What Is It?

Carcinoid tumors have been called “cancers in slow motion.” They grow slowly and are less likely than other tumors to spread (metastasize) to other parts of the body.

Most carcinoid tumors originate in the small intestine, but about 10 percent originate somewhere in the lungs. Carcinoid tumors of the lung make up only 1 percent to 3 percent of all lung cancers.

Some carcinoid tumors produce hormones that can cause a number of symptoms, but carcinoid tumors in the lung are much less likely to do so.

There are two types of carcinoid tumors of the lung: typical and atypical. Typical carcinoid tumors are about nine times more common than atypical carcinoid tumors, and are less likely to spread beyond the lungs.

Carcinoid tumors of the lung occur equally in women and men, and appear mostly in people ages 45 to 55.

Carcinoid tumors tend to occur near the center of the lungs. For this reason, more common symptoms include coughing up blood or pneumonia. Sometimes, these tumors don’t produce any symptoms, and are found on a routine chest X-ray. The severity and range of symptoms depend on the size of the tumor and whether it produces abnormal hormones. Potential symptoms include:

• A persistent cough
• Coughing up blood (hemoptysis)
• Shortness of breath or wheezing
• Pneumonia (a lung infection)
• Facial flushing
• Diarrhea
• Fast heartbeat
• Weight gain
• Increased facial and body hair

Carcinoid tumors can be seen on routine chest X-rays and computed tomography (CT) scans. When a tumor is seen on an X-ray or CT scan, your doctor will need to remove cells from the tumor so they can be examined under a microscope. This is called a biopsy. A lung biopsy can be taken in several ways:

• In bronchoscopy, a fiber-optic viewing tube is passed into the lungs through your airways. It allows your doctor to examine the tumor directly and also to remove cells for examination. This procedure is most effective when the tumor is located near the center of the lung.
• Needle biopsy is a technique for removing cells from tumors outside the central airways. Guided by a CT scan, the doctor inserts a long needle between the ribs and uses it to remove (aspirate) tissue from the tumor.
• Thoracotomy, or surgically opening the chest cavity, may be necessary to obtain a biopsy in some cases.

If your doctor suspects that you have a carcinoid tumor, he or she also may order blood and urine tests that would detect any abnormal hormones the tumor might be producing.

A noninvasive test called octreotide scintigraphy can help determine if the carcinoid tumor has spread beyond the lungs. A small amount of a radioactive drug is injected into a vein. The drug is attracted to carcinoid tumors. Your doctor will use a camera that detects radioactivity to see where the drug accumulates.

As with any cancer, even if carcinoid tumors disappear (go into remission), there is a chance they can recur.

Unlike most lung tumors, carcinoid tumors have not been associated with smoking, air pollution or other chemical exposures. There are no known ways to prevent this type of cancer.

Surgery is the primary treatment for carcinoid tumors. There are several surgical options. When the tumor is located in a large airway, the surgeon may do a sleeve resection, in which the section of the airway containing the tumor is removed. Small carcinoid tumors at the edges of a lung may require a wedge resection, in which a small wedge of lung is removed. More extensive carcinoid tumors may require removal of a lobe of a lung (lobectomy) or an entire lung (pneumonectomy).

Carcinoid tumors usually do not respond to chemotherapy. New types of chemotherapy are being studied to see if they can help people who have tumors that have spread to other parts of the body.

A drug called octreotide (Sandostatin) can be used when carcinoid tumors are disrupting the body’s hormones. The drug is chemically related to a natural hormone called somatostatin. It is used to relieve flushing, diarrhea and other symptoms of carcinoid syndrome. There is some evidence that it also may help inhibit or reverse tumor growth as well. Octreotide isn’t a cure, however, and is used only when the disease has spread.

Another drug, called MIBG (for metaiodobenzylguanidine), is taken up by carcinoid cells and damages them. Researchers are studying MIBG to see if it is effective.

Most people diagnosed with lung carcinoid tumors do not have symptoms. Instead, the tumors are often seen on chest X-rays taken for other reasons.

If you have symptoms of carcinoid tumors of the lung, contact your doctor for an evaluation as soon as possible.

Because carcinoid tumors grow and spread slowly, they often are discovered at an early stage. The prognosis for people with early-stage typical carcinoid tumors of the lung is usually very good. Atypical carcinoid tumor is more likely to have spread to nearby tissues or lymph nodes. Survival rates are lower for people with atypical carcinoid tumors and carcinoid tumors that have spread to other parts of the body.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.