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Cryosurgery is a technique that involves destroying the liver tumor by freezing the cells with liquid nitrogen. Success rates reflecting a reduction of levels of hormone-like substances related to the carcinoid tumor using this procedure are reported to be up to 80-90%.

Other Approaches

Other approaches that may be utilized to treat metastases which occur outside of the liver include:

• Chemotherapy
• Octreotide therapy

Chemotherapy

Chemotherapy is a form of drug therapy that uses anticancer drugs, also called cytotoxic or antineoplastic drugs, to destroy cancer cells. The choice of drug(s) given depends upon the specific type of cancer. In many types of cancers, a combination of anticancer drugs is administered at the same time (combination chemotherapy). Some anticancer drugs may be given orally while others are administered intravenously (IV).

Common side effects of cancer chemotherapy may include:

• Hair loss
• Mucositis - swelling, irritation, and ulceration of the mucosal cells that line the digestive tract. It can occur anywhere along the digestive tract from the mouth to the anus.
• Increased susceptibility to infections
• Fatigue and general loss of energy
• Nausea and vomiting
• Loss of appetite
• Increased susceptibility to bleeding and bruising

It is important to note that the side-effects of chemotherapy are temporary and usually disappear after the chemotherapy has been stopped. A variety of strategies are available to help better control the common side-effects of cancer chemotherapy and patients should discuss the various options available to reduce or eliminate the side-effects with their oncologist.

Octreotide Therapy

Octreotide is the most effective drug used in the treatment of carcinoid syndrome. Some studies report that up to 80% of patients report improvement in their symptoms while on a regimen of octreotide.

Some of the palliative properties of octreotide include:

• Inhibition of the synthesis and release of hormones from the cancer cells.
• Improvement of the absorption of fluid in the GI tract which reduces the symptoms of diarrhea.

Another application for the use of octreotide involves its ability to deliver targeted radiotherapy to carcinoid cells. This technique involves the administration of radiolabeled octreotide which is attracted to the receptors on the cells of carcinoid tumors. A newer version of radiolabeled octreotide, Yttrium 90-DOTA Octreotide, has been developed and appears to:

• Improve survival rates and
• Reduce tumor associated pain