Treatment:

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 destroying the local blood supply or giving chemotherapy directly into the liver.

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

Sandostatin (octreotide) injections are sometimes given to people with advanced carcinoid tumors that cannot be removed with surgery. This drug can block and reverse tumor growth. Interferon is often given with octreotide to help stop tumor growth.

A serotonin antagonist may be prescribed to control diarrhea and poor absorption of nutrients from the intestines (malabsorption).

One of several combinations of chemotherapy may be given through a vein (IV) or by mouth. If one combination does not work, another combination may be effective. About one-third of patients benefit from chemotherapy.

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 Paxil, Serzone, and Prozac) may make symptoms worse by increasing levels of serotonin. However, do not stop taking these medicines unless your doctor tells you to do so.

Support Groups:

Learn more about carcinoid syndrome and get support from:

• The Carcinoid Cancer Foundation
• The Caring for Carcinoid Foundation

Expectations (prognosis):

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

In people with the syndrome, the tumor has usually spread to the liver, which lowers the survival rate. People with carcinoid syndrome are also more likely to have a separate cancer (second primary tumor) at the same time.

The outlook is more favorable thanks to new treatment methods, such as Sandostatin.

Complications:

• Increased risk of falls and injury (from low blood pressure)
• Bowel obstruction (from tumor)
• Gastrointestinal bleeding
• Right-sided heart failure

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of carcinoid syndrome.