Rare Cancer in Adulthood - Carcinoid/ Carcinoid Tumors

Carcinoid is a slow-growing type of neuroendocrine tumor, arisen from the malignant cells of the neuroendocrine system, but it can produce hormones and release them into the bloodstream, causing symptoms of flushing in the face and chest and wheezing. Approximately 75–87% The tumors found in the digestive tract such as appendix, small bowel, stomach. etc. at the level of the ileum and 28% in the respiratory tract of all cases.

Symptoms
1. Abdominal pain and cramps
Due to the tumor in the abdomen has affected the nerve of the area.
2. Symptoms due to production of hormones from the cancer
a. Facial flushing
b. Chest flushing
c. Diarrhea
d. Wheezing
e. Etc.

Causes and risk factors
1. Family history
Increased risk of carcinoid for people with family history with the disease.
2. Health condition
Certain chronic health conditions, such as a peptic ulcer or Zollinger Ellison syndrome can increase risk of the carcinoid.
3. Race
Black men of African descent are at higher risk than other races.
4. Gender
Women are at higher risk of carcinoid before the age of 50, but the risk reverses after that
5. Smoking
A study in Europe also found that smoking may double the risk of having a carcinoid tumor in the small intestine than non smokers
6. Syndrome
Family syndrome with multiple endocrine neoplasia 1 (MEN1) is at higher risk of the disease.
7. Etc.

Grades
The grade of mesothelioma are depending to the tendency of spreading. Low grade cancers usually grow more slowly and are less likely to spread while high grade cancer indicates otherwise.

Stages
Carcinoid is classified as 5 stages
1. Stage 0
If the cancerous cell have not penetrated into deeper tissue and remain on the surface of the organ.
2. Stage I
In stage I, the cancerous cells are no longer in the surface but have invaded into deep the inside tissue lining but still completely inside the affected organ.
a. Stage IA
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1:
The spreading is not less than 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2:
The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.
b.Stage IB:
The cancer in this stage have invaded the other tissue of the organ, & less than 5mm (1/5 inch).
b.1. Stage IB1:
Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:
Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)
3. Stage IIIn stage II, the cancerous cells have spread to distant tissues, but is still within the affected organ.

4. Stage III
In this stage, cancerous cells has spread to the tissues immediately surrounding the affected organ.

5. Stage IV
In this stage, cancerous cells has spread to the tissue immediately outside of the affected organ to distant parts of the body.

Diagnosis and test
After recording your family history and symptoms of above, a physical exam is to check for any sign of tumor,especially in the abdominal region.
1. Urinary and blood test
The tests is to measure the levels of the levels of serotonin or its by-products such as 5-hydroxyindoleacetic acid (5-HIAA), neuropeptide, neurotensin, secretin, etc. over 24 hours period, the higher levels may be an indication of carcinoid. Serotonin-rich foods such as pineapple, eggplant, walnuts, banana, etc. may interfere with result make sure you follow the instruction your doctor before taking the tests.

2. Chest x ray
If your doctor suspected the cancer has spread to the lung or the primary cancer is in the lung.

3. CT scan
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details. The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes. Unfortunately, CT scan can only review the existence of cancer, but can not tell it is a primary or secondary cancer.

4. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the tissue, the organ and surrounding areas.

5. Positron emission tomography (PET)
Positron emission tomography (PET) is a type of nuclear medicine imaging with the uses of small amounts of short-lived radioactive material, either injected into a vein, swallowed or inhaled as a gas which will appear in the area of the body being examined, where it gives off energy in the form of gamma rays detected by a camera of positron emission tomography that produces a three-dimensional image or picture of functional processes of the organ in the body.

6. Etc.


Preventions
A. How to avoid
1. People with stomach pain and ulcer may have carcinoid growth in the stomach without knowing, because it is slow grow and most of time it can be discovered before causing any symptoms or problem.
2. Quit smoking
Since smoking double the risk of carcinoid, stop smoking can reduces it.
3. Etc.

B. Diet
Although there no effective way in preventing the development of carcinoids, eating foods contains high amount of antioxidants and have been found to have some effects in killing cancers in certain studies might be helpful in preventing the disease.
1. Green tea
Green tea contain low levels of oxalate and some researchers believe that the amount of oxalate may already absorbed by the digestive system, before it has the change to enter the body . In some clinical studies researchers suggested that the polyphenols in green tea, may play an important role in the prevention of cancer by killing cancerous cells and stopping their progression.

2. Grape
Grape contains high amount of resveratrol which in some clinical studies of resveratrol, researchers found that resveratrol demonstrated an ability to reduce tumors already in existence, prevent cellular damage, and work to increase the effectiveness of chemotherapy.

3. Cruciferous vegetables
Cruciferous vegetables such as cauliflower, broccoli, cabbage, etc. beside contain high amount of antioxidants, but also phytonutrients that have been shown to help prevent the onset and halt the progression of certain cancers.

4. Carrot
In a study from the University of Newcastle upon Tyne (UK) and the University of Southern Denmark (Odense) used a rat model to study the effect of carrots and falcarinol on tumor development, researchers found that found a diet rich in carrots provides anticancer benefits due to the activity of the chemical falcarinol.

