What you need to know about lung carcinoid tumors

Have you had a cough for a while? Maybe it's accompanied by phlegm? Or do you feel a little short of breath? We often forget about these things, thinking that they are just a common cold. But very rarely, there may be something else behind such a minor symptom that we need to pay attention to. Today we are going to talk about a rare but very important cancerous condition of the lungs. That is Lung Carcinoid Tumors.

Simply put, what are these lung carcinoid tumors?

This needs a little explanation. There is a special type of cell in our body that belongs to the nervous system and the hormonal system. We call these neuroendocrine cells. Think of these cells as the coordinators in our body. When a message comes from the nervous system, their job is to produce hormones in response to it and control various activities in the body. For example, these cells help control the way our breath enters the lungs and the way food moves through the digestive tract.

So, for some reason, when these neuroendocrine cells start to divide and multiply uncontrollably, tumors form in those places. We call lung carcinoid tumors the cancerous tumors that start in these neuroendocrine cells in the lungs.

But don't be afraid when you hear the word "cancer." Because there are two types of these carcinoid tumors. The two behave very differently.

The two main types of cassinoid cysts

They are divided into two main types based on their growth rate and ability to spread.

What could be the symptoms of this condition?

Most of the time, especially those with typical cysts, there are no symptoms . They are discovered incidentally during a chest X-ray for another reason. However, some people may experience the following symptoms:

• Persistent cough (sometimes with blood or mucus)
• Chest pain
• Difficulty breathing (dyspnea)
• Hearing a faint 'whistling' sound when breathing (wheezing)

A special condition called Carcinoid Syndrome

Very rarely, these tumors start to produce too much of the hormone serotonin. This can cause hormonal imbalances in the body, leading to a variety of symptoms. This is called carcinoid syndrome . Its symptoms include:

• Severe diarrhea
• Redness or feeling of warmth in the face and neck (flushing)
• Weight gain without reason
• Difficulty breathing or asthma-like symptoms

If these symptoms are present, it is essential to seek medical advice immediately.

Why do tumors like this form? Are there any risk factors?

In fact, the exact reason why these neuroendocrine cells suddenly start dividing uncontrollably has not yet been discovered .

However, some people have been found to be at slightly higher risk of developing this condition. These factors include:

• Having a rare, inherited genetic condition called Multiple Endocrine Neoplasia type 1 (MEN1) .
• Smoking (especially for the atypical type)
• Being a woman (women are slightly more likely to have this condition)
• Being between the ages of 45 and 55. Although the disease is most commonly diagnosed in people in this age group, this condition can occur at any age, even in very young children.

How to recognize this condition?

If you have any of the symptoms mentioned above, you should first see your doctor. He or she will ask you about your symptoms, listen to your chest with a stethoscope, and, if in doubt, recommend some tests to confirm the diagnosis.

1. Imaging: The first step is to take a chest X-ray . If any abnormalities are found, a CT scan (Computed Tomography scan) may be ordered. A CT scan can produce very clear, cross-sectional images of the lungs, allowing the size and location of the tumor to be determined.

2. Blood and urine tests: These tests are done to see if certain hormones produced by these tumors are present in the blood or urine.

3. Biopsy: This is the most important test to confirm the disease 100%. Here, a very small piece of tissue is taken from the tumor and examined under a microscope. This can determine exactly whether the tumor is a carcinoid tumor, typical or atypical. The most common method used to obtain this tissue sample is bronchoscopy . Here, a thin tube with a small camera is passed through the airways to examine the tumor and a small piece is taken.

What are the treatment options?

The best treatment for you will depend on the type, size, location of the tumor, and your overall health. The good news is that most lung carcinoid tumors can be completely cured with surgery alone.

There are several main treatment options:

• Surgery:
• Lobectomy: Complete removal of the lobe of the lung where the tumor is located.
• Wedge Resection: Removal of only the tumor and a small amount of tissue around it.
• Pneumonectomy: Very rarely, the entire lung may need to be removed.
• Lymph node removal: The surgeon may decide to remove nearby lymph nodes to see if the cancer has spread and to prevent further spread.

• Radiation Therapy: This treatment is given if surgery cannot completely remove the tumor or if the patient is in a medical condition that makes surgery impossible. It involves external-beam radiation or the placement of small radioactive materials near the tumor (brachytherapy).

• Chemotherapy:Because these tumors grow slowly, conventional chemotherapy, which targets fast-growing cells, is not very effective. Therefore, this treatment is rarely given to typical types. However, this treatment may be necessary for fast-growing atypical types or when they have spread to other organs.

• Other medications:
• Octreotide: This hormonal medication is given to control the symptoms caused by carcinoid syndrome.
• MTOR inhibitors (e.g. Everolimus): A type of drug that inhibits tumor growth.

What is the recovery rate and outlook?

This is a problem for many people.

Atypical carcinoid tumors are a little more complicated to treat. The risk of recurrence is slightly higher. However, this condition can also be successfully controlled by using a combination of different treatments.

Overall, the five-year survival rate for all types of lung carcinoid tumors is a very high 89% . This means that out of 100 people diagnosed with this disease, 89 are still healthy after 5 years.

When should you see a doctor?

If you experience new or worsening symptoms, especially shortness of breath, diarrhea, or unexplained weight loss, let your doctor know. Don't hesitate to talk about any questions or concerns.

When to go to the ETU (Emergency Treatment Unit) immediately

If you have the following severe symptoms, go to the nearest hospital's Emergency Department (ETU) immediately:

• Feeling very short of breath (even when at rest).
• Coughing up blood.
• New or worsening chest pain.
• Confusion or altered consciousness.
• Blue discoloration of the skin, lips, or fingernails (cyanosis).

Questions to ask your doctor

It's normal to have questions when you receive a diagnosis like this. It may be helpful to ask your doctor questions like these:

• Is this typical or atypical?
• Has this spread to other places?
• What treatment do you recommend?
• What is the outlook for this type of tumor?
• How to manage symptoms at home?

Receiving a diagnosis of any cancer is a difficult experience. But remember, most lung carcinoids are very treatable and have a low risk of recurrence. Talk openly with your medical team about what to expect for your condition. They will explain the best treatment options to you and answer any questions you may have.