrome who are cured with surgery, follow-up care does not need to be intensive. For patients with advanced disease, follow-up care should be scheduled on a regular basis.

• #40 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Patients benefit from specific drugs that either suppress production of vasoactive amines or block the peripheral effects. […] Patients with malignant carcinoid syndrome, diarrhea and weight loss are severe problems that need to be controlled. […] The major nutrients are absorbed easily and do not exacerbate the diarrhea, while most vegetables are very irritating. […] Patients with severe diarrhea should be careful to avoid dehydration or vitamin deficiency. Nicotinamide and niacin supplements are very useful and must be prescribed, along with potassium, magnesium, iron, and essential elements. […] Mild (not stressful) physical activity is not harmful and is possible if desired. No intense physical activities are allowed. […] In patients with malignant carcinoid syndrome who are cured with surgery, follow-up care does not need to be intensive. For patients with advanced disease, follow-up care should be scheduled on a regular basis.

• #41 Neuroendocrine Tumors (NETs)

  https://www.dukehealth.org/treatments/cancer/neuroendocrine-tumors

  Neuroendocrine tumors may release hormones that can cause a range of problems with your digestive system, from common stomach issues like cramping and diarrhea to stomach ulcers. […] If your tumor has metastasized, we have options for treatment. […] Most people with neuroendocrine tumors receive hormone therapy via a monthly injection to reduce symptoms caused by hormonal imbalances. Hormone therapy may also help shrink the tumor. […] Your care team may connect you with dietitians and nutritionists who can help you manage stomach problems and keep you feeling as well as possible.

• #42 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Patients benefit from specific drugs that either suppress production of vasoactive amines or block the peripheral effects. […] Patients with malignant carcinoid syndrome, diarrhea and weight loss are severe problems that need to be controlled. […] The major nutrients are absorbed easily and do not exacerbate the diarrhea, while most vegetables are very irritating. […] Patients with severe diarrhea should be careful to avoid dehydration or vitamin deficiency. Nicotinamide and niacin supplements are very useful and must be prescribed, along with potassium, magnesium, iron, and essential elements. […] Mild (not stressful) physical activity is not harmful and is possible if desired. No intense physical activities are allowed. […] In patients with malignant carcinoid syndrome who are cured with surgery, follow-up care does not need to be intensive. For patients with advanced disease, follow-up care should be scheduled on a regular basis.

• #43 Treating Gastrointestinal Carcinoid Tumors | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/treating.html

  If you’ve been diagnosed with a gastrointestinal (GI) carcinoid tumor, your cancer care team will discuss your treatment options with you. It’s important to weigh the benefits of each treatment option against the possible risks and side effects. […] Its important to discuss and understand all your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care. […] Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms. […] Nursing care and special equipment can make staying at home a workable option for many families.

• #44 Carcinoid Tumors, Cancer, Information, Resources

  https://www.cancercare.org/diagnosis/carcinoid%20tumor

  Cancer Care provides free, professional support services for people affected by carcinoid tumors, as well as carcinoid tumor treatment information and additional resources. Our staff can help you better cope with a carcinoid tumor. Oncology social workers help you cope with the emotional and practical challenges of carcinoid tumor. Cancer Care offers a free, private online support group for individuals in treatment for carcinoid and neuroendocrine tumors. A support group can be a wonderful way to find social connection, resources and information from others going through similar experiences. To learn more about our current offerings and how to register, you can contact our Hopeline at 800-813-HOPE (4673) to speak to one of our professional oncology social workers. […] Cancer Care offers a number of general face-to-face, telephone, and online support groups that may meet your needs.

• #45 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  For some people with gastrointestinal (GI) carcinoid tumor, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is a very common if you have had cancer. […] For other people, the cancer may never go away completely. These people may stay on drug therapy or get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. […] It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems and will examine you and may order lab tests or x-rays and scans to look for signs of cancer or treatment side effects.

• #46 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  For some people with gastrointestinal (GI) carcinoid tumor, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is a very common if you have had cancer. […] For other people, the cancer may never go away completely. These people may stay on drug therapy or get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. […] It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems and will examine you and may order lab tests or x-rays and scans to look for signs of cancer or treatment side effects.

• #47 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  Its important for all GI carcinoid tumor survivors, to let their health care team know about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or a second cancer. […] Standard recommendations for doctor visits and follow-up tests have not yet been defined for GI carcinoid tumors. […] For some rectal tumors, sigmoidoscopy is recommended 12 months after treatment and possibly annually thereafter. […] Follow-up visits and imaging tests may be slightly more frequent for those patients whose cancers could not be completely removed with surgery, who have cancer that has spread to other organs like the liver, or have cancers that are growing very quickly. […] Talk with your doctor about developing a survivorship care plan for you. […] Even after treatment, its very important to keep health insurance.

