Types of treatment for carcinoid
This page gives a general overview of the treatments for carcinoid (neuroendocrine tumours).
- A quick guide to what's on this page
- The main treatments
- Surgery for carcinoid tumours
- Somatostatin analogues for carcinoid
- Radiotherapy for carcinoid tumours
- Radiofrequency ablation therapy for carcinoid
Types of treatment for carcinoid
Your doctor will plan your treatment according to where your carcinoid started, whether it has spread, the symptoms you have, how the cells look under a microscope, your general health and whether you have carcinoid syndrome.
Carcinoids grow at different rates but they often grow very slowly. Some may not grow at all for months or years.
If your carcinoid is not growing or causing symptoms, you may start treatment with a somatostatin analogue, such as octreotide. Or your doctors may decide that you don’t need any treatment straight away. They may just keep an eye on you with scans at regular intervals.
If your carcinoid is causing symptoms or growing, you may have one or more of the following treatments
- Somatostatin analogues
- Blocking the blood supply to tumours in the liver (hepatic artery embolisation)
- Radiofrequency ablation to tumours in the liver
- Supportive care
You can view and print the quick guides for all the pages in the treating carcinoid section.
There are several different types of treatment that doctors use for carcinoid. But you may not have any treatment straight away if your carcinoid is not causing symptoms or growing. Your doctor may just keep an eye on it.
If you have a growing carcinoid or symptoms, you will have surgery if it is possible to remove the tumour.
If you can't have surgery, there are a number of different treatments to control carcinoid and its symptoms. People often need a combination of treatments for carcinoid. These include treatment with
You may have surgery if you
- have a small carcinoid tumour (early stage disease)
- are generally well
When the aim of this surgery is to completely remove the carcinoid, it is known as curative or radical surgery.
Sometimes you may have surgery to relieve symptoms of carcinoid that has spread – especially within the abdomen or to the liver. For example, surgery could remove a tumour blocking your bowel, or a tumour causing carcinoid syndrome. This is called palliative surgery or debulking.
The type of surgery depends on where the tumour is in the body.
Somatostatin analogues, such as octreotide and lanreotide, are the most common drug treatments for carcinoid. They are proteins that can slow down the production of hormones by the tumour. For many people, these drugs work well to control carcinoid tumours and their symptoms.
You can have radiotherapy in different ways for carcinoid
This is a type of internal radiotherapy. You may have targeted radionuclide treatments if you cannot have surgery or have carcinoid that has spread and is causing symptoms.
Doctors call it targeted therapy because it goes directly to the carcinoid cells, wherever they are in the body. It has very little effect on other cells in the body. One of 2 different substances are mainly used, called MIBG and octreotide. It is possible to attach radioactivity to either of these substances. Then, when the MIBG or octreotide finds the carcinoid cells, it carries the radiation to them and kills them. To have this type of treatment your scans must show that your tumour absorbs either MIBG or octreotide.
A new targeted radionuclide treatment, uses microscopic beads coated with a radioactive substance called yttrium-90. These beads are injected into blood vessels that feed carcinoid tumours in the liver. The beads block the blood vessels and the radiation kills the tumour cells. This treatment is called selective internal radiotherapy (SIRT).
If you have symptoms from carcinoid tumours that have spread to your bones or brain, you may have external radiotherapy treatment. This is especially helpful in controlling pain.
Doctors use radiofrequency ablation (RFA) to treat small carcinoid tumours in the liver.
Your doctor guides a probe through your skin into the tumour. The probe is an electrode – it passes a radiofrequency current into the tumour. This creates heat and destroys the tumour.
You are most likely to have chemotherapy if you have a fast growing tumour (high grade), or the tumour has spread to other parts of the body and is causing symptoms, particularly tumours of the pancreas (pancreatic neuroendocrine tumours).
You usually have a combination of 2 or 3 chemotherapy drugs.
Hepatic artery embolisation treatment is for people with carcinoid that has spread to their liver and who can’t have surgery.
The treatment blocks the blood supply to the tumour, and so the cells die. Doctors may give chemotherapy directly into the liver at the same time (called chemoembolisation).
Interferon alpha (INF-α) is a type of biological therapy that stimulates the body’s own immune response to help treat cancer. You may have interferon if your carcinoid has spread to other parts of your body. It helps to control symptoms and may slow the growth of tumour cells.
You may have interferon on its own or with one of the somatostatin analogues.
You may just have simple treatments to control the symptoms of your carcinoid. You may be able to limit the symptoms of carcinoid syndrome with changes to your diet. You may just need to treat diarrhoea with loperamide (Immodium) or codeine phosphate for example.
You can read more in our section about coping with carcinoid syndrome.
Your doctors will plan your treatment according to
- Where your carcinoid started (the primary tumour)
- Whether it has spread
- The symptoms you have
- How the cells look under a microscope (the grade)
- Your general health
- Whether you have carcinoid syndrome
Carcinoids grow at different rates but they often grow very slowly. Some may not grow at all for months or years. Even if your carcinoid is not growing or causing symptoms your doctors are likely to decide to start treatment with a somatostatin analogue. Or they may decide that you don’t need any treatment straight away. They may just keep an eye on you with scans at regular intervals.
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