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Pancreatic carcinoid: treatment
Last reviewed: 23.04.2024
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Carcinoids grow slowly, so it is often possible to carry out a radical operation. In the presence of multiple metastases in the liver, surgery to remove them is very traumatic. Recently, other methods of eliminating metastases in the liver have also been used - their destruction through selective de-sterilization, by local intra-arterial infusion of cytotoxic drugs. Palliative surgery and subsequent medication often allow the disappearance of symptoms. In such situations, the survival of patients is often 10 and even 20 years.
In the presence of carcinoid syndrome, surgical intervention itself is associated with a risk of developing formidable complications from the cardiovascular and respiratory systems. Complications are associated not only with the release of serotonin from the tumor, but also with the blockade of enzyme systems involved in its metabolism. To prevent them, patients are injected with serotonin antagonists - aminazine, deseril, peritol, etc. It is possible that an earlier absent carcinoid syndrome appeared during the operation. This can lead to the development of cardiovascular and hepatic insufficiency in the postoperative period, to paresis of the gastrointestinal tract and other complications.
Chemotherapeutic (5-fluorouracil, cyclophosphamide, streptozotocin) agents, serotonin antagonists (for example, peritol 8-32 mg / day), corticosteroids (prednisolone 5-20 mg / day), symptomatic therapy with antidiarrheal, bronchodilator, spasmolytic drugs, etc. Somatostatin, a paninhibitor of external and internal secretion, is promising. There are reports of a decrease in the frequency and severity of hot flashes, diarrhea. Periodically conducted courses of treatment with nicotinic acid in connection with the violation of the exchange of tryptophan, going to the synthesis of serotonin, with a carcinoid tumor.
From the diet exclude products containing large amounts of tryptophan and serotonin. Patients should abandon alcohol.
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