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The quality of life of patients with carcinoid syndrome depends mainly on the extent of successful control of tumor growth and serotonin-mediated symptoms of carcinoid syndrome. Because carcinoid tumors produce hormones such as serotonin, drugs that promote the production of serotonin should be avoided, if possible. These include morphine, monamine oxidase inhibitors, and alcohol among others. Patients with carcinoid tumors who are taking medications for other indications should consult with their doctors to determine if any of these medications may promote serotonin production.

Patients can take certain precautions to minimize the individual symptoms of carcinoid syndrome, including:

Flushing

Foods that contain serotonin should also be avoided by patients with carcinoid tumors or carcinoid syndrome. These include:

• Walnuts
• Bananas
• Chocolate
• Cheese
• Eggs
• Alcohol
• Tomatoes
• Pineapple

Because stress (both emotional and physical) also causes the body to release endogenous hormones, it is important for patients with carcinoid tumors to control and reduce stress to the greatest extent possible.

Heart Failure

Heart failure is a condition in which the right side of the heart loses its ability to pump blood efficiently. Without treatment, the condition can lead to serious, life-threatening complications. The goals of treatment of heart failure include the reduction of cardiac work load, control of symptoms, and improvement of heart function. A variety of treatment options are available to control heart failure including medications, surgery, or behavior modification. Bed rest or reduced physical activity may be recommended to minimize the heart's work load. Decreased dietary sodium (salt) may be recommended. Decreased fluid intake may be recommended.

Drugs that may be used to control heart failure include:

• Vasodilators - These drugs are used to expand blood vessels and decrease blood flow resistance. This allows blood to flow more easily and makes the heart's work easier or more efficient. Examples of vasodilators include:

  • Captopril
  • Enalapril

• Diuretics - These drugs reduce the swelling and water build-up caused by heart failure. Examples of diuretics include:

  • Lasix (furosemide)
  • Bumex (bumetanide)
  • Demadex (torsemide)
  • Esidrix (hydrochlorothiazide)
  • Zaroxolyn (metolazone)
  • Aldactone (spironolactone)

• Digitalis - Digitalis, also known as digoxin or digitoxin, is a drug that strengthens the contraction of the heart muscle, slows the heart rate, and helps eliminate fluid from body tissues.

Wheezing

Bronchodilators are drugs that relax the muscles in the lungs to make breathing easier and are helpful in controlling wheezing. Examples of bronchodilators include:

• Albuterol (Proventil, Ventolin)
• Epinephrine (Primatene)
• Ipratropium (Atrovent)
• Metaproterenol (Alupent, Metaprel)
• Terbutaline (Brethine)

Diarrhea

Many prescription and over-the-counter drugs are available for the treatment of diarrhea. Examples of some prescription drugs to control diarrhea include:

• Adsorbents:

  • bismuth subsalicylate
  • kaolin
  • pectin

• Intestinal Muscle Relaxants

  • codeine
  • diphenoxylate
  • loperimide
  • paregoric (tincture of opium)