Localized Gastrointestinal Carcinoid Tumors
Regional Gastrointestinal Carcinoid Tumors
Metastatic Gastrointestinal Carcinoid Tumors
Recurrent Gastrointestinal Carcinoid Tumors

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with localized gastrointestinal carcinoid tumor ¹.

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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with regional gastrointestinal carcinoid tumor ².

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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with metastatic gastrointestinal carcinoid tumor ³.

Treatment of recurrent gastrointestinal carcinoid tumors may include the following:

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

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent gastrointestinal carcinoid tumor ⁴.

Glossary Terms

A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed.

The opening of the rectum to the outside of the body.

A small, fingerlike pouch that sticks out from the cecum (the first part of the large intestine near the end of the small intestine).

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called immunotherapy, biotherapy, biological response modifier therapy, and BRM therapy.

The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called the intestine.

A surgical procedure in which the doctor creates a new pathway for the flow of body fluids.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A slow-growing type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

A combination of symptoms caused by the release of serotonin and other substances from carcinoid tumors of the gastrointestinal tract. Symptoms may include flushing of the face, flat angiomas (small collections of dilated blood vessels) of the skin, diarrhea, bronchial spasms, rapid pulse, and sudden drops in blood pressure.

A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

A procedure in which tissue is frozen to destroy abnormal cells. This is usually done with a special instrument that contains liquid nitrogen or liquid carbon dioxide. Also called cryoablation.

Refers to cancer that has spread from the original (primary) tumor to distant organs or distant lymph nodes. Also known as distant metastasis.

The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor.

Removal by surgery.

A procedure to destroy tissue (such as a tumor) using an electric current. Also called electrofulguration.

GI. Refers to the stomach and intestines. Also called GI.

The major blood vessel that carries blood to the liver.

Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called hormonal therapy, hormone treatment, or endocrine therapy.

The process of tying off blood vessels so that blood cannot flow to a part of the body or to a tumor.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

Treatment that affects cells in the tumor and the area close to it.

Restricted to the site of origin, without evidence of spread.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

Having to do with metastasis, which is the spread of cancer from one part of the body to another.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

A glandular organ located in the abdomen. It makes pancreatic juices, which contain enzymes that aid in digestion, and it produces several hormones, including insulin. The pancreas is surrounded by the stomach, intestines, and other organs.

An injection of ethanol (alcohol) through the skin directly into the tumor to kill cancer cells.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

A procedure that uses radio waves to heat and destroy abnormal cells. The radio waves travel through electrodes (small devices that carry electricity). Radiofrequency ablation may be used to treat cancer and other conditions.

An unstable form of a chemical element that releases radiation as it breaks down and becomes more stable. Radioisotopes may occur in nature or be made in a laboratory. In medicine, they are used in imaging tests and in treatment. Also called radionuclide.

The last several inches of the large intestine closest to the anus.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

Treatment with anticancer drugs directed to a specific area of the body.

A procedure that uses surgery to remove tissue or part or all of an organ.

The part of the digestive tract that is located between the stomach and the large intestine.

A ring-shaped muscle that relaxes or tightens to open or close a passage or opening in the body. Examples are the anal sphincter (around the opening of the anus) and the pyloric sphincter (at the lower opening of the stomach).

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.