Lung Carcinoid Tumor

Lung Carcinoid Tumor

A lung carcinoid tumor is a rare type of lung cancer that develops from neuroendocrine cells. These cells are found throughout the body including the lungs that produce hormones or hormone-like substances that help in regulating various bodily functions. 

Lung carcinoid tumors can be classified as either typical or atypical, depending on their appearance under a microscope. 

Typical carcinoids are the most common type of lung carcinoid cancer accounting for 9 out of 10 lung carcinoid cases. It tends to be slow-growing and has a low risk of spreading to other parts of the body. 

Atypical carcinoids are more aggressive and have a higher risk of spreading beyond the lungs.

If you have been diagnosed with a lung carcinoid tumor, it is important to work closely with your healthcare team to develop a personalized treatment plan and to receive ongoing care and support.

Causes and Risk Factors

The exact cause of lung cancer is yet not known. However, several factors are associated with their development including –

1. Smoking – Cigarette smoking is the most significant risk factor for lung carcinoid tumors.

Lung Carcinoid Tumor

2. Family history – A family history of lung cancer or other types of cancer can increase the risk of developing lung carcinoid tumors.

3. Radon exposure – Radon is a naturally occurring gas that can accumulate in homes and other buildings. Prolonged exposure to high levels of radon has been linked to an increased risk of lung cancer.

4. Asbestos exposure – People who have been exposed to asbestos, particularly those who work in the construction and manufacturing industries, have a higher risk of developing lung carcinoid tumors.

5. Genetic mutations – Some genetic mutations, such as those in the MEN1 and NF1 genes, have been linked to an increased risk of lung carcinoid tumors.

It is important to note that while these factors may increase the risk of developing lung carcinoid tumors, not everyone who has them will develop the disease. Additionally, some people may develop lung carcinoid tumors without any known risk factors.

Symptoms

Typical carcinoids are low-grade tumors that grow slowly and are usually found in people under the age of 50. Atypical carcinoids are more aggressive, grow faster, and have a higher risk of spreading to other parts of the body. 

It is a condition related to the overproduction of hormones released by neuroendocrine cells. Around 25% of the people with carcinoid tumors don’t have any symptoms at all.

The common symptoms of lung carcinoid tumors that may be noticeable in some patients are –

1. Coughing up blood
2. Shortness of breath or wheezing
3. Chest pain
4. Difficulty breathing
5. Fatigue or weakness
6. Recurring pneumonia or bronchitis
7. Unintentional weight loss
8. Flushing or redness of the skin
9. Diarrhea or abdominal pain (in rare cases)

It is necessary to take into account that some people with lung carcinoid tumors may not experience any symptoms at all, especially in the early stages. If you are experiencing any of these symptoms, it’s important to consult a healthcare professional for early detection of the condition.

Diagnosis and Tests

Your healthcare provider will ask for your medical history and any symptoms you may be experiencing. The provider will also check for breathing of the lungs to determine your health condition. If they notice certain issues after the physical examination then they may perform additional tests to determine the exact stage and type of disease.

The common tests performed for accurate diagnosis of your condition are –

1. Chest X-rays – These help in detecting the presence of lung carcinoid tumors except in cases where the tumor is very small or hidden behind the chest making it difficult to detect.
2. Computed Tomography (CT scan) – If chest X-rays fail in identifying the location of the tumor then a CT scan is preferred. It helps in viewing the cross-sectional image of the lungs. CT scan is also effective in identifying the spread of cancer to the lungs or other organs. 
3. Blood and Urine tests – Hormones become abnormal when there are carcinoid tumors in the body. A blood test will help in measuring the levels of serotonin or chromogranin-A hormone that indicates the presence of a lung carcinoid tumor. Urine tests will check for levels of the 5-HIAA hormone which identifies the metabolite of serotonin.
4. Biopsy – It is a surgical procedure in which a small amount of tissue is removed and examined under a microscope to identify the presence of tumors in cells.

Two types of biopsy are performed for diagnosis of lung carcinoid tumor 

• Non-surgical biopsies – They are done in hospitals without any surgical incision. Although sedation needs to be administered before the procedure. It takes only a few hours to recover from the procedure and the patient can leave on the same day. Mostly, a non-surgical biopsy called bronchoscopy is used where a thin, flexible camera is inserted in the breathing passages for a biopsy to be performed.
• Surgical Biopsies – It is a surgical incision procedure made in the chest and is performed after anesthesia administration. It may be required hospitalization and the recovery time is much longer compared to non-surgical biopsy.

Once a diagnosis of lung carcinoid tumor is confirmed, further tests may be done to determine the stage of cancer for the best treatment options. 

Treatments

The treatment options for lung carcinoid tumors depend on several factors, such as the size and location of the tumor, whether it has spread to other parts of the body, and the overall health of the patient. The following are the most common treatment options for lung carcinoid tumors:

1. Surgery – Surgery is usually the preferred treatment for early-stage lung carcinoid tumors. The type of surgery depends on the size and location of the tumor. For small tumors, a wedge resection or segmentectomy may be done, while for larger tumors, a lobectomy or pneumonectomy may be required.

• Lobectomy – It involves the removal of a portion of the lung called the lobe.

• Pneumonectomy – It involves the removal of the entire lung.

• Sublobar resection – It includes wedge resection or segmentectomy category. Segmentectomy involves the removal of one part of the lobe while wedge resection refers to the removal of a small, wedge-shaped portion of the lung. 

• Lymph node dissection – Lymph nodes are removed during this procedure to determine if the tumor has spread to these nodes.

2. Radiation therapy – Radiation therapy may be used in conjunction with surgery, particularly if the tumor is large or has spread to nearby tissues. It may also be used to relieve symptoms caused by the tumor, such as pain or shortness of breath.
3. Chemotherapy – Chemotherapy is not typically used to treat lung carcinoid tumors, as they tend to be less responsive to chemotherapy than other types of lung cancer. However, it may be used if the tumor has spread to other parts of the body.
4. Targeted therapy – Targeted therapy is a newer treatment option that may be used for advanced-stage lung carcinoid tumors. It involves drugs that specifically target certain molecules or pathways in the tumor cells to stop them from growing and dividing.
5. Observations – For small tumors that are not causing any symptoms, the doctor may recommend simply monitoring the tumor with regular imaging tests to see if it grows or changes over time.

The treatment plan for lung carcinoid tumors is individualized based on the patient’s specific situation and may involve a combination of these treatments.

Major Outlook for Lung Carcinoid Tumors

The prognosis for patients with lung carcinoid tumors can vary widely depending on several factors, including the size and location of the tumor, whether it has spread to other parts of the body, and the overall health condition of the patient. 

If the tumor is small and has not spread beyond the lungs, then approximately a five-year survival rate for patients with lung carcinoid tumors is witnessed to be around 90%. However, if the tumor has spread to other parts of the body, the five-year survival rate can drop to around 25-50%.

However, patients with lung carcinoid tumors need to work closely with their healthcare team to develop a personalized treatment plan to receive proper ongoing care and monitoring to ensure the best possible outcome. 

Regular follow-up appointments with a healthcare provider are recommended for individuals who have been diagnosed with a lung carcinoid tumor so that they can effectively monitor for any cancer recurrence or the development of new tumors. Remember, getting a prognosis after treatment is very good.