• #48 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  Its important for all GI carcinoid tumor survivors, to let their health care team know about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or a second cancer. […] Standard recommendations for doctor visits and follow-up tests have not yet been defined for GI carcinoid tumors. […] For some rectal tumors, sigmoidoscopy is recommended 12 months after treatment and possibly annually thereafter. […] Follow-up visits and imaging tests may be slightly more frequent for those patients whose cancers could not be completely removed with surgery, who have cancer that has spread to other organs like the liver, or have cancers that are growing very quickly. […] Talk with your doctor about developing a survivorship care plan for you. […] Even after treatment, its very important to keep health insurance.

• #49 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  Its important for all GI carcinoid tumor survivors, to let their health care team know about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or a second cancer. […] Standard recommendations for doctor visits and follow-up tests have not yet been defined for GI carcinoid tumors. […] For some rectal tumors, sigmoidoscopy is recommended 12 months after treatment and possibly annually thereafter. […] Follow-up visits and imaging tests may be slightly more frequent for those patients whose cancers could not be completely removed with surgery, who have cancer that has spread to other organs like the liver, or have cancers that are growing very quickly. […] Talk with your doctor about developing a survivorship care plan for you. […] Even after treatment, its very important to keep health insurance.

• #50 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  If you have (or have had) a GI carcinoid tumor, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. […] Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight is important. […] If cancer does come back at some point, your treatment options will depend on where the cancer is, what treatments youve had before, and your health. […] People whove had a GI carcinoid tumor can still get other cancers. […] Some amount of feeling depressed, anxious, or worried is normal when GI carcinoid is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others.

• #51 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  Its important for all GI carcinoid tumor survivors, to let their health care team know about any new symptoms or problems, because they could be caused by the cancer coming back or by a new disease or a second cancer. […] Standard recommendations for doctor visits and follow-up tests have not yet been defined for GI carcinoid tumors. […] For some rectal tumors, sigmoidoscopy is recommended 12 months after treatment and possibly annually thereafter. […] Follow-up visits and imaging tests may be slightly more frequent for those patients whose cancers could not be completely removed with surgery, who have cancer that has spread to other organs like the liver, or have cancers that are growing very quickly. […] Talk with your doctor about developing a survivorship care plan for you. […] Even after treatment, its very important to keep health insurance.

• #52 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  If you have (or have had) a GI carcinoid tumor, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. […] Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight is important. […] If cancer does come back at some point, your treatment options will depend on where the cancer is, what treatments youve had before, and your health. […] People whove had a GI carcinoid tumor can still get other cancers. […] Some amount of feeling depressed, anxious, or worried is normal when GI carcinoid is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others.

• #53 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  For some people with gastrointestinal (GI) carcinoid tumor, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is a very common if you have had cancer. […] For other people, the cancer may never go away completely. These people may stay on drug therapy or get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. […] It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems and will examine you and may order lab tests or x-rays and scans to look for signs of cancer or treatment side effects.

• #54 Living as a Gastrointestinal Carcinoid Tumor Survivor | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/after-treatment/follow-up.html

  If you have (or have had) a GI carcinoid tumor, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. […] Adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight is important. […] If cancer does come back at some point, your treatment options will depend on where the cancer is, what treatments youve had before, and your health. […] People whove had a GI carcinoid tumor can still get other cancers. […] Some amount of feeling depressed, anxious, or worried is normal when GI carcinoid is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others.

• #55 Guidelines for the diagnosis and management of carcinoid tumours. Part 1: The gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1891174/

  Carcinoid tumours are relatively rare and, in general, slow growing. Proper patient management can lead to cure, particularly if the tumour can be fully resected, or to long-term palliation with medical treatment or cytoreductive surgery, or both, with significant prolongation of survival. A good understanding of the use of somatostatin analogues to achieve effective symptomatic control and of the importance of adequate follow-up and cardiac monitoring to prevent or effectively treat cardiac complications can contribute significantly to optimal control of this complex disease, ultimately improving the quality of life of affected patients. […] The main goals of carcinoid tumour management are symptom control, biochemical control (that is, normalizing the 5-hiaa level), objective tumour control, and quality-of-life improvement. Different strategies are used to manage functioning and non-functioning carcinoid tumours. Somatostatin analogues for symptom control, frequent debulking, and better management of cardiac complications have improved survival rates.

