The most important treatment modality for the carcinoid syndrome is octreotide, a synthetic hormone similar in structure to the naturally-occurring hormone, somatostatin. Somatostatin is widely distributed in the body where it can inhibit the secretion of many other hormones including growth hormone, insulin, and gastrin. It exerts its action by binding to specific receptors on the membranes of cells that produce and release hormones and chemical substances.

Octreotide is an agent chemically related to a natural hormone, somatostatin. It is very helpful in treating the flushing, diarrhea, and wheezing from carcinoid syndrome. While this drug rarely shrinks carcinoid tumors, it may slow or stop their growth. Although this is not curative, it can prolong life. The main side effects are pain at the site of the injection, and rarely, stomach cramps, nausea, vomiting, headaches, dizziness, and fatigue. Octreotide causes sludging of bile and may cause gallstones in the gallbladder (cholelithiasis). It can also result in insulin resistance that can make pre-existing diabetes more difficult to control.

This drug has become available as a long-acting injection that needs to be given only once a month, which may help patients more than the short-acting version. A similar drug, lanreotide, is also being studied, as is a newer agent called pasireotide.

 Interferons are natural substances that normally activate the body’s immune system. They also slow the growth of tumor cells. Interferon-alfa is sometimes helpful in shrinking or slowing the growth of metastatic neuroendocrine cancers and improving symptoms of carcinoid syndrome. Its usefulness is sometimes limited by its flu-like side effects, which may be severe. The drug is given by injection.

An antihistamine called cyproheptadine can help relieve some symptoms. Other medicines are also available to control specific symptoms. Please ask your doctor about these, or describe your symptoms to your doctor and ask about medicines to control them.

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