Gastrointestinal (GI) Oncology Program

Patient and Family Education

Gastrointestinal Carcinoid Tumor

Treatment Options

There are four primary treatment options for patients with gastrointestinal carcinoid tumors: surgery, radiation therapy, biological therapy, and chemotherapy. The choice of which to use depends on the extent of the cancer and the patient’s overall health.

Surgery

Many gastrointestinal carcinoid tumors can be cured by surgery. Depending on where the cancer started, the doctor may take out the cancer using one of the following operations:

A simple appendectomy to remove the appendix. If part of the colon is also taken out, the operation is called a hemicolectomy. The doctor may also remove lymph nodes and look at them under a microscope to see if they contain cancer.
Local excision uses a special instrument inserted into the colon or rectum through the anus to cut the tumor out. This operation can be used for very small tumors.
Fulguration uses a special tool inserted into the colon or rectum through the anus. An electric current is then used to burn the tumor away.
Bowel resection takes out the cancer and a small amount of healthy tissue on either side. The healthy parts of the bowel are then sewn together. The doctor will also remove lymph nodes and have them looked at under a microscope to see if they contain cancer.
Cryosurgery kills the cancer by freezing it.
Hepatic artery ligation cuts and ties off the main blood vessel that brings blood into the liver (the hepatic artery).
Hepatic artery embolization uses drugs and other agents to reduce or block the flow of blood to the liver in order to kill cancer cells growing in the liver.
Side effects: The side effects of surgery depend on the location of the tumor and the type of operation, among other factors. Patients are often uncomfortable during the first few days after surgery, but the pain can usually be controlled with medicine. The recovery period after an operation varies from patient to patient.

Radiation Therapy

Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy). Usually external-beam radiation is used for gastrointestinal carcinoid tumors. It has not been proven to be effective at curing the cancer, so it is generally used to relieve pain.

Side effects: The most common side effects of radiation therapy are tiredness, skin reactions in the treated areas (such as a rash or redness), and loss of appetite. Radiation therapy may also cause a decrease in the number of white blood cells that help protect the body against infection. Most of these side effects can be treated or controlled and in most cases they are not permanent.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Most anticancer drugs are injected into a vein (IV) or muscle, but some are given by mouth. Chemotherapy is a systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body to kill cancerous cells. It is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on. Gastrointestinal carcinoid tumors are not usually sensitive to chemotherapy, so this treatment is usually used to relieve symptoms when cancer has spread.

Side effects: Chemotherapy drugs generally fight rapidly dividing cells in the body. Cells that divide rapidly include both the targeted cancer cells and healthy cells in the blood, digestive tract, and hair follicles. Depending on which anticancer drugs a patient receives, he or she may experience symptoms when healthy cells are damaged along with the cancer cells. If healthy blood cells are destroyed by chemotherapy, the patient may be more susceptible to infections, bruising or bleeding, and fatigue. When cells in the hair roots or digestive tract are affected by anticancer drugs, the patient may have hair loss, nausea, vomiting, or mouth sores. Not all chemotherapy patients develop all of these side effects, and the symptoms usually go away during the recovery period or after the treatments are done. Doctors can prescribe medicines and other treatments to control most of the symptoms.

Biological Therapy

Biological therapy (or immunotherapy) is treatment to help the body’s own immune system fight cancer. Materials made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy. Doctors are studying ways to use biological therapy along with other treatments to prevent the recurrence of stomach cancer.

Side effects of biological therapy: Depending on the type of treatment used, biological therapy can cause symptoms resembling those that occur following other forms of therapy: rashes, susceptibility to bruising and bleeding, or flu-like symptoms such as nausea, vomiting, diarrhea, and fever. Because these symptoms may be severe, patients may be hospitalized during treatment.

This page was last updated on: October 5, 2009.

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