About Gastric Carcinoid Tumors

Gastric carcinoid tumors can be benign or cancerous and originate from neuroendocrine cells.

They are slow growing, but spread in a similar way to other malignancies. 

They are not unique to the stomach, but can be found through the GI tract.

They are often small, although can grow to large sizes because of the capacious nature of the stomach.

What Symptoms Might I Have?

You might have no symptoms at all or you may develop symptoms related to the tumor or the chemical messengers they produce.

Chemical messengers or hormones are normally produced by the body to affect local or distant cells to perform an action.

Carcinoid's are no different in this respect. In the stomach, the symptoms you might experience include:

Carcinoid Symptoms

  • Heartburn and Indigestion
  • Nausea and Vomiting
  • Early satiety (feeling full early) 
  • Weight loss
  • Flushing
  • Tiredness and Anemia
  • Wheezing and breathlessness
  • Diarrhea
  • Itching from wheals or urticaria
  • Black tarry stools from bleeding
  • Yellow stools from fat malabsorption

How Are They Diagnosed?

The diagnosis may be considered if you have any of the features outlined above.

Symptoms of flushing and wheeze don't normally occur until the tumor has spread through the liver and in to the lungs.

Your doctor may arrange some blood tests and an endoscopy. If a tumor is found on endoscopy, biopsies or small pieces of tissue will be taken for analysis.

They are classified into type 1 to 3 depending on size and spreading potential.

Other tests may be organised including a measurement of your serum gastrin level (gastrin is a neuroendocrine hormone that promotes acid secretion in the stomach) and 5-HIAA or 5-Hydroxyindoleacetic acid, a breakdown product of Serotonin, a messenger that some tumors produce. 

Further tests to ascertain any spread of your tumor may be considered including CT scanning, PET scanning and special scans known as radionucleotide scans or octreotide scanning. Octreotide is a drug which some carcinoids absorb.

How Will My Carcinoid Tumor Be Treated?

Gastric carcinoid's are normally removed surgically if possible.

Type 1 and 2 carcinoids can sometimes be removed endoscopically by a technique known as EMR or endoscopic mucosal resection.

If it has spread or is giving you symptoms, your oncologist may consider treating you with octrotide or somatostatin analogues.

Imatinib (Glivec), Sunitinib (Sutent), Interferon and Everolimus (Afinitor) are targeted therapies that have been used for these tumors.

Other chemotherapy agents have also been tried along with radiotherapy.

If you have evidence of tumor in the liver, interventional radiologists may be able to embolize or block off the blood supply to it by insertion of a drug to clot off the area.

Sometimes chemoembolization is used instead where a combination of a drug to clot off the blood supply and also a chemotherapy agent to kill off the carcinoid is preferred.

What Is the Prognosis In Gastric Carcinoid Tumors?

The prognosis is usually very good in Type 1 and 2 gastric carcinoid with 5 year survival rates of 96.1%. 

In the more aggressive, type 3 form the 5 year survival is not so good at about 33%.

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