Supportive therapy manages the symptoms caused by the cancer, but it does not actively treat the cancer. Functional neuroendocrine tumours or carcinomas require treatment to manage the symptoms caused by the overproduction of hormones. Other complications of neuroendocrine cancers, such as cardiac valve damage, congestive heart failure and intestinal obstruction, may also require active medical or surgical treatment.
The excessive levels of different hormones cause various signs and symptoms. Treatment with somatostatin congeners like octreotide (Sandostatin) reduces the high levels of these hormones and helps control symptoms of severe diarrhea or flushing in certain cancers of the gastrointestinal tract. This greatly reduces the severity of symptoms and improves quality of life. In some people, somatostatin congener therapy has the added benefit of shrinking the size of the neuroendocrine tumour or carcinoma.
Echocardiography shows that the heart is affected (carcinoid heart disease) in more than 50% of people with carcinoid syndrome. 5-hydroxyindoleacetic acid (5-HIAA) is a product of the breakdown of serotoninserotoninA type of neurotransmitter (a chemical that transmits signals or impulses from one neuron, or nerve cell, to another neuron cell or other specialized cells) that causes blood vessels to narrow and regulates the movement of the intestines.. People with neuroendocrine tumours who have elevated 5-HIAA often develop cardiac disease. Giving octreotide therapy to block the production of serotonin at an early stage of the disease helps to lower the levels of 5-HIAA. This treatment helps prevent further cardiac damage. Active treatment of cardiac complications by a cardiologist or cardiac surgeon improves cardiac function and prolongs survival.
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