What is the Role of Surgery in Carcinoid Tumours

Carcinoid tumour Overview

Carcinoid tumours are benign or non-cancerous tumours that originate in neuroendocrine cells. After its development, a carcinoid tumour keeps growing. Plus, it also keeps releasing chemicals due to which individuals start showing symptoms. Because carcinoid tumours originate in neuroendocrine cells, they are also called neuroendocrine tumors.

All organs in the body have neuroendocrine cells. But they are primarily found in the digestive or gastrointestinal system. They produce hormones and liberate the juices that aid digestion. Neuroendocrine cells tend to become cancerous due to their vulnerability to alterations. When becoming cancerous, they go out of control which is the primary cause of carcinoid tumours.

While there are many options for carcinoid tumour treatment, surgery is the best among them.

Organs Where Carcinoid Tumour Starts

In most cases, a carcinoid tumour starts in the lower part of the small intestine or the ileum. However, it can also occur in different parts of the body. It occurs in the following organs:

• Stomach
• Rectum
• Pancreas
• Ovaries
• Lungs
• Kidneys
• Appendix

How common are carcinoid tumours? What is carcinoid syndrome?

Carcinoid tumours are rare and they affect nearly 4 out of 100,000 adults. Carcinoid syndrome refers to the set of symptoms due to the chemicals released by carcinoid tumours. On average, it affects about 10% of people who develop carcinoid tumours.

What are the causes and symptoms of a neuroendocrine tumour?

Neuroendocrine tumour specifically affects people who have the following medical conditions:

• A chronic inflammatory disease in the GI tract, namely atrophic gastritis
• Small bowel neuroendocrine tumour
• Multiple endocrine neoplasias
• Tuberous sclerosis complex
• Von Hipple Lindau disease
• Neurofibromatosis type 1

In most cases, the symptoms of carcinogenic cancer are not visible. However, there are certain symptoms that individuals who are affected by a neuroendocrine tumour display. These include the following:

• Wheezing
• Inexplicable weight loss
• Shortness of breath
• Rectal bleeding
• Nausea and vomiting
• Hypotension or low blood pressure
• Yellow skin or jaundice
• Damage of the heart muscle or heart murmur
• Weakness or fatigue
• Diarrhoea
• Low red blood cells or anaemia
• Abdominal pain

Knowing the cause of a carcinoid tumour, as well as its symptom, is essential. This plays a vital role in the determination of the surgery for its treatment.

The role of surgery in carcinoid tumour treatment

Surgery is the best way to treat a carcinoid tumour. If you are diagnosed with this form of tumour, your surgeon may recommend one of the available options for its surgery. In comparison to the other options, surgery can reduce your tumour bulk and improve your quality of life by treating the symptoms. For this to happen, it is necessary to choose the right kind of treatment option.

The different kinds of neuroendocrine tumour surgery include the ones given below.

1. Pancreatic Neuroendocrine Tumour Surgery

Your surgeon will recommend one of the following surgeries to treat your pancreatic neuroendocrine tumour:

• Cytoreduction or debulking surgery to remove cancer if it has spread to different parts of the body
• Enucleation to only remove the tumour if it occurs in only one side of the pancreas
• Distal pancreatectomy to remove both the tail and the body of the pancreas
• Pancreatoduodenectomy to remove the pancreatic head and many other organs like the bile duct, the small intestine, the stomach, the lymph nodes, and the gall bladder

2. Gastrointestinal Tumour Surgery

As a part of gastrointestinal tumour surgery, your doctor will recommend one of the following surgery options: 

• Small bowel resection to either remove the small intestine fully or some of its parts and the organs to which the tumour spreads 
• Segmental colon resection or hemicolectomy to remove the colon, the tissue near it, lymph nodes, and blood vessels
• Resection to remove an entire organ in which cancer can be detected
• Local excision to remove a tumour and a small part of the tissue around the tumour
• Liver transplant to entirely remove the liver and replace it with a healthy liver
• Liver resection to remove that portion of the liver which has cancer
• Gastrectomy to remove the entire stomach
• Endoscopic resection to remove a tumour inside the gastrointestinal tract (GI)
• Cytoreduction to surgically remove cancer when cancer spreads to the other parts of the body
• Cryosurgery or cryotherapy to remove the tissue that causes neuroendocrine tumour
• Cholecystectomy for removing the gallbladder
• Appendectomy for the removal of the appendix

3. Lung Neuroendocrine Tumour Surgery

In the case of lung neuroendocrine tumour surgery, your surgeon may recommend one of the following surgery options:

• Lobectomy for removing the lung’s entire lobe
• Lymph node dissection for removing lymph nodes
• Pneumonectomy to remove the entire lung
• Sleeve resection to remove your tumour and bronchioles
• Wedge resection to remove the healthy tissue around your tumour shaped like a wedge
• Liver resection to remove the whole of the liver

4. Partial Nephrectomy and Robotic Nephrectomy

If a carcinoid tumour affects the kidneys, your doctor will either perform a partial nephrectomy or a robotic nephrectomy. The former refers to the process of removing a cancer tumour manually by keeping as much kidney tissue as possible, whereas the latter is performed with the help of a robot.

Takeaway

A carcinoid tumour may affect a wide range of organs. Its proper diagnosis is necessary to determine the right surgical option. Surgery for removing a carcinoid tumour is an ideal solution that improves the lives of individuals who are affected by a neuroendocrine tumour. Your doctor will perform one of the above surgeries to remove a cancerous tumour.