Featuring Dr. Richard Bebb, MD, ABIM, FRCPC, Endocrinologist What is Carcinoid Syndrome? Duration: 3 minutes, 25 seconds

Carcinoid syndrome is an uncommon disease. There are tissues in the body that produce hormones and sometimes those tissues will form tumours.

It’s part of the – we call the enterochromaffin system. These tissues can form small tumours that make themselves evident not by the tumour itself but by the hormones that are produced. For carcinoid syndrome, these carcinoid tumours can produce a whole array of various different metabolites that have symptoms in patients and can lead to the diagnosis.

The classic symptoms of carcinoid are related to a metabolite that causes diarrhea and flushing episodes. Most carcinoid tumours are in the intestinal area. They’re below the diaphragm and above the pubic area and they’re in the abdomen.

They’ll cause an uncontrolled production of hormones that causes these flushing episodes and at the same time profound diarrhea can occur. Other manifestations you can develop as well.

The metabolites can cause an asthma-like syndrome with wheezing. After many, many years of carcinoid the metabolites can cause scarring of the valves of the heart and can result in heart failure because of valve damage. The usual early manifestations relate to the diarrhea and flushing.

It’s an unusual syndrome. It’s diagnosed by, first of all, suspecting it. Like many endocrine abnormalities, patients have had the disease for a long time before it gets diagnosed because it can be very, very slow in onset and the manifestations can be gradual in development.

If you or your practitioner suspect it, there is testing for it. And the gold standard for carcinoid is a 24-hour urine collection of metabolites produced by the tumour. It’s called 5-Hydroxyindoleacetic acid. Measuring that in the urine is one of the key ways of diagnosing the tumour.

Fortunately, most carcinoid tumours, not all of them but most of them, are benign. The tumours don’t tend to spread from one place to another like a classical cancer. And again, the manifestation in patients is related to the hormones produced by the tumour.

So, if it’s diagnosed early based on the symptoms and then we detect where it is by CT scan or other tests of localizing, they can quite often be removed with complete cure.

If you’re concerned that you might have carcinoid syndrome or have some symptoms of it, do discuss it with your primary care practitioner.

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist