PDQ® Treatment Patients
PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.
To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.
PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.
Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.
To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.
PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.
Gastrointestinal carcinoid tumors are cancers in which cancer (malignant) cells are found in certain hormone-making cells of the digestive, or gastrointestinal, system. The digestive system absorbs vitamins, minerals, carbohydrates, fats, proteins, and water from the food that is eaten and stores waste until the body eliminates it. The digestive system is made up of the stomach and the small and large intestines. The last 6 feet of intestine is called the colon. The last 10 inches of the colon is the rectum. The appendix is an organ attached to the large intestine.
There are often no signs of a gastrointestinal carcinoid tumor in its early stages. Often the cancer will make too much of some of the hormones, which can cause symptoms. A doctor should be seen if the following symptoms persist: pain in the abdomen, flushing and swelling of the skin of the face and neck, wheezing, diarrhea, and symptoms of heart failure, including breathlessness.
If there are symptoms, a doctor may order blood and urine tests to look for signs of cancer. Other tests may also be done. If there is a carcinoid tumor, the patient has a greater chance of getting other cancers in the digestive system, either at the same time or at a later time.
The chance of recovery (prognosis) and choice of treatment depend on whether the cancer is just in the gastrointestinal system or has spread to other places, and on the patient's general state of health.
Once gastrointestinal carcinoid tumor is found, more tests will be done to find out if cancer cells have spread to other parts of the body. The following stages are used for gastrointestinal carcinoid tumor:
The cancer is found in the appendix, the colon or rectum, the small intestine, or stomach, but it has not spread to other parts of the body.
Cancer has spread from the appendix, colon or rectum, stomach, or small intestine to nearby tissues or lymph nodes (small, bean-shaped structures that are found throughout the body that produce and store infection-fighting cells).
Cancer has spread to other parts of the body.
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the first place it was found or in another part of the body.
There are treatments for all patients with gastrointestinal carcinoid tumors. Four kinds of treatment are used:
Local excision uses a special instrument inserted into the colon or rectum
through the anus to cut the tumor out. This operation can be used for very
Fulguration uses a special tool inserted into the colon or rectum through the
anus. An electric current is then used to burn the tumor away.
Bowel resection takes out the cancer and a small amount of healthy tissue on
either side. The healthy parts of the bowel are then sewn together. The
doctor will also remove lymph nodes and have them looked at under a
microscope to see if they contain cancer.
Cryosurgery kills the cancer by freezing it.
Hepatic artery ligation cuts and ties off the main blood vessel that brings
blood into the liver (the hepatic artery).
Hepatic artery embolization uses drugs or other agents to reduce or block
the flow of blood to the liver in order to kill cancer cells growing in the
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the digestive system.
Biological therapy tries to get the patient's body to fight the cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.
Treatment of gastrointestinal carcinoid tumor depends on the type of tumor, the stage, and the patient's overall health.
Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of gastrointestinal carcinoid tumor. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
If the cancer started in the appendix, the treatment will probably be surgery to remove the appendix (appendectomy) with or without removal of part of the colon (hemicolectomy) and lymph nodes.
If the cancer started in the rectum, treatment will probably be simple surgery to remove the cancer, surgery using electric current to burn the cancer away, surgery to remove part of the rectum, or surgery to remove the anus and part of the rectum. An opening will be made for waste to pass out of the body (colostomy) into a disposable bag attached near the colostomy (colostomy bag).
If the cancer started in the small intestine, the treatment will probably be surgery to remove part of the bowel (bowel resection). Lymph nodes may also be taken out and looked at under the microscope to see if they contain cancer.
If the cancer started in the stomach, pancreas, or colon, the treatment will probably be surgery to remove the organ affected by the cancer and possibly other nearby organs.
The treatment will probably be surgery to remove the organ affected by the cancer and possibly other nearby organs.
Treatment may be one of the following:
2. Chemotherapy to relieve symptoms caused by the cancer.
3. Chemotherapy injected directly into the hepatic artery to block the artery and kill cancer cells growing in the liver.
4. Radiation therapy to relieve symptoms caused by the cancer.
5. Radioactive substances injected into the cancer to relieve the symptoms caused by the cancer.
6. Biological or immunological therapy.
Treatment options for metastatic carcinoid tumor may be one of the following:
2. Surgery to cut and tie the main artery that goes to the liver (hepatic artery ligation) or injecting chemotherapy into the liver through the hepatic artery to block the artery and kill cancer cells growing in the liver.
3. Drugs designed to relieve symptoms caused by the cancer.
4. Biological therapy to relieve symptoms caused by the cancer.
5. A clinical trial of new combinations of chemotherapy drugs.
The treatment depends on many factors, including where the cancer came back and what treatment the patient received before. Clinical trials are studying new treatments.
TO LEARN MORE..... CALL 1-800-4-CANCER
To learn more about gastrointestinal carcinoid tumors, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.
The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:
For more information from the National Cancer Institute, please write to this address: