General Information About Gastrointestinal Carcinoid Tumors
Stages of Gastrointestinal Carcinoid Tumors
Treatment Option Overview
Treatment Options for Gastrointestinal Carcinoid Tumors
To Learn More About Gastrointestinal Carcinoid Tumors
Get More Information From NCI
Changes to This Summary (02/03/2012)
About PDQ
General Information About Gastrointestinal Carcinoid Tumors
A gastrointestinal carcinoid tumor is cancer that forms in the lining of the gastrointestinal tract.
The gastrointestinal (GI) tract is part of the body's digestive system. It helps to digest food, takes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from food to be used by the body and helps pass waste material out of the body. The GI tract is made up of these and other organs:
- Stomach.
- Small intestine (duodenum, jejunum, and ileum).
- Colon.
- Rectum.
Gastrointestinal carcinoid tumors form from a certain type of neuroendocrine cell (a type of cell that is like a nerve cell and a hormone -making cell). These cells are scattered throughout the chest and abdomen but most are found in the GI tract. Neuroendocrine cells make hormones that help control digestive juices and the muscles used in moving food through the stomach and intestines. A GI carcinoid tumor may also make hormones and release them into the body.
GI carcinoid tumors are rare and most grow very slowly. Most of them occur in the appendix, small intestine, and rectum. Sometimes more than one tumor will form.
See the following PDQ summaries for more information related to GI and other types of carcinoid tumors:
- Non-Small Cell Lung Cancer Treatment 1.
- Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment 2.
- Rectal Cancer Treatment 3.
- Small Intestine Cancer Treatment 4.
- Unusual Cancers of Childhood 5
Health history can affect the risk of gastrointestinal carcinoid tumors.
Anything that increases a person's chance of developing a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk.
Risk factors for GI carcinoid tumors include the following:
- Having a family history of multiple endocrine neoplasia type 1 (MEN1) syndrome or neurofibromatosis type 1 (NF1) syndrome.
- Having certain conditions that affect the stomach's ability to make stomach acid, such as atrophic gastritis, pernicious anemia, or Zollinger-Ellison syndrome.
Some gastrointestinal carcinoid tumors have no symptoms in the early stages.
The growth of the tumor and/or the hormones the tumor makes may cause symptoms. Some tumors, especially tumors of the stomach or appendix, may not cause symptoms. Carcinoid tumors are often found during tests or treatments for other conditions.
Carcinoid tumors in the small intestine (duodenum, jejunum, and ileum), colon, and rectum sometimes cause symptoms as they grow or because of the hormones they make. Other conditions may cause the same symptoms. Talk to your doctor if any of the following symptoms occur.
- Duodenum
Symptoms of GI carcinoid tumors in the duodenum (first part of the small intestine, that connects to the stomach) may include the following:
- Abdominal pain.
- Constipation
- Diarrhea.
- Change in stool color.
- Nausea.
- Vomiting.
- Jaundice (yellowing of the skin and whites of the eyes).
- Heartburn.
- Jejunum and ileum
Symptoms of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part of the small intestine, that connects to the colon) may include the following:
- Abdominal pain.
- Weight loss for no known reason.
- Feeling very tired.
- Feeling bloated
- Diarrhea.
- Nausea.
- Vomiting.
- Colon
Symptoms of GI carcinoid tumors in the colon may include the following:
- Abdominal pain.
- Weight loss for no known reason.
- Rectum
Symptoms of GI carcinoid tumors in the rectum may include the following:
- Blood in the stool.
- Pain in the rectum.
- Constipation.
Carcinoid syndrome may occur if the tumor spreads to the liver or other parts of the body.
The hormones made by gastrointestinal carcinoid tumors are usually destroyed by liver enzymes in the blood. If the tumor has spread to the liver and the liver enzymes cannot destroy the extra hormones made by the tumor, high amounts of these hormones may remain in the body and cause carcinoid syndrome. This can also happen if tumor cells enter the blood. Symptoms of carcinoid syndrome include the following:
- Redness or a feeling of warmth in the face and neck.
- Abdominal pain.
- Feeling bloated.
- Diarrhea.
- Wheezing or other trouble breathing.
- Fast heartbeat.
These symptoms and others may be caused by gastrointestinal carcinoid tumors or by other conditions. Talk to your doctor if any of these symptoms occur.
Imaging studies and tests that examine the blood and urine are used to detect (find) and diagnose gastrointestinal carcinoid tumors.
The following tests and procedures may be used:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:
- The number of red blood cells, white blood cells, and platelets.
- The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
- The portion of the sample made up of red blood cells.
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as hormones, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it. The blood sample is checked to see if it contains a hormone produced by carcinoid tumors. This test is used to help diagnose carcinoid syndrome.
- Tumor marker test: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances, such as chromogranin A, made by organs, tissues, or tumor cells in the body. Chromogranin A is a tumor marker. It has been linked to neuroendocrine tumors when found in increased levels in the body.
- Twenty-four-hour urine test: A test in which a urine sample is checked to measure the amounts of certain substances, such as hormones. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it. The urine sample is checked to see if it contains a hormone produced by carcinoid tumors. This test is used to help diagnose carcinoid syndrome.
- Somatostatin receptor scintigraphy (SRS): A type of radionuclide scan used to find carcinoid tumors. In SRS, radioactive octreotide, a drug similar to somatostatin, is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to carcinoid tumor cells that have somatostatin receptors. A radiation -measuring device detects the radioactive material, showing where the carcinoid tumor cells are in the body. This procedure is also called an octreotide scan.
- MIBG scan: A procedure used to find neuroendocrine tumors, such as carcinoid tumors. A very small amount of radioactive material called MIBG (metaiodobenzylguanidine) is injected into a vein and travels through the bloodstream. Carcinoid tumors take up the radioactive material and are detected by a device that measures radiation.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells.
- Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs, such as the stomach, small intestine, colon, or rectum, and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
- Upper endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through the mouth and passed through the esophagus into the stomach. Sometimes the endoscope also is passed from the stomach into the small intestine. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease.
- Colonoscopy: A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.
- Capsule endoscopy: A procedure used to see all of the small intestine. The patient swallows a capsule that contains a tiny camera. As the capsule moves through the gastrointestinal tract, the camera takes pictures and sends them to a receiver worn on the outside of the body.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Tissue samples may be taken during endoscopy and colonoscopy.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
- Where the tumor is in the gastrointestinal tract.
- The size of the tumor.
- Whether the cancer has spread from the stomach and intestines to other parts of the body, such as the liver or lymph nodes.
- Whether the patient has carcinoid syndrome or has carcinoid heart syndrome.
- Whether the cancer can be completely removed by surgery.
- Whether the cancer is newly diagnosed or has recurred.
Stages of Gastrointestinal Carcinoid Tumors
After a gastrointestinal carcinoid tumor has been diagnosed, tests are done to find out if cancer cells have spread within the stomach and intestines or to other parts of the body.
Staging is the process used to find out how far the cancer has spread. The information gathered from the staging process determines the stage of the disease. The results of tests and procedures used to diagnose gastrointestinal carcinoid tumors may also be used for staging. See the General Information 6 section for a description of these tests and procedures. Other tests that may be used for staging include the following:
- Angiogram: A procedure to look at blood vessels and the flow of blood. A contrast dye is injected into a blood vessel near the tumor. As the contrast dye moves through the blood vessel, x-rays are taken to check the blood vessels that go to the tumor.
- Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
- X-ray of the abdomen: An x-ray of the organs and tissues inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The plan for cancer treatment depends on where the carcinoid tumor is found and whether it can be removed by surgery.
For many cancers it is important to know the stage of the cancer in order to plan treatment. However, the treatment of gastrointestinal carcinoid tumors is not based on the stage of the cancer. Treatment depends mainly on whether the tumor can be removed by surgery and if the tumor has spread.
Treatment is based on whether the tumor:
- Can be completely removed by surgery.
- Has spread to other parts of the body.
- Has come back after treatment. The tumor may come back in the stomach or intestines or in other parts of the body.
- Has not gotten better with treatment.
Treatment Option Overview
There are different types of treatment for patients with gastrointestinal carcinoid tumors.
Different types of treatment are available for patients with gastrointestinal (GI) carcinoid tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Four types of standard treatment are used:
Treatment of gastrointestinal carcinoid tumors usually includes surgery. One of the following surgical procedures may be used:
- Endoscopic resection: Surgery to remove a small tumor that is on the inside lining of the GI tract. An endoscope is inserted through the mouth and passed through the esophagus to the stomach and sometimes, the duodenum. An endoscope is a thin, tube-like instrument with a light, a lens for viewing, and a tool for removing tumor tissue.
- Local excision: Surgery to remove the tumor and a small amount of normal tissue around it.
- Resection: Surgery to remove part or all of the organ that contains cancer. Nearby lymph nodes may also be removed
- Cryosurgery: A treatment that uses an instrument to freeze and destroy carcinoid tumor tissue. This type of treatment is also called cryotherapy. The doctor may use ultrasound to guide the instrument.
- Radiofrequency ablation: The use of a special probe with tiny electrodes that release high-energy radio waves (similar to microwaves) that kill cancer cells. The probe may be inserted through the skin or through an incision (cut) in the abdomen.
- Liver transplant: Surgery to remove the whole liver and replace it with a healthy donated liver.
- Hepatic artery embolization: A procedure to embolize (block) the hepatic artery, which is the main blood vessel that brings blood into the liver. Blocking the flow of blood to the liver helps kill cancer cells growing there.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Radiopharmaceutical therapy is a type of radiation therapy. Radiation is given to the tumor using a drug that has a radioactive substance, such as iodine I 131, attached to it. The radioactive substance kills the tumor cells.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Chemoembolization of the hepatic artery is a type of regional chemotherapy that may be used to treat a gastrointestinal carcinoid tumor that has spread to the liver. The anticancer drug is injected into the hepatic artery through a catheter (thin tube). The drug is mixed with a substance that embolizes (blocks) the artery, and cuts off blood flow to the tumor. Most of the anticancer drug is trapped near the tumor and only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on the substance used to block the artery. The tumor is prevented from getting the oxygen and nutrients it needs to grow. The liver continues to receive blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Hormone therapy with a somatostatin analogue is a treatment that stops extra hormones from being made. GI carcinoid tumors are treated with octreotide or lanreotide which are injected under the skin or into the muscle. Octreotide and lanreotide may also have a small effect on stopping tumor growth.
Treatment for carcinoid syndrome may also be needed.
Treatment of carcinoid syndrome may include the following:
- Hormone therapy with a somatostatin analogue stops extra hormones from being made. Carcinoid syndrome is treated with octreotide or lanreotide to lessen flushing and diarrhea. Octreotide and lanreotide may also help slow tumor growth.
- Interferon therapy stimulates the body’s immune system to work better and lessens flushing and diarrhea. Interferon may also help slow tumor growth.
- Taking medicine for diarrhea.
- Taking medicine for skin rashes.
- Taking medicine to breathe easier.
- Taking medicine before having anesthesia for a medical procedure.
Other ways to help treat carcinoid syndrome include avoiding things that cause flushing or difficulty breathing such as alcohol, nuts, certain cheeses and foods with capsaicin, such as chili peppers. Avoiding stressful situations and certain types of physical activity can also help treat carcinoid syndrome.
For some patients with carcinoid heart syndrome, a heart valve replacement may be done.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site 7.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Several types of targeted therapy are being studied in the treatment of GI carcinoid tumors.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Treatment Options for Gastrointestinal Carcinoid Tumors
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Carcinoid Tumors in the StomachTreatment of gastrointestinal (GI) carcinoid tumors in the stomach may include the following:
- Endoscopic surgery (resection) for small tumors.
- Surgery (resection) to remove part or all of the stomach. Nearby lymph nodes for larger tumors, tumors that grow deep into the stomach wall, or tumors that are growing and spreading quickly may also be removed.
For patients with GI carcinoid tumors in the stomach and MEN1 syndrome, treatment may also include:
- Surgery to remove tumors in the duodenum (first part of the small intestine, that connects to the stomach).
- Hormone therapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor 8 and regional gastrointestinal carcinoid tumor 9. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
Carcinoid Tumors in the Small IntestineIt is not clear what the best treatment is for GI carcinoid tumors in the duodenum (first part of the small intestine, that connects to the stomach). Treatment may include the following:
- Endoscopic surgery (resection) for small tumors.
- Surgery (local excision) to remove the tumor, for slightly larger tumors.
- Surgery resection to remove the tumor and nearby lymph nodes.
Treatment of GI carcinoid tumors in the jejunum (middle part of the small intestine) and ileum (last part of the small intestine, that connects to the colon) may include the following:
- Surgery (resection) to remove the tumor and the membrane that connects the intestines to the back of the abdominal wall. Nearby lymph nodes are also removed.
- A second surgery to remove the membrane that connects the intestines to the back of the abdominal wall, if any tumor remains or the tumor continues to grow.
- Hormone therapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor 8 and regional gastrointestinal carcinoid tumor 9. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
Carcinoid Tumors in the AppendixTreatment of GI carcinoid tumors in the appendix may include the following:
- Surgery (resection) to remove the appendix.
- Surgery (resection) to remove the right side of the colon including the appendix. Nearby lymph nodes are also removed.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor 8 and regional gastrointestinal carcinoid tumor 9. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
Carcinoid Tumors in the ColonTreatment of GI carcinoid tumors in the colon may include the following:
- Surgery (resection) to remove part of the colon and nearby lymph nodes, in order to remove as much of the cancer as possible.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor 8 and regional gastrointestinal carcinoid tumor 9. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
Carcinoid Tumors in the RectumTreatment of GI carcinoid tumors in the rectum may include the following:
- Endoscopic surgery (resection) for small tumors.
- Surgery (local excision) to remove slightly larger tumors that have not spread into the muscle layer of the rectal wall.
- Surgery (resection) to remove the top part of the rectum and the left side of the colon, for slightly larger tumors that have may spread to the muscle layer of the rectal wall or nearby tissues. Nearby lymph nodes are also removed.
- Surgery (local excision) to remove as much tumor as possible when the tumor has spread to distant parts of the body. This is palliative therapy to relieve symptoms and improve quality of life.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized gastrointestinal carcinoid tumor 8 and regional gastrointestinal carcinoid tumor 9. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
Metastatic Gastrointestinal Carcinoid TumorsDistant metastases
Treatment of distant metastases of gastrointestinal carcinoid tumors is usually palliative therapy to relieve symptoms and improve quality of life. Treatment may include the following:
- Surgery (resection) to remove as much of the tumor as possible. .
- Hormone therapy.
- Radiopharmaceutical therapy.
- Radiation therapy for cancer that has spread to the bone, brain, or spinal cord.
- A clinical trial of a new treatment.
Liver metastases
Treatment of cancer that has spread to the liver may include the following:
- Surgery resection to remove the tumor from the liver.
- Hepatic artery embolization.
- Cryosurgery.
- Radiofrequency ablation.
- Liver transplant.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with metastatic gastrointestinal carcinoid tumor 11. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
Recurrent Gastrointestinal Carcinoid TumorsTreatment of recurrent gastrointestinal carcinoid tumors may include the following:
- Surgery to remove part or all of the tumor.
- A clinical trial of a new treatment.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent gastrointestinal carcinoid tumor 12. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 10.
To Learn More About Gastrointestinal Carcinoid Tumors
For more information from the National Cancer Institute about gastrointestinal carcinoid tumors, see the following:
- Gastrointestinal Carcinoid Tumor Home Page 13
- Cryosurgery in Cancer Treatment: Questions and Answers 14
- Understanding Cancer Series: Targeted Therapies 15 (Advances in Targeted Therapies)
- Targeted Cancer Therapies 16
For general cancer information and other resources from the National Cancer Institute, see the following:
- What You Need to Know About™ Cancer 17
- Understanding Cancer Series: Cancer 18
- Cancer Staging 19
- Chemotherapy and You: Support for People With Cancer 20
- Radiation Therapy and You: Support for People With Cancer 21
- Coping with Cancer: Supportive and Palliative Care 22
- Cancer Library 23
- Information For Survivors/Caregivers/Advocates 24
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Changes to This Summary (02/03/2012)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Changes were made to this summary to match those made to the health professional version.
About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site 26. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site 10. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Glossary Termsabdomen (AB-doh-men)The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.abdominal (ab-DAH-mih-nul) Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.abnormal (ab-NOR-mul) Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).acid (A-sid) A chemical that gives off hydrogen ions in water and forms salts by combining with certain metals. Acids have a sour taste and turn certain dyes red. Some acids made by the body, such as gastric acid, can help organs work the way they should. An example of an acid is hydrochloric acid. Acidity is measured on a scale called the pH scale. On this scale, a value of 7 is neutral, and a pH value of less than 7 to 0 shows increasing acidity.appendix (uh-PEN-dix) A small, fingerlike pouch that sticks out from the cecum (the first part of the large intestine near the end of the small intestine).biopsy (BY-op-see) The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.blood (blud) A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.blood chemistry study (blud KEH-mih-stree STUH-dee) A procedure in which a sample of blood is examined to measure the amounts of certain substances made in the body. An abnormal amount of a substance can be a sign of disease in the organ or tissue that produces it.cancer (KAN-ser) A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.capsule (KAP-sul) In medicine, a sac of tissue and blood vessels that surrounds an organ, joint, or tumor. A capsule is also a form for medicine that is taken by mouth. It usually has a shell made of gelatin with the medicine inside.carbohydrate (KAR-boh-HY-drayt) A sugar molecule. Carbohydrates can be small and simple (for example, glucose) or they can be large and complex (for example, polysaccharides such as starch, chitin or cellulose).carcinoid (KAR-sih-noyd) A slow-growing type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.carcinoid syndrome (KAR-sih-noyd SIN-drome) A combination of symptoms caused by the release of serotonin and other substances from carcinoid tumors of the gastrointestinal tract. Symptoms may include flushing of the face, flat angiomas (small collections of dilated blood vessels) of the skin, diarrhea, bronchial spasms, rapid pulse, and sudden drops in blood pressure.cell (sel) The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.chromogranin A (KROH-moh-GRA-nin …) A protein found inside neuroendocrine cells, which release chromogranin A and certain hormones into the blood. Chromogranin A may be found in higher than normal amounts in patients with certain neuroendocrine tumors, small cell lung cancer, prostate cancer, and other conditions. Measuring the amount of chromogranin A in the blood may help to diagnose cancer or other conditions or find out how well treatment is working or if cancer has come back. Chromogranin A is a type of tumor marker. Also called CgA.colon (KOH-lun) The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.colonoscope (koh-LAH-noh-SKOPE) A thin, tube-like instrument used to examine the inside of the colon. A colonoscope has a light and a lens for viewing and may have a tool to remove tissue.colonoscopy (KOH-luh-NOS-koh-pee) Examination of the inside of the colon using a colonoscope, inserted into the rectum. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.complete blood count (kum-PLEET blud kownt) A test to check the number of red blood cells, white blood cells, and platelets in a sample of blood. Also called blood cell count and CBC.condition (kun-DIH-shun) In medicine, a health problem with certain characteristics or symptoms.constipation (KON-stih-PAY-shun) A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements don’t happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish.CT scan (… skan) A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.device (dee-VISE) An object that has a specific use. In medicine, wheelchairs, pumps, and artificial limbs are examples of devices.diagnosis (DY-ug-NOH-sis) The process of identifying a disease, such as cancer, from its signs and symptoms.diarrhea (dy-uh-REE-uh) Frequent and watery bowel movements.digestion (dy-JES-chun) The process of breaking down food into substances the body can use for energy, tissue growth, and repair.digestive system (dy-JES-tiv SIS-tem) The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum.drug (drug) Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.duodenum (DOO-ah-DEE-num) The first part of the small intestine that connects to the stomach.endoscope (EN-doh-SKOPE) A thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may have a tool to remove tissue.endoscopic ultrasound (en-doh-SKAH-pik...) A procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument that has a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal organs to make a picture (sonogram). Also called endosonography and EUS.endoscopy (en-DOS-koh-pee) A procedure that uses an endoscope to examine the inside of the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.enzyme (EN-zime) A protein that speeds up chemical reactions in the body.esophagus (ee-SAH-fuh-gus) The muscular tube through which food passes from the throat to the stomach.family history (FA-mih-lee HIH-stuh-ree) A record of the relationships among family members along with their medical histories. This includes current and past illnesses. A family history may show a pattern of certain diseases in a family. Also called family medical history.gastritis (gas-TRY-tis) Inflammation of the lining of the stomach.gastrointestinal (GAS-troh-in-TES-tih-nul) Refers to the stomach and intestines. Also called GI.gastrointestinal carcinoid tumor (GAS-troh-in-TES-tih-nul KAR-sih-noyd TOO-mer) An indolent (slow-growing) cancer that forms in cells that make hormones in the lining of the gastrointestinal tract (the stomach and intestines). It usually occurs in the appendix (a small fingerlike pouch of the large intestine), small intestine, or rectum. Having gastrointestinal carcinoid tumor increases the risk of forming other cancers of the digestive system.gastrointestinal tract (GAS-troh-in-TES-tih-nul trakt) The stomach and intestines. The gastrointestinal tract is part of the digestive system, which also includes the salivary glands, mouth, esophagus, liver, pancreas, gallbladder, and rectum.glucose (GLOO-kose) A type of sugar; the chief source of energy for living organisms.hemoglobin (HEE-moh-GLOH-bin) The substance inside red blood cells that binds to oxygen in the lungs and carries it to the tissues.hormone (HOR-mone) One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.injection (in-JEK-shun) Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."intestine (in-TES-tin) The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called bowel.jaundice (JAWN-dis) A condition in which the skin and the whites of the eyes become yellow, urine darkens, and the color of stool becomes lighter than normal. Jaundice occurs when the liver is not working properly or when a bile duct is blocked.lens (lenz) A clear disk that focuses light, as in a camera or microscope. In the eye, the lens is a clear, curved structure at the front of the eye behind the pupil. It focuses light rays that enter the eye through the pupil, making an image on the retina (light-sensitive layers of nerve tissue at the back of the eye).liver (LIH-ver) A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.lymph node (limf node) A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.malignant (muh-LIG-nunt) Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.medical history (MEH-dih-kul HIH-stuh-ree) A record of information about a person’s health. A personal medical history may include information about allergies, illnesses, surgeries, immunizations, and results of physical exams and tests. It may also include information about medicines taken and health habits, such as diet and exercise. A family medical history includes health information about a person’s close family members (parents, grandparents, children, brothers, and sisters). This includes their current and past illnesses. A family medical history may show a pattern of certain diseases in a family.microscope (MY-kroh-SKOPE) An instrument that is used to look at cells and other small objects that cannot be seen with the eye alone.mineral (MIH-neh-rul) In medicine, a mineral is a nutrient that is needed in small amounts to keep the body healthy. Mineral nutrients include the elements calcium, magnesium, and iron.MRI A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging.multiple endocrine neoplasia type 1 syndrome (MUL-tih-pul EN-doh-krin NEE-oh-PLAY-zhuh ... SIN-drome) A rare, inherited disorder that affects the endocrine glands and can cause tumors in the parathyroid and pituitary glands and the pancreas. These tumors are usually benign (not cancer). They cause the glands to secrete high levels of hormones, which can lead to other medical problems, such as kidney stones, fertility problems, and severe ulcers. In some cases, tumors inside the pancreas can become malignant (cancer). Also called MEN1 syndrome, multiple endocrine adenomatosis, and Wermer syndrome.National Cancer Institute (NA-shuh-nul KAN-ser IN-stih-TOOT) The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI.nausea (NAW-zee-uh) A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.nerve cell (nerv sel) A type of cell that receives and sends messages from the body to the brain and back to the body. The messages are sent by a weak electrical current. Also called neuron.neuroendocrine (NOOR-oh-EN-doh-krin) Having to do with the interactions between the nervous system and the endocrine system. Neuroendocrine describes certain cells that release hormones into the blood in response to stimulation of the nervous system.neuroendocrine tumor (NOOR-oh-EN-doh-krin TOO-mer) A tumor that forms from cells that release hormones in response to a signal from the nervous system. Some examples of neuroendocrine tumors are carcinoid tumors, islet cell tumors, medullary thyroid carcinomas, pheochromocytomas, and neuroendocrine carcinomas of the skin (Merkel cell cancer). These tumors may secrete higher-than-normal amounts of hormones, which can cause many different symptoms.neurofibromatosis type 1 (NOOR-oh-FY-broh-muh-TOH-sis ...) A rare genetic condition that causes brown spots and tumors on the skin, freckling in skin areas not exposed to the sun, tumors on the nerves, and developmental changes in the nervous system, muscles, bone, and skin. Also called NF1.nutrient (NOO-tree-ent) A chemical compound (such as protein, fat, carbohydrate, vitamin, or mineral) contained in foods. These compounds are used by the body to function and grow.octreotide (OK-tree-oh-tide) A drug similar to the naturally occurring growth hormone inhibitor somatostatin. Octreotide is used to treat diarrhea and flushing associated with certain types of tumors.organ (OR-gun) A part of the body that performs a specific function. For example, the heart is an organ.oxygen (OK-sih-jen) A colorless, odorless gas. It is needed for animal and plant life. Oxygen that is breathed in enters the blood from the lungs and travels to the tissues.PDQ PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.pernicious anemia (per-NIH-shus uh-NEE-mee-uh) A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12.PET scan (… skan) A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun) An exam of the body to check for general signs of disease.platelet (PLAYT-let) A tiny piece of a cell found in the blood that breaks off from a large cell found in the bone marrow. Platelets help wounds heal and prevent bleeding by forming blood clots. Also called thrombocyte.polyp (PAH-lip) A growth that protrudes from a mucous membrane.prognosis (prog-NO-sis) The likely outcome or course of a disease; the chance of recovery or recurrence.protein (PROH-teen) A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.radiation (RAY-dee-AY-shun) Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).radioactive (RAY-dee-oh-AK-tiv) Giving off radiation.radionuclide (RAY-dee-oh-NOO-klide) An unstable form of a chemical element that releases radiation as it breaks down and becomes more stable. Radionuclides may occur in nature or be made in a laboratory. In medicine, they are used in imaging tests and in treatment. Also called radioisotope.radionuclide scanning (RAY-dee-oh-NOO-klide SKAN-ing) A procedure that produces pictures (scans) of structures inside the body, including areas where there are cancer cells. Radionuclide scanning is used to diagnose, stage, and monitor disease. A small amount of a radioactive chemical (radionuclide) is injected into a vein or swallowed. Different radionuclides travel through the blood to different organs. A machine with a special camera moves over the person lying on a table and detects the type of radiation given off by the radionuclides. A computer forms an image of the areas where the radionuclide builds up. These areas may contain cancer cells. Also called scintigraphy.receptor (reh-SEP-ter) A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell.recover (ree-KUH-ver) To become well and healthy again.rectum (REK-tum) The last several inches of the large intestine closest to the anus.recur (ree-KER) To come back or to return.red blood cell (red blud sel) A cell that carries oxygen to all parts of the body. Also called erythrocyte and RBC.risk factor (... FAK-ter) Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.scan (skan) A picture of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body.scanner (SKA-ner) In medicine, an instrument that takes pictures of the inside of the body.small intestine (... in-TES-tin) The part of the digestive tract that is located between the stomach and the large intestine.somatostatin receptor scintigraphy (SOH-muh-toh-STA-tin reh-SEP-ter sin-TIH-gruh-fee) A type of radionuclide scan used to find carcinoid and other types of tumors. Radioactive octreotide, a drug similar to somatostatin, is injected into a vein and travels through the bloodstream. The radioactive octreotide attaches to tumor cells that have receptors for somatostatin. A radiation-measuring device detects the radioactive octreotide, and makes pictures showing where the tumor cells are in the body. Also called octreotide scan and SRS.sonogram (SAH-noh-gram) A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called ultrasonogram.stomach (STUH-muk) An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.stool (stool) The material in a bowel movement. Stool is made up of undigested food, bacteria, mucus, and cells from the lining of the intestines. Also called feces.surgery (SER-juh-ree) A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.symptom (SIMP-tum) An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.tissue (TIH-shoo) A group or layer of cells that work together to perform a specific function.tumor (TOO-mer) An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.tumor marker (TOO-mer MAR-ker) A substance found in tissue, blood, or other body fluids that may be a sign of cancer or certain benign (noncancerous) conditions. Most tumor markers are made by both normal cells and cancer cells, but they are made in larger amounts by cancer cells. A tumor marker may help to diagnose cancer, plan treatment, or find out how well treatment is working or if cancer has come back. Examples of tumor markers include CA-125 (in ovarian cancer), CA 15-3 (in breast cancer), CEA (in colon cancer), and PSA (in prostate cancer).ultrasound (UL-truh-SOWND) A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.upper endoscopy (UH-per en-DOS-koh-pee) Examination of the inside of the stomach using an endoscope, passed through the mouth and esophagus. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Also called gastroscopy.urine (YOOR-in) Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.vein (vayn) A blood vessel that carries blood to the heart from tissues and organs in the body.vitamin (VY-tuh-min) A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.vomit (VAH-mit) To eject some or all of the contents of the stomach through the mouth.white blood cell (hwite blud sel) A type of immune cell. Most white blood cells are made in the bone marrow and are found in the blood and lymph tissue. White blood cells help the body fight infections and other diseases. Granulocytes, monocytes, and lymphocytes are white blood cells. Also called leukocyte and WBC.x-ray (EX-ray) A type of radiation used in the diagnosis and treatment of cancer and other diseases. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.Zollinger-Ellison syndrome (ZOLE-lin-jer-EH-lih-sun SIN-drome) A disorder in which tumors of the pancreatic islet cells produce large amounts of gastrin (a hormone), leading to excess acid in the stomach and, possibly, a peptic ulcer (ulcer of the stomach or the upper part of the small intestine). |
