Your Questions About Carcinoid Syndrome
Sandra asks…
How rare is carcinoid syndrome?
Any statistics on how many people it affects i.e. 1 out of 100 000? or any stats like that?
Jill answers:
The incidence of carcinoids is probably 7-8 cases per year, but this approximation is underestimated because many patients never develop the related syndrome. Some researchers estimated real incidence may be 1-2 cases per 100,000 individuals.
Ken asks…
My mother has been diagnosed with Carcinoid Syndrome, a type of cancer….?
Anyone have any experience with this…apparently it is really rare. We live in a small town with doctors lacking expertise on the subject and are looking for someone, or somewhere else for treatment.
Jill answers:
I don’t know a lot about the pathophysiology of this disease, but I can tell you that I am presently administering chemo for a patient with carcinoid syndrome. We have her on Streptozosin (Zanosar) and 5FU (5-fluorouracil). She has had a partial response to this treatment and continues to be doing well.
Donald asks…
A scenario involving SSRI/SNRI administration in serotonin positive carcinoid syndrome (please read on)?
Consider someone who has yet to be diagnosed with serotonin positive carcinoid. Reasons for seeking medical attention include: “flushing”, diarrhea, and an atypical symptom like, nausea. The primary GP, whilst investigating possible etiologies thorough various imaging and serum modalities, prescribes a low dose SNRI until test results can be ascertained. Perhaps, under the working hypothesis of IBS, anxiety, or simply as a means to provide relief from suffering (i.e, the aforementioned sxs) via the anticholinergic properties of a given SNRI.
If a person who actually had serotonin carcinoid syndrome took these meds, what would you expect would happen? Serotonin syndrome? A paradoxical reaction? Exacerbation of primary sxs? Something else?
BTW: Not a personal Q. Just curious 
.
Please excuse my spelling mistake above: “thorough” should be “through” and I should not have included “SSRI” in the header Q. Oppsie. Sorry, guys .
Thanx for answering, Spreedog . A lot of extra info too. Cool!
It just seemed to me, after doing my own reading, that a patient with this rare condition may be initially treated for anxiety. The sxs mimick the condition, from what I can see.
I envisioned an SSRI or SNRI perhaps even being an appropriate “soothing” choice as an effort to ameliorate pesky sxs while other tests are pursued. But, so, I simply wondered what would happen IF an SSRI or SNRI was, indeed, prescribed, all the while without info that the patient has this syndrome where SSRI’s may not help, but even be a dangerous choice.
I guess you are saying administration would exacerbate originally presenting sxs, yes? So, no paradoxical reaction? No serotonin syndrome, either? No room for individuality in terms of response, either? I mean, aside from “primary sxs” presentation that is. The drugs would make presenting symptoms (whatever they may be) worse. Period. Yes?
If these tumors are secreting serotonin, I’m not sure how that would/could result in heart palpitations. One would expect the opposite, no?
I also wonder how closely sxs would mirror SSRI overdose–i.e., serotonin syndrome…
I’m essentially making queries out of my a$s here. I know nothing about this, but I find it really interesting….
Jill answers:
Had to do some research on this one.
This situation isn’t common; I never had a patient with this in 20 years.
Also, since cytotoxic chemotherapy works poorly if at all for the majority of these patients, medical oncologists are not always consulted.
An NCI (USA) study http://www3.interscience.wiley.com/journal/102528538/abstractevaluated 10,878 carcinoid tumors that were identified by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI) from 1973 to 1999 – - so that’s only 418 cases per year in the U.S. With onlly a fraction having carcinoid syndrome.
From Medline Plus : http://www.nlm.nih.gov/medlineplus/ency/article/000347.htm { A Mayo Clinic Review says nearly the same thing.}
Carcinoid tumors are rare, slow-growing cancers that usually start in the lining of the digestive tract or in the lungs. Because they grow slowly and don’t produce symptoms in the early stages, the average age of people diagnosed with digestive or lung carcinoids is about 60.
In later stages the tumors sometimes produce hormones that can cause carcinoid syndrome. The syndrome causes flushing of the face and upper chest, diarrhea, and trouble breathing.
Surgery is the main treatment for carcinoid tumors. If they haven’t spread to other parts of the body, surgery can cure the cancer.
- – - –
Most carcinoid tumors have no symptoms. They only produce the syndrome about 10% of the time. So the syndrome is a rare manifestation of a rare malignancy.
When symptoms do occur, they may include:
* Abdominal pain that comes and goes
* Bright red flushing of the face
* Diarrhea (may be explosive and severe)
* Heart palpitations
* Low blood pressure
* Wheezing
Sometimes symptoms are brought on by physical exertion, or eating or drinking things such as blue cheeses, chocolate, or red wine.
- – - -
A serotonin antagonist may be prescribed to control diarrhea and poor absorption of nutrients from the intestines (malabsorption).
Avoid alcohol, large meals, and foods high in tyramine (aged cheeses, avocado, many processed foods), because they may trigger symptoms.
Some common medicines, like selective serotonin reuptake inhibitors (SSRIs, such as Paxil, Serzone, and Prozac) may make symptoms worse by increasing levels of serotonin. However, do not stop taking these medicines unless your doctor tells you to do so.
One of several combinations of chemotherapy may be given through a vein (IV) or by mouth. If one combination does not work, another combination may be effective. About one-third of patients benefit from chemotherapy. But responses are limited and partial; chemotherapy is not a cure in this type of malignancy.
Thomas asks…
carcinoid syndrome and pellegra?
Jill answers:
Tryptophan is an amino acid that is metabolized to nicotinic acid, an essential B vitamin. In the presence of Carcinoid syndrome more than of 70%(normally 1%) of tryptophan is diverted to take part in the production of sertonin, the active substance produced by the tumor. The net result is a relative lack of production of nicotinic acid or a nicotinic acid (niacin)deficiency resulting in the clinical picture of pellagra.
Chris asks…
could allergies and carcinoid syndrome go hand and hand…..xolair would help???
Jill answers:
Xolair works on Immunoglobulin E that causes asthma. But, carcinoid syndrome is mainly due to excess serotonin. Unless you are experiencing asthma, your doctor would not prescribe Xolair injections.
Powered by Yahoo! Answers
Tags: serotonin carcinoid syndrome, carcinoid tumors, carcinoid syndrome, Health Medical Pharma
I’ll gear this review to 2 types of people: current Zune owners who are considering an upgrade, and people trying to decide between a Zune and an iPod. (There are other players worth considering out there, like the Sony Walkman X, but I hope this gives you enough info to make an informed decision of the Zune vs players other than the iPod line as well.)
Appreciating the dedication you put into your site and detailed information you offer. It’s great to come across a blog every once in a while that isn’t the same old rehashed information. Excellent read! I’ve bookmarked your site and I’m including your RSS feeds to my Google account.
This design is wicked! You obviously know how to keep a reader entertained. Between your wit and your videos, I was almost moved to start my own blog (well, almost…HaHa!) Wonderful job. I really loved what you had to say, and more than that, how you presented it. Too cool!
Judging by the way you write, you seem like a professional writer.
Hands down, Apple’s app store wins by a mile. It’s a huge selection of all sorts of apps vs a rather sad selection of a handful for Zune. Microsoft has plans, especially in the realm of games, but I’m not sure I’d want to bet on the future if this aspect is important to you. The iPod is a much better choice in that case.
Great post at Your Questions About Carcinoid Syndrome | HowToCleanseYourBody. I was checking constantly this blog and I’m impressed! Extremely useful information specifically the last part
I care for such info a lot. I was seeking this particular info for a long time. Thank you and good luck.
I’ll gear this review to 2 types of people: current Zune owners who are considering an upgrade, and people trying to decide between a Zune and an iPod. (There are other players worth considering out there, like the Sony Walkman X, but I hope this gives you enough info to make an informed decision of the Zune vs players other than the iPod line as well.)
Nice post at Your Questions About Carcinoid Syndrome | HowToCleanseYourBody. I was checking constantly this blog and I am impressed! Extremely useful info specially the last part
I care for such info a lot. I was seeking this particular info for a very long time. Thank you and good luck.
Zune and iPod: Most people compare the Zune to the Touch, but after seeing how slim and surprisingly small and light it is, I consider it to be a rather unique hybrid that combines qualities of both the Touch and the Nano. It’s very colorful and lovely OLED screen is slightly smaller than the touch screen, but the player itself feels quite a bit smaller and lighter. It weighs about 2/3 as much, and is noticeably smaller in width and height, while being just a hair thicker.
Hey, I think your site might be having browser compatibility issues. When I look at your website in Ie, it looks fine but when opening in Internet Explorer, it has some overlapping. I just wanted to give you a quick heads up! Other then that, terrific blog!
I view something truly interesting about your weblog so I bookmarked .
Appreciating the commitment you put into your blog and in depth information you provide. It’s nice to come across a blog every once in a while that isn’t the same outdated rehashed material. Great read! I’ve bookmarked your site and I’m adding your RSS feeds to my Google account.
I am not new to blogging and truly appreciate your site. There is much prime content that peaks my interest. I am going to bookmark your web site and keep checking you out.
The Zune concentrates on being a Portable Media Player. Not a web browser. Not a game machine. Maybe in the future it’ll do even better in those areas, but for now it’s a fantastic way to organize and listen to your music and videos, and is without peer in that regard. The iPod’s strengths are its web browsing and apps. If those sound more compelling, perhaps it is your best choice.
I’ll gear this review to 2 types of people: current Zune owners who are considering an upgrade, and people trying to decide between a Zune and an iPod. (There are other players worth considering out there, like the Sony Walkman X, but I hope this gives you enough info to make an informed decision of the Zune vs players other than the iPod line as well.)
I find this information useful and I think everyone will benefit from the
The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.
Hands down, Apple’s app store wins by a mile. It’s a huge selection of all sorts of apps vs a rather sad selection of a handful for Zune. Microsoft has plans, especially in the realm of games, but I’m not sure I’d want to bet on the future if this aspect is important to you. The iPod is a much better choice in that case.
I’m not sure why but this site is loading extremely slow for me. Is anyone else having this issue or is it a problem on my end? I’ll check back later on and see if the problem still exists.
Its like you read my mind! You seem to know a lot about this, like you wrote the book in it or something. I think that you can do with a few pics to drive the message home a bit, but instead of that, this is wonderful blog. A great read. I’ll definitely be back.
Very interesting info!Perfect just what I was searching for!
I find this information useful and I think everyone will benefit from the
I’ll gear this review to 2 types of people: current Zune owners who are considering an upgrade, and people trying to decide between a Zune and an iPod. (There are other players worth considering out there, like the Sony Walkman X, but I hope this gives you enough info to make an informed decision of the Zune vs players other than the iPod line as well.)
I just want to thank you for sharing your views and this information. I was glad when I landed here and saw the time you put into your blog. People could learn a lot from the way you present it and write. Thanks!!
Your current positions normally have got many of really up to date info. Where do you come up with this? Just declaring you are very resourceful. Thanks again
I like this post, enjoyed this one thanks for putting up.
Between me and my husband we’ve owned more MP3 players over the years than I can count, including Sansas, iRivers, iPods (classic & touch), the Ibiza Rhapsody, etc. But, the last few years I’ve settled down to one line of players. Why? Because I was happy to discover how well-designed and fun to use the underappreciated (and widely mocked) Zunes are.
This is getting a bit more subjective, but I much prefer the Zune Marketplace. The interface is colorful, has more flair, and some cool features like ‘Mixview’ that let you quickly see related albums, songs, or other users related to what you’re listening to. Clicking on one of those will center on that item, and another set of “neighbors” will come into view, allowing you to navigate around exploring by similar artists, songs, or users. Speaking of users, the Zune “Social” is also great fun, letting you find others with shared tastes and becoming friends with them. You then can listen to a playlist created based on an amalgamation of what all your friends are listening to, which is also enjoyable. Those concerned with privacy will be relieved to know you can prevent the public from seeing your personal listening habits if you so choose.
Zune and iPod: Most people compare the Zune to the Touch, but after seeing how slim and surprisingly small and light it is, I consider it to be a rather unique hybrid that combines qualities of both the Touch and the Nano. It’s very colorful and lovely OLED screen is slightly smaller than the touch screen, but the player itself feels quite a bit smaller and lighter. It weighs about 2/3 as much, and is noticeably smaller in width and height, while being just a hair thicker.
Sorry for the huge review, but I’m really loving the new Zune, and hope this, as well as the excellent reviews some other people have written, will help you decide if it’s the right choice for you.
If you’re still on the fence: grab your favorite earphones, head down to a Best Buy and ask to plug them into a Zune then an iPod and see which one sounds better to you, and which interface makes you smile more. Then you’ll know which is right for you.
This is getting a bit more subjective, but I much prefer the Zune Marketplace. The interface is colorful, has more flair, and some cool features like ‘Mixview’ that let you quickly see related albums, songs, or other users related to what you’re listening to. Clicking on one of those will center on that item, and another set of “neighbors” will come into view, allowing you to navigate around exploring by similar artists, songs, or users. Speaking of users, the Zune “Social” is also great fun, letting you find others with shared tastes and becoming friends with them. You then can listen to a playlist created based on an amalgamation of what all your friends are listening to, which is also enjoyable. Those concerned with privacy will be relieved to know you can prevent the public from seeing your personal listening habits if you so choose.