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What Is the Most Common Symptom of Carcinoid Syndrome?

Rendering of carcinoid syndrome and small bowel cancer
The most common symptom of carcinoid syndrome is flushing, which causes skin redness or warmth.

Carcinoid syndrome is a group of symptoms that occur when some neuroendocrine tumors (also called carcinoid tumors) overproduce hormones such as serotonin. 

The most common symptom of carcinoid syndrome is flushing, which causes skin redness or warmth.  

  • Episodes typically last 30 seconds up to 30 minutes
  • Usually occurs on the face, neck, or upper chest
  • Triggers for flushing episodes may include eating a large meal or drinking alcohol

Other symptoms of carcinoid syndrome may include:

  • Fast heartbeat
  • Abdominal cramps
  • Watery diarrhea
  • Skin rash 
  • Spider veins (telangiectasias), usually on the nose, cheek, or upper lip
  • Trouble breathing/shortness of breath
  • Wheezing
  • Carcinoid heart disease, which affects the heart valves, and does not always cause symptoms. Symptoms include: 

What Causes Carcinoid Syndrome?

Carcinoid syndrome is caused by an overproduction of hormones such as serotonin by a neuroendocrine tumor, resulting in the characteristic symptoms. 

Carcinoid syndrome commonly occurs when a neuroendocrine tumor that starts in the small intestine spreads to the liver, where the hormones produced by the tumor can enter the bloodstream, which can result in symptoms.
 

How Is Carcinoid Syndrome Diagnosed?

Carcinoid syndrome is diagnosed with a patient history and physical examination, and tests including: 

  • Urine tests 
  • Blood tests
    • 5-HIAA (5-hydroxyindoleacetic acid) 
    • Chromogranin A (CgA) 
  • Imaging tests
  • Echocardiogram (“echo”) 
  • Pancreastatin Test, Substance P and Neurokinin A Tests
  • Full body imaging tests: Somatostatin Receptor Scintigraphy (SRS) Test (Octreoscan)

What Is the Treatment for Carcinoid Syndrome?

Treatment for carcinoid syndrome depends on the symptoms, where the tumor is located, and how much the cancer has spread.

Treatment aimed at controlling symptoms of carcinoid syndrome includes:

  • Anti-diarrheal medications
  • Medicines to block neuroendocrine tumors from producing the substances that cause symptoms
  • Dietary modifications
    • Avoid foods and substances with high levels of amines, nitrogen-containing organic compounds, or adrenaline-like substances or alcohol that can trigger the release of serotonin and other hormones from carcinoid tumors
    • Avoid foods such as: 
      • Fatty meats, smoked or salted fish, aged cheeses, chocolate, red wine, alcohol, eggs, pineapple, nuts, bananas, tomatoes, kiwi fruit, and plums
    • Eat smaller meals
  • Adjusting prescription medications
    • Some drugs can affect amine or adrenaline levels
    • Don’t stop taking a prescribed medication without first talking to your doctor
  • Palliative therapy (supportive care) to help manage pain, maintain quality of life, and reduce stress that comes with a serious illness
    • Surgery to reduce tumor size and reduce pain 
    • Counseling to manage mental stress and emotional burdens
  • Treatment for carcinoid heart disease
    • May involve surgery to replace a diseased heart valve with a healthy heart valve

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References
Image Source: iStock Images

https://www.uptodate.com/contents/carcinoid-syndrome-the-basics?search=carcinoid%20syndrome&source=search_result&selectedTitle=1~78&usage_type=default&display_rank=1

https://www.carcinoidsyndrome.org/