• #56 Guidelines for the diagnosis and management of carcinoid tumours. Part 1: The gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1891174/

  Carcinoid tumours are relatively rare and, in general, slow growing. Proper patient management can lead to cure, particularly if the tumour can be fully resected, or to long-term palliation with medical treatment or cytoreductive surgery, or both, with significant prolongation of survival. A good understanding of the use of somatostatin analogues to achieve effective symptomatic control and of the importance of adequate follow-up and cardiac monitoring to prevent or effectively treat cardiac complications can contribute significantly to optimal control of this complex disease, ultimately improving the quality of life of affected patients. […] The main goals of carcinoid tumour management are symptom control, biochemical control (that is, normalizing the 5-hiaa level), objective tumour control, and quality-of-life improvement. Different strategies are used to manage functioning and non-functioning carcinoid tumours. Somatostatin analogues for symptom control, frequent debulking, and better management of cardiac complications have improved survival rates.

• #57 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Quality of life can be dramatically improved for NET and carcinoid syndrome patients. For instance, a patient’s debilitating diarrhea can be reduced from 10 times a day to 5 times a day, which allows the individual to attend social functions or work again. […] Nevertheless, many of the treatments for NETs are administered differently than what the typical oncology nurse is accustomed to, so again, it’s important to consult with a specialist and review all administration instructions carefully before beginning new treatments. It’s also important to tailor a treatment plan based on the patient’s specific symptoms and then work collaboratively with all relevant care team members to treat the whole patient.

• #58 Gastrointestinal Carcinoid Cancer Treatment | UVA Health Charlottesville

  https://uvahealth.com/services/gastrointestinal-cancer/carcinoid-cancer-gi

  We may also remove nearby lymph nodes for larger tumors, tumors that grow deep into the stomach wall, or tumors that are growing and spreading quickly. […] Not all patients with GI carcinoid tumors develop carcinoid syndrome. But if you develop this condition, we’ll help you manage a range of possible symptoms: […] These symptoms result from the carcinoid tumors release of certain hormones and bioactive substances. We have all the latest treatments: […] Medicine for diarrhea […] Medicine for skin rashes […] Medicine to breathe easier […] Medicine before having anesthesia for a medical procedure.

• #59 Malignant Carcinoid Syndrome Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/282515-treatment

  Complete surgical removal of all tumor tissues, when feasible, is the best treatment for carcinoid syndrome because it may result in a complete and permanent cure. […] Systemic medical therapy should be used to control humorally mediated symptoms when the cancer spreads elsewhere. […] Patients with severe diarrhea may develop dehydration, which usually manifests as dark brown or intensely yellow urine. Intravenous fluid infusion may be needed to keep up with the fluid loss from diarrhea. Replacement of essential dietary elements and vitamins may be necessary. Along with potassium, magnesium, and iron, supplemental niacin is especially important, as decreased ingestion and absorption can be compounded by increased serotonin production by the tumor, which depletes stores of tryptophan that would otherwise be used to generate niacin.

• #60 Carcinoid Tumor Care | Nebraska Medicine Omaha, NE

  https://www.nebraskamed.com/cancer/carcinoid-neuroendocrine

  Surgery to remove the tumor is the first line of treatment. The staged hepatectomy procedure involves removing a portion of the tumor from the liver. A port vein embolism to block the blood supply to the affected part of the liver is then performed to stimulate growth to the unaffected portion. If the carcinoid tumor is unresectable and localized to the liver the patient may be a possible liver transplant candidate. […] These types of tumors tend to recur so we will continue to monitor you for the rest of your life. Our clinic will work closely with your primary care doctor to ensure proper follow-up. […] Addressing a patients physical, educational, emotional and spiritual needs are important aspects of providing a more complete and holistic approach to care. A host of amenities and supportive services are available to help meet these needs. This includes personal care services such as wigs, wig fittings, prosthetic and bra fittings, yoga, massage therapy, skin care and make-up lessons specifically geared for people with or recovering from cancer are also provided in a private setting.

• #61 Carcinoid Tumor Care | Nebraska Medicine Omaha, NE

  https://www.nebraskamed.com/cancer/carcinoid-neuroendocrine

  Nebraska Medicine offers a host of cancer support services to help you with your physical, emotional, educational and financial needs. […] Our Survivorship Clinic is designed to help you deal with the emotional and physical challenges cancer can leave behind such as fear of recurrence, physical and medical long-term side effects and helping you return to a normal life again. It will also help you transition back into the care of your primary care physician.

• #62 Carcinoid Tumor Care | Nebraska Medicine Omaha, NE

  https://www.nebraskamed.com/cancer/carcinoid-neuroendocrine

  Surgery to remove the tumor is the first line of treatment. The staged hepatectomy procedure involves removing a portion of the tumor from the liver. A port vein embolism to block the blood supply to the affected part of the liver is then performed to stimulate growth to the unaffected portion. If the carcinoid tumor is unresectable and localized to the liver the patient may be a possible liver transplant candidate. […] These types of tumors tend to recur so we will continue to monitor you for the rest of your life. Our clinic will work closely with your primary care doctor to ensure proper follow-up. […] Addressing a patients physical, educational, emotional and spiritual needs are important aspects of providing a more complete and holistic approach to care. A host of amenities and supportive services are available to help meet these needs. This includes personal care services such as wigs, wig fittings, prosthetic and bra fittings, yoga, massage therapy, skin care and make-up lessons specifically geared for people with or recovering from cancer are also provided in a private setting.

• #63 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Quality of life can be dramatically improved for NET and carcinoid syndrome patients. For instance, a patient’s debilitating diarrhea can be reduced from 10 times a day to 5 times a day, which allows the individual to attend social functions or work again. […] Nevertheless, many of the treatments for NETs are administered differently than what the typical oncology nurse is accustomed to, so again, it’s important to consult with a specialist and review all administration instructions carefully before beginning new treatments. It’s also important to tailor a treatment plan based on the patient’s specific symptoms and then work collaboratively with all relevant care team members to treat the whole patient.

• #64 Diagnosing and Treating Patients with Neuroendocrine Tumors and Carcinoid Syndrome

  https://www.oncnursingnews.com/view/diagnosing-and-treating-patients-with-neuroendocrine-tumors-and-carcinoid-syndrome

  Neuroendocrine tumors (NETs) are rare and often misdiagnosed. Some people with NETs develop carcinoid syndrome, which is most often marked by debilitating diarrhea and facial flushing. I believe it’s important for oncology nurses to encourage our patients to accurately describe their life-disrupting symptoms. Many of my patients with carcinoid syndrome are having diarrhea 10 times a day, or their face is so flushed it is like red leather, so I work closely with them to provide solutions to help improve their quality of life. The good news is that with proper diagnosis and treatment, these symptoms can be successfully managed and our patients’ lives can be significantly prolonged. […] Carcinoid syndrome is real. Sadly, many patients are referred to psychiatrists because their healthcare provider does not believe their symptoms are occurring. I always ask every patient whether they are experiencing any GI or flushing symptoms and whether their symptoms have persisted with no explanation.

• #65 Guidelines for the diagnosis and management of carcinoid tumours. Part 1: The gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1891174/

  Carcinoid tumours are relatively rare and, in general, slow growing. Proper patient management can lead to cure, particularly if the tumour can be fully resected, or to long-term palliation with medical treatment or cytoreductive surgery, or both, with significant prolongation of survival. A good understanding of the use of somatostatin analogues to achieve effective symptomatic control and of the importance of adequate follow-up and cardiac monitoring to prevent or effectively treat cardiac complications can contribute significantly to optimal control of this complex disease, ultimately improving the quality of life of affected patients. […] The main goals of carcinoid tumour management are symptom control, biochemical control (that is, normalizing the 5-hiaa level), objective tumour control, and quality-of-life improvement. Different strategies are used to manage functioning and non-functioning carcinoid tumours. Somatostatin analogues for symptom control, frequent debulking, and better management of cardiac complications have improved survival rates.

• #66 Guidelines for the diagnosis and management of carcinoid tumours. Part 1: The gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1891174/

  Carcinoid tumours are relatively rare and, in general, slow growing. Proper patient management can lead to cure, particularly if the tumour can be fully resected, or to long-term palliation with medical treatment or cytoreductive surgery, or both, with significant prolongation of survival. A good understanding of the use of somatostatin analogues to achieve effective symptomatic control and of the importance of adequate follow-up and cardiac monitoring to prevent or effectively treat cardiac complications can contribute significantly to optimal control of this complex disease, ultimately improving the quality of life of affected patients. […] The main goals of carcinoid tumour management are symptom control, biochemical control (that is, normalizing the 5-hiaa level), objective tumour control, and quality-of-life improvement. Different strategies are used to manage functioning and non-functioning carcinoid tumours. Somatostatin analogues for symptom control, frequent debulking, and better management of cardiac complications have improved survival rates.

• #67 Carcinoid Tumor Care | Nebraska Medicine Omaha, NE

  https://www.nebraskamed.com/cancer/carcinoid-neuroendocrine

  Surgery to remove the tumor is the first line of treatment. The staged hepatectomy procedure involves removing a portion of the tumor from the liver. A port vein embolism to block the blood supply to the affected part of the liver is then performed to stimulate growth to the unaffected portion. If the carcinoid tumor is unresectable and localized to the liver the patient may be a possible liver transplant candidate. […] These types of tumors tend to recur so we will continue to monitor you for the rest of your life. Our clinic will work closely with your primary care doctor to ensure proper follow-up. […] Addressing a patients physical, educational, emotional and spiritual needs are important aspects of providing a more complete and holistic approach to care. A host of amenities and supportive services are available to help meet these needs. This includes personal care services such as wigs, wig fittings, prosthetic and bra fittings, yoga, massage therapy, skin care and make-up lessons specifically geared for people with or recovering from cancer are also provided in a private setting.

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