Under the Radar

Carcinoid cancer is a rare, but real, risk.

When you hear the word "cancer," you likely think of the biggies- lung, breast, prostate, skin-the cancers that grab attention. But there are other cancers out there that you've likely never even heard of.

Carcinoid cancer is one of them.

This slow-growing cancer is diagnosed in just 11,000 to 12,000 Americans each year, though likely there are many more people living with the disease but free of symptoms. It typically develops in the gastrointestinal tract, though it can also appear in the lungs. The cancer takes two major forms. In the first group of people, the tumor can grow for years without notice. Often, the cancer spreads and people notice symptoms caused by the cancer in the new location.

But for people in the second group, even though the cancer can be quite small, it can cause hormonal changes that lead to symptoms such as:

• skin flushing
• diarrhea
• problems with the right side of the heart

A. David McCollum, M.D., an oncologist on the medical staff at Baylor University Medical Center at Dallas, notes that most people don't need to worry about carcinoid cancer. "It's very uncommon and there is no active screening recommended. All that's needed is your annual exam," he says. If your doctor has reason to suspect carcinoid cancer, he or she can check for hormone levels in your blood and urine or perform other diagnostic tests.

Sometimes, women mistake the flushing of carcinoid cancer for the hot flashes of menopause. That was the case with Norma J. Harmon of Dallas. Now 75, she beat the disease with the help of surgeries and chemotherapy. "I told Dr. McCollum I should have had this treated years ago," she says. "I feel like a brand-new lady."

For people whose cancer has not spread-in most cases those whose hormonal symptoms allowed for early detection-surgery may be the only treatment necessary. "Another new, very effective therapy is biological treatment," explains Zhiyong Li, M.D., a hematologist/oncologist on the medical staff at Baylor Medical Center at Garland. Monthly injections of biological agents can control the flushing and diarrhea of carcinoid cancer. "Patients do well, even though the disease lasts for years," Dr. Li says.

Carcinoid cancer can often be carefully watched, with no further action. "Patients can live for a long time before treatment is required," Dr. McCollum says. "It's cancer-it's not benign-but in the spectrum of cancers, it progresses much slower than most."

By Stephanie Thurrott

Are you keeping up with your annual checkups? If you need a referral to a physician on the medical staff at the Baylor facility nearest you, call 1-800-4BAYLOR or use our on-line physician directory. Visit our Health Library for more information about cancer.