How are lung carcinoid tumors treated?
The method of treatment will depend on the size of the tumor, its location and your overall health. The two main forms of treatment are surgery and radiation therapy.
Many lung carcinoid tumors can be treated with surgery alone, except in cases where the tumor has spread to other organs. In cases where the carcinoid cannot be completely removed, palliative surgery may be performed to remove most of the tumor or to relieve symptoms.
The main types of surgical treatment are:
- Lobectomy: This type of surgical procedure involves the removal of a portion of the lung called a lobe. It may be performed to remove a peripheral carcinoid tumor (one that is located at the edge of the lungs). One lobe of the lung is removed during a lobectomy. The removal of two lobes is called a bilobectomy. A procedure known as sleeve resection falls into this category. A sleeve resection removes sections of the airway above and below the tumor along with the tumor. The sections of the airway are then reconnected, similar to sewing the sections of a sleeve together after part of it has been cut off.
- Pneumonectomy: This procedure involves removal of the entire lung.
- Sublobar resection: This category includes segmentectomy and wedge resection. Segmentectomy refers to the removal of a part of one lobe of the lung. Wedge resection refers to removing a small, wedge-shaped portion of the lung in cases where the tumor is very small.
- Lymph node dissection: Often, the lymph nodes near the lungs are removed during the above surgeries to determine if the tumor has spread to these nodes and possibly to reduce the risk of the tumor spreading to other parts of the body.
Radiation therapy: This type of treatment uses high-energy radiation to destroy cancer cells. Usually, the patient undergoes a series of radiation treatments over a certain period of time. External-beam radiation therapy is the usual type of radiation therapy to treat carcinoid tumors. Radiation may also be given through tiny pellets or rods that are delivered to the tumor or close to it through a small catheter. This is known as internal radiation or brachytherapy.
A drug called Sandostatin® (octreotide) is sometimes used to treat carcinoid syndrome by controlling hormone output.
Chemotherapy: This may be required in cases in which the tumor has spread from the lungs to other organs. Chemotherapy involves the use of drugs administered via the bloodstream (intravenously) to destroy cancer cells. Chemotherapy might be given in the hospital or in a doctor's office or a clinic. Usually a certain number of treatments are given over time.
For treating metastic cancer, an mTOR inhibitor, everolimus (AFINITOR®), is used ahead of chemotherapy in these cases. Also, peptide radioligand therapy is used for metastatic disease where the treatment is avilable.