Treatment Options for Gastrointestinal Carcinoid Tumors

by National Cancer Institute

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Localized Gastrointestinal Carcinoid Tumors

Carcinoid tumors in the appendix

Treatment of localized gastrointestinal carcinoid tumors in the appendix may include the following:

• Appendectomy.
• Appendectomy and local excision.
• Appendectomy, bowel resection with anastomosis, and removal of lymph nodes.

Rectal carcinoid tumors

Treatment of localized gastrointestinal carcinoid tumors in the rectum may include the following:

• Fulguration.
• Local excision.
• Resection.

Surgery that saves the sphincter muscles (the muscles that open and close the anus) may be possible.

Small bowel carcinoid tumors

Treatment of localized gastrointestinal carcinoid tumors in the small intestine may include the following:

• Local excision.
• Resection with removal of nearby lymph nodes.

Gastric, colon, and pancreatic carcinoid tumors

Treatment of localized gastrointestinal carcinoid tumors in the stomach, colon, or pancreas is usually resection.

Regional Gastrointestinal Carcinoid Tumors

Treatment is usually surgery to remove all the cancer that can be seen at the site of the original tumor, as well as nearby tissues and lymph nodes.

If the tumor cannot be completely removed by surgery, treatment is usually palliative therapy to relieve symptoms and improve the patient's quality of life. This may include the following:

• Resection, cryosurgery, or radiofrequency ablation to remove as much of the tumor as possible.
• Chemoembolization to shrink tumors in the liver.

Metastatic Gastrointestinal Carcinoid Tumors

Distant metastases

If the metastatic gastrointestinal carcinoid tumor is not causing symptoms, there may be a period of watchful waiting before treatment is given. Treatment of distant metastases of gastrointestinal carcinoid tumors is usually palliative therapy that may include the following:

• Surgery to bypass or remove part of a tumor blocking the small intestine.
• Chemotherapy, which may include chemoembolization.
• Radiation therapy, sometimes with radioisotopes such as radioactive iodine (I131).
• MIBG (metaiodobenzylguanidine) therapy.
• Biologic therapy and/or hormone therapy.
• Clinical trials of new treatments.

Carcinoid syndrome

Treatment of metastatic gastrointestinal carcinoid tumors that are causing carcinoid syndrome may include the following:

• Resection, cryosurgery, radiofrequency ablation, or percutaneous ethanol injection for tumors in the liver.
• Hepatic artery ligation or embolization, with or without regional or systemic chemotherapy.
• Hormone therapy.
• Biologic therapy with or without chemotherapy.
• Clinical trials of new combinations of chemotherapy.

A heart valve replacement may be done for some patients with carcinoid syndrome.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Cancer.gov Web site.

Recurrent Gastrointestinal Carcinoid Tumors

Treatment of recurrent gastrointestinal carcinoid tumors may include the following:

• Surgery to remove part or all of the tumor
.
• A clinical trial.

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