Overview

Carcinoid syndrome occurs when a rare cancerous tumor called a carcinoid tumor secretes certain chemicals into your bloodstream, causing a variety of signs and symptoms. Carcinoid tumors occur most commonly in the gastrointestinal tract or lungs.

Carcinoid syndrome typically occurs in people who have carcinoid tumors that are advanced. Treatment for carcinoid syndrome usually involves treating the cancer. However, because most carcinoid tumors don't cause carcinoid syndrome until they're advanced, a cure may not be possible. In those cases, medications may relieve your carcinoid syndrome symptoms and make you more comfortable.

Source: http://www.mayoclinic.com

Symptoms

The signs and symptoms of carcinoid syndrome depend on which chemicals the carcinoid tumor secretes into your bloodstream.

The most common signs and symptoms include:

• Skin flushing. The skin on your face and upper chest feels hot and changes color — ranging from pink to purple. Flushing episodes may last from a few minutes to a few hours or longer.

  Flushing may happen for no obvious reason, though sometimes it can be triggered by stress, exercise or drinking alcohol.

• Facial skin lesions. Purplish areas of spiderlike veins may appear on your nose and upper lip.
• Diarrhea. Frequent, watery stools sometimes accompanied by abdominal cramps may occur in people who have carcinoid syndrome.
• Difficulty breathing. Asthma-like signs and symptoms, such as wheezing and shortness of breath, may occur at the same time you experience skin flushing.
• Rapid heartbeat. Periods of a fast heart rate could be a sign of carcinoid syndrome.

When to see a doctor

Make an appointment with your doctor if you have signs and symptoms that concern you.

Source: http://www.mayoclinic.com

Causes

Carcinoid syndrome is caused by a carcinoid tumor that secretes serotonin or other chemicals into your bloodstream. Carcinoid tumors occur most commonly in the lungs or in the gastrointestinal tract, including your stomach, small intestine, appendix, colon and rectum.

Only a small percentage of carcinoid tumors secrete the chemicals that cause carcinoid syndrome. When these tumors do secrete the chemicals, the liver normally neutralizes the chemicals before they have a chance to travel through your body and cause symptoms.

However, when an advanced tumor spreads (metastasizes) to the liver itself, it may secrete chemicals that aren't neutralized before reaching the bloodstream. Most people who experience carcinoid syndrome have an advanced cancer that has spread to the liver.

Some carcinoid tumors don't have to be advanced to cause carcinoid syndrome. For instance, carcinoid lung tumors that secrete chemicals into the blood do so farther upstream from the liver, which then cannot process and eliminate the chemicals.

Carcinoid tumors in the intestine, on the other hand, secrete the chemicals into blood that must first pass through the liver before reaching the rest of the body. The liver usually neutralizes the chemicals before they can affect the rest of the body.

What causes carcinoid tumors is unclear.

Source: http://www.mayoclinic.com

Diagnosis

Your doctor will assess your signs and symptoms to rule out other causes of skin flushing and diarrhea. If no other causes are found, your doctor may suspect carcinoid syndrome.

To confirm a diagnosis, your doctor may recommend further tests, including:

• Urine test. Your urine may contain a substance made when your body breaks down serotonin. An excess amount of this substance could indicate that your body is processing extra serotonin, the chemical most commonly excreted by carcinoid tumors.
• Blood test. Your blood may contain high levels of certain substances, including the protein chromogranin A, which is released by some carcinoid tumors.
• Imaging tests. Imaging tests also may be used to locate the primary carcinoid tumor and determine whether it has spread. Your doctor may start with a computerized tomography (CT) scan of your abdomen, because most carcinoid tumors are found in the gastrointestinal tract. Other scans, such as MRI or nuclear medicine scans, may be helpful in certain cases.

Source: http://www.mayoclinic.com

Complications

Having carcinoid syndrome can cause the following complications:

• Carcinoid heart disease. Some people with carcinoid syndrome develop carcinoid heart disease. Carcinoid syndrome causes a thickening of the heart valves, making it difficult for them to function properly. As a result, the heart valves may leak.

  Signs and symptoms of carcinoid heart disease include fatigue and shortness of breath during physical activity. Carcinoid heart disease can eventually lead to heart failure.

  Your doctor may recommend medications for your heart. Surgical repair of damaged heart valves may be an option in advanced carcinoid heart disease.

• Bowel obstruction. Cancer that spreads to the lymph nodes next to your small intestine can cause narrowing and kinking of your intestine, leading to a bowel obstruction.

  Signs and symptoms of a bowel obstruction include severe, cramping abdominal pain and vomiting. Surgery may be necessary to relieve the obstruction.

• Carcinoid crisis. Carcinoid crisis causes a severe episode of flushing, low blood pressure, confusion and breathing difficulty.

  Carcinoid crisis can occur in people with carcinoid tumors when they are exposed to certain triggers, including anesthetic used during surgery. Carcinoid crisis can be fatal. Your doctor may give you medications before surgery to reduce the risk of carcinoid crisis.

Lifestyle and home remedies

Talk to your doctor about self-care measures that may improve your signs and symptoms. Self-care measures can't replace treatment, but they may complement it. Ask your doctor if you should:

• Avoid things that cause skin flushing. Certain substances or situations, such as alcohol or large meals, can trigger flushing. Some people experience flushing when they're feeling stressed or upset.

  Keep track of what causes your flushing, and try to avoid those triggers.

• Consider taking a multivitamin. Chronic diarrhea makes it difficult for your body to process the vitamins and nutrients in the food you eat. Ask your doctor whether taking a multivitamin may be a good idea for you.

Source: http://www.mayoclinic.com

Coping and support

You may be relieved to finally find an answer to what's been causing your signs and symptoms, but a diagnosis of a rare disease, such as carcinoid syndrome, can be stressful. As you develop your way of coping with a cancer diagnosis, talk with your health care team about how you feel and consider trying to:

• Find out enough about carcinoid syndrome to make decisions about your care. Ask your doctor questions about your condition. Ask members of your health care team to recommend resources where you can get more information.

  Knowing about your condition may enable you to better participate in decisions about your care.

• Talk to other people with carcinoid syndrome. Support groups for people with carcinoid syndrome put you in touch with those who have faced the same challenges you are facing.

  Ask your doctor about groups in your area. Carcinoid syndrome is rare, though, so you may need to connect with people outside your immediate area or online.

• Take care of yourself. Do what you can to maintain a healthy lifestyle. Eat a diet full of fruits and vegetables. When you feel up to it, include light exercise in your daily routine.

  Cut extra stress out of your life when possible. Get plenty of sleep so that you feel rested when you wake up. Take care of your body and mind so that you're better able to stick to your cancer treatment plan.

Source: http://www.mayoclinic.com