Tests, Treatments & Therapies for Gastrointestinal Carcinoid Tumors

At the University of Colorado Cancer Center, we use the most minimally invasive approach possible for both diagnosis and treatment of gastrointestinal carcinoid tumors. We recognize that both work-up and management requires a multidisciplinary approach with numerous specialists working closely together.

We use both standard treatments and those being tested in clinical trials. You might consider participating in a trial, which are designed to improve current treatments or get information on new treatments. If a new treatment is proven better than the standard treatment, the new treatment may become the standard treatment.

Staging and Detection Tests

Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:

  • Different types of scans
  • Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)

Scans and other tests may also be used:

  • In a “surveillance program” looking for any signs of relapse after treatment
  • In a “screening program” to detect cancer early in individuals at high-risk
  • To monitor responses to treatment

Tests that may be used include:

Blood, urine tests – Simple tests that help test for disease and guide treatment.

Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.

Types of scans and procedures include:

Barium swallow – You swallow barium liquid, and it flows through the esophagus and into the stomach. X-rays are taken to look for abnormal areas.

Bone scan – An imaging test to detect bone abnormalities. It is done through magnetic resonance imaging (MRI), X-ray computed tomography (CT) or nuclear medicine.

Endoscopy – A thin, lighted tube, called an endoscope, is used to look inside the first part of the stomach to check for abnormal areas and could possibly biopsy these areas. May also be used in combination with ultrasound.

Radionuclide scans – These scans use small amounts of radioactivity and special cameras to locate carcinoid tumors.

Ultrasound – High-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.

PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. You get an injection of a short-lived radioactive substance before having the scan. Cancerous tissue will build up more of the substance and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, can also sometimes “light up.”

Treatment & Therapy for Gastrointestinal Carcinoid Tumors

The following treatments may be used alone or in combination to treat stomach cancer.

Surgery

A surgical oncologist –  a doctor who specializes in cancer operations-will perform an operation to remove the tumor and other areas that are affected by cancer.

Appendectomy – Your appendix is removed, sometimes laparascopically-using small incisions.

Bowel resection and anastomosis – The surgical oncologist removes the bowel tumor and a small section of healthy bowel on each side. The healthy parts of the bowel are then sewn together. Lymph nodes are removed and checked for cancer.

Fulguration – The surgical oncologist uses a special tool that employs an electric current to burn away the tumor.

Hepatic artery ligation or embolization – The surgical oncologist ties or blocks off the main blood vessel that brings blood into the liver. Blocking the flow of blood to the liver helps kill cancer cells growing there.

Hepatic resection – The surgical oncologist removes part or all of the liver.

Radiofrequency ablation – The surgical oncologist uses a special probe with tiny electrodes that release high-energy radio waves (similar to microwaves) that kill cancer cells.

Radiation Therapy (“Radiotherapy”):

Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:

  • Kill cancer cells
  • Prevent cancer cells from developing or recurring
  • Improve many of the symptoms caused by cancer

Radiation therapy can be:

  • Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
  • Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
  • Almost as effective as surgery in people who are not fit enough for an operation
  • Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)

Chemotherapy and other drug-based treatments:

Anti-cancer drug treatments – Chemotherapy-and new “targeted therapies”-involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.

View current stomach cancer clinical trials available at UCCC.

Anti-cancer drug treatments may involve:

  • Single drugs or combinations of drugs
  • Intravenous injections or tablets/capsules
  • Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
  • Taking some drugs every day or only on a few days within the cycles
  • Taking other medicines to reduce or eliminate side effects associated with chemotherapy
  • Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
  • Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials

Chemotherapy and targeted therapies can:

  • Be given before surgery to make the operation easier
  • Be given in combination with radiotherapy to make both treatments more effective
  • Be given after surgery to reduce the chances of cancer coming back
  • Successfully control advanced cancer and many cancer-related symptoms

Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing.

  • Hormones are substances produced by glands in the body and circulated in the bloodstream
  • The presence of some hormones can cause certain cancers to grow
  • If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working

MIBG (metaiodobenzylguanidine)

MIBG is a drug therapy that is sometimes used with or without radioactive iodine to lessen symptoms of gastrointestinal carcinoid tumors.

Biologic Therapy (biotherapy or immunotherapy

Biologic therapy uses your immune own system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.

Clinical Trials

The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:

  • New drugs
  • New combinations of therapies
  • New treatment delivery methods

Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center-one of only 39 in the United States-your treatment will always include the latest and most comprehensive care options.

Learn more about clinical trials at UCCC.