Carcinoid tumour: Causes, Symptoms, Treatment and Cost

Carcinoid tumour is a type of slow-growing cancer that typically develops in certain cells of the digestive system, such as the appendix, small intestine and rectum. Carcinoid tumours can also spread to other organs, such as the lungs and liver. These tumours may secrete hormones or other substances that cause various symptoms.

There are three types of carcinoid tumour:- typical, atypical, and small cell.

• Typical: Typical carcinoid tumours usually have slow rates of growth and metastasize infrequently.
• Atypical: Atypical carcinoids grow more rapidly and are more likely to spread to other parts of the body.
• Small cell: Small cell carcinoids are the most aggressive type and can spread quickly, making them difficult to treat.

• The exact cause of carcinoid tumours is unknown, but they are believed to be related to hereditary or environmental factors.
• Genetic mutations and other abnormalities have been observed in cells from patients with this condition.
• Exposure to carcinogenic substances, such as asbestos and tobacco smoke, have also been linked to a higher risk of carcinoid tumours.
• Other cases may be due to family history or radiation exposure.

• Carcinoid tumours are slow-growing tumours, commonly found in the gastrointestinal tract, lungs and rarely in other sites.
• Symptoms can depend on where the carcinoid tumour is located, but may include abdominal pain, diarrhoea, shortness of breath, wheezing and a feeling of something stuck in the throat or chest.
• Some carcinoid tumours will produce hormones that cause a syndrome of facial redness and flushing (carcinoid syndrome).
• Other symptoms can include fatigue due to anaemia (low red blood cell count), low blood sugar (hypoglycemia), heart valve disease or carcinoid crisis with fever, low blood pressure and shock.

• Avoid smoking and exposure to secondhand smoke.
• Eat a diet rich in fruits, vegetables, and whole grains.
• Exercise regularly.
• Reduce alcohol consumption.
• Maintain healthy weight.
• Use sunscreen when exposed to the sun.

• Physical Examination:A physical examination will be conducted to check for signs and symptoms related to carcinoid tumours, such as skin discoloration, abdominal masses, and any other visible indications.
• Chest X-Ray:This test takes pictures of the inside of your chest in order to detect any abnormalities that could be related to a carcinoid tumour of lung cancer.
• CT Scan (Computed Tomography):This test is an imaging test used to create a three-dimensional image of the chest in order to better visualise possible tumours or abnormalities that may not have been seen on an X-ray.
• Magnetic Resonance Imaging (MRI):This test uses strong magnetic fields and radio waves in order to generate detailed images of your organs and other parts of your body, allowing doctors to view very specific parts of your chest and abdomen in even greater detail than a traditional X-ray or CT scan would allow.
• Endoscopy:An endoscopy is an examination using a thin, flexible tube with a light and camera attached that allows doctors or specialists to see inside the organs in question, such as the liver or small intestines on which carcinoid tumours can be found. It is often used when imaging tests do not reveal enough details about the tumour's size, shape or exact location within the organ it affects.
• Lab Test:Blood tests may also be conducted for certain markers associated with carcinoid tumours such as Chromogranin A(CgA). Elevated levels CgA are often seen with patients who have this type of tumour present and can help aid diagnosis when paired with other diagnostic tests.

• Carcinoid syndrome:A range of symptoms including facial flushing, abdominal cramping, diarrhoea and wheezing.
• Heart valve problems:Abnormalities of cardiac valves and enlargement of the right side of the heart (cor pulmonale).
• Tumour spread:Spread to lymph nodes in the abdomen and beyond can occur although spread to other organs is rare.
• Obstruction of various organs:Can cause obstruction in gastrointestinal tract, bladder or bile ducts resulting in nausea, vomiting, urinary or biliary symptoms.

• Drink tulsi tea regularly to reduce the symptoms of carcinoid tumour.
• Consume a mixture of ginger and honey on a regular basis to reduce inflammation caused by the tumour.
• Incorporate warm ghee into the diet to help alleviate the digestion-related side effects of carcinoid tumour.
• Take herbal tonics, such as Amruthotharam Kashayam, and Nirgundi mixed with honey or jaggery to boost immunity and reduce pain.
• Have Turmeric mixed with honey/jaggery/ghee to reduce inflammation in the body caused by carcinoid tumour.

• Eat a balanced diet: Eating a healthy diet full of fresh fruits, veggies, lean proteins, whole grains and healthy fats can help maintain your health and overall sense of wellbeing when living with carcinoid tumours.
• Increase antioxidant-rich foods: Antioxidants have been linked with reducing risk factors for cancer, including carcinoid tumours. Eating food rich in antioxidants like dark leafy greens and fruit can help protect the body.
• Consume probiotic-rich foods: Probiotics are beneficial bacteria that live in the digestive tract and can improve gut health by fighting off unhealthy bacteria and promoting nutrient absorption from food. Fermented dairy products like yoghurt, kefir as well as other fermented vegetables can provide probiotics for your body’s needs.