5. Soy
In laboratory studies, saponins have shown the ability to inhibit the reproduction of cancer cells and slow the growth of tumors in several different tissues.

6. Etc.

C. Nutritional supplements
1. Antioxidant - free radical scavengers
Vitamin A, C, E are free radical scavengers enhanced the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth. For more information of how antioxidants help to treat cancer, click here

2. Beta -carotene
In some laboratory, animal, and human studies, researchers found that vitamin A, certain retinoids may also inhibit cancer development.

3. Indole-3-carbinol
Cabbage, a curciferous vegetables contains high amount of indole-3-carbinol, a chemical which boosts DNA repair in cells and appears to block the growth of cancer cells.

4. Modified citrus pectin
In a study, researcher found modified citrus pectin may help block the growth and metastasis of solid tumors.

5. Phytochemicals
Phytochemicals are under active research for possible benefits immune system, and as anti-cancer agents. Flavonoids found abundant in berry, inhibit caner cell in vitro study.

6. Etc.

Treatments
A. In conventional medicine
1. Surgery
In most cases, due to slow growth over a long period of time before it can cause any symptom, carcinoid is discovered in operation of other diseases and it is removed in the same surgery.

2. Radiotherapy
a. By using high-energy x-rays or other types of radiation, radiation therapy kills lung cancer cells and keep them from growing or regrowing. Depending to stage or grade there are two types of radiation therapy. In carcinoma, radiotherapy is useful when it is cauing symptoms or the recurrence of the cancer.
b. Side effects
b.1.. Fatigue
b.2. Chest pain
b.3. Heart problem
b.4. Short of breath
b.5. Skin discoloration or pinkness, irritation.
b.6. Etc.

3. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of indolent lymphomas, as it has spread to a distant parts of the body by using drugs, such as streptozotocin, 5-flourouracil, dacarbazine, etc. taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells. In carcinoma, chemotherapy is not very sensitive, but can be helpful to relieve symptoms caused hormonal change.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

4. Embolization
a. Embolization is a minimally invasive treatment to block the blood vessels or vascular channels of the cancer. In carcinoma, by injecting certain substance into the artery that feeds the tumor to block the blood supply to the tumor, thus reducing the symptoms caused by 5-ht, under guiding of x ray image.
b. Risks and side effects
1. Fever
2. Pain in the affected area.
3. Nausea and vomiting
4. Etc.

B. Herbal medicine
1. Fenugreek
Fenugreek is used both as a herb (the leaves) and as a spice (the seed), genus Trigonella, belonging to family Fabaceae. Vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers.

2. Celandine
Celandine is a herbaceous perennial plant, genus Chelidonium, belonging to the family Papaveraceae, native to Europe and western Asia and introduced widely in North America.
In a study of Ukrain (Ukrain is an anticancer drug based on the extract of the plant)– a new cancer cure? A systematic review of randomised clinical trials, researcher suggested, according to the data from randomised clinical trials that Ukrain to have potential as an anticancer drug. However, numerous caveats prevent a positive conclusion, and independent rigorous studies are urgently needed.

3. Asparagus Cochinchinensis
In vitro studies researchers found that curcumin acts as a weak phytoestrogen, exhibits neuroprotective, antiproliferative and preventative effects against cancer.

4. Absinthe
Absinthe is also known as Wormwood, a distilled, highly alcoholic beverage flowers extracted from leaves of the herb Artemisia absinthium. In a study, researchers at the University of Washington found that wormwood can be used as a promising potential treatment for cancer.

5. Aloe
in some studies, researchers suggest that some chemical compounds of aloe, such as acemannan, aloeride, and di(2-ethylhexyl)phthalate (DEHP) may have immunomodulating and anticancer effects.

6. Etc.

C. Traditional Chinese medicine
1. Dang qui
Dang qui is also known as Chinese angelica root. A study published in the journal Life Sciences in August 2004 showed that an extract of Dang qui was able to slow the proliferation of several different types of cancer cells in vitro.

2. Huang Qi
In study of Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials, researchers found that astragalus may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.
According to the American Cancer Society, the substances, licochalcone-A, licocoumarone and glabridin, which are present in licorice root, may prevent mutations in the DNA and kill existing cancer.

3. Pu Kong Yin (Dandelion Root)
In a study of the efficacy of dandelion root extract in inducing apoptosis in drug-resistant human melanoma cells, researchers found that treatment with this common, yet potent extract of natural compounds has proven novel in specifically inducing apoptosis in chemoresistant melanoma, without toxicity to healthy cells.

4. Bai Hua She She Cao
The Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine, National University of Singapore researcher results showed that the ethanol extract from Bai Hua She She Cao effectively evokes cancer cell apoptosis, possibly through burst-mediated caspase activation.

5. Jie Geng
The Researchers found that aponins in Jie Geng have been shown to very significantly augment the cytotoxicity of immunotoxins and other targeted toxins directed against human cancer cells.

6. Etc.

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