• Processed foods:Processed foods contain high levels of salt, sugar, and saturated or trans fat, which can be harmful for people with carcinoid tumours.
• Alcohol:Drinking alcohol in excess can increase the risk of certain kinds of cancer, including carcinoid tumours. It is best to avoid alcohol altogether or limit consumption to no more than one drink per day.
• Fried foods:Fried food contains high levels of fat and often has added sugar or salt which can be harmful for people with carcinoid tumours.
• Refined carbohydrates:Refined carbohydrates are found in processed and refined grains such as white bread, pasta and rice, which can increase blood sugar levels quickly and are bad for people with carcinoid tumours.
• Red meat:Research suggests that a diet high in red meat may be associated with an increased risk of certain types of cancer, including carcinoid tumours. It is best to limit red meat intake to no more than a few times per week and opt for leaner cuts when consuming it at all.

• Resection Surgery:This is the most common treatment for Carcinoid tumours. It involves completely removing the tumour as well as any surrounding tissue affected by it.
• Laser Ablation:This is a minimally invasive procedure that uses special tools to pinpoint and destroy portions of the tumour.
• Radiofrequency Ablation:Using radiofrequency energy, this procedure increases the temperature around tumours to destroy them without harming surrounding healthy cells.
• Gamma Knife Radiosurgery:Instead of an actual surgery, Gamma Knife Radiosurgery is a technique that precisely directs radiation at targeted tumours to destroy or shrink them much like an actual knife would do during surgery.
• Chemotherapy/Targeted Therapy:Chemotherapeutic drugs are sometimes used in certain cases on their own or as part of other treatments like laser ablation and radiofrequency ablation to help reduce tumour size and eliminate cancerous cells in distant locations from the original tumour site.

In most cases, it is beneficial to consult a gastroenterologist or pulmonary specialist for carcinoid tumour diagnosis and treatment. Depending on the type of cancer, other specialists may be consulted, including an oncologist or surgeon who specialises in treating cancerous growths.

• Chemotherapy:A range of drugs used to slow or stop the growth of cancer cells.
• Interferon therapy:A type of drug used to increase the body’s immune response against cancerous cells.
• Targeted therapy:Drugs that help block or slow down the growth signals that cancer cells use to survive and spread.
• Hormone therapy:Certain drugs are used to help inhibit tumour growth, by blocking hormones needed for it to grow, or by blocking receptors related to it.

The timeline for recovery from a Carcinoid tumour depends on the size and location of the tumour, as well as the type and aggressiveness of treatment used. Generally, it can take several weeks or months after treatment is completed for a patient to fully recover.

Due to the highly variable nature of carcinoid tumours, there is no singular or single treatment option that can provide a permanent cure. Treatment options such as surgery, radiation, and chemotherapy may be used to alleviate symptoms, slow progression of the disease or even provide a partial remission but there is no guarantee of long-term success or a complete cure in all cases.

• After carcinoid tumour surgery, the patient’s doctor should monitor regularly to ensure that no recurrent tumour is present.
• The patient should attend regular follow-up appointments and tests, including CT scans or ultrasounds, to monitor for treatment success and any cancer recurrence.
• Depending on the particular type of cancer and the treatment plan set by their doctor, the patient may need to take medications or vitamins for a certain period of time after their surgery, such as vitamin B12 or cortisol treatments.
• Life-style modifications such as quitting smoking, exercising regularly and maintaining a healthy diet can help improve overall health and can reduce the risk of recurrence or impact of tumour progression in those who are already receiving treatment for carcinoid tumours.
• Additionally, patients may be recommended lifestyle interventions such as psychotherapy or mindfulness techniques which can help them cope with stress from their treatment regimen in order to achieve better outcomes from it.

The cost for treatment of Carcinoid tumours in India vary depending on the severity and stage of cancer.

Treatment options include chemotherapy, surgery, hormonal therapy, and radiation therapy, each of which may range from Rs 1 lakh to Rs 10 lakh or higher.

Drugs used to treat carcinoid tumours are costly as well, ranging from Rs 15000 to Rs one lakh or more per month.

With every treatment option and drugs included, the overall cost of treatments for carcinoid tumours in India can be around 4-5 lakhs or more.

• Treatment side-effects vary depending on the type of therapy used.
• Surgery can cause bleeding, infection, nerve damage, and reaction to anaesthesia.
• Chemotherapy can cause nausea, vomiting, hair loss and an increased risk of infection.
• Radiation therapy may cause diarrhoea, vomiting, fatigue and redness or discomfort at the site of radiation delivery.
• Targeted therapies may cause skin rashes or bone marrow suppression leading to low blood cell count in some cases.

If you are suffering from any complications relating to carcinoid tumours then you should consult a doctor nearby as they can cause complications like 'heart valve problem, tumour spread, obstruction of various organs' in which treatment courses can range from a few months to years depending on the severity of the situation.