Management of carcinoid syndrome depends on getting early diagnosis, proper monitoring, and treatment. Your doctor will discuss the best treatment for you and help you to set up an easy-to-follow treatment plan.
Medical Therapy for Carcinoid Syndrome
Most patients with carcinoid syndrome are diagnosed after they have already started experiencing symptoms like diarrhea and flushing, and it is important that they gain control over these debilitating symptoms. This is the primary goal of treating carcinoid syndrome.1,2
There is medical therapy available to help give you control over the diarrhea and flushing associated with carcinoid syndrome. Antidiarrheal medications do not work to control the diarrhea associated with carcinoid syndrome. Your doctor will discuss the best treatment for you and help you set up an easy-to-follow treatment plan. It is important that you speak to your doctor about starting treatment at the first sign of symptoms.3,4
Sandostatin® is a somatostatin analogue, which is a type of medicine that works directly at the site of the carcinoid tumors to help decrease the production of hormones that lead to diarrhea and flushing of carcinoid syndrome. It is the only approved medical therapy for the control of these 2 symptoms associated with carcinoid syndrome.5,6
With Sandostatin® LAR Depot (octreotide acetate for injectable suspension), you get the benefit of 2 formulations that can help you maintain control over the diarrhea and flushing you might be experiencing. Sandostatin® LAR Depot is the only somatostatin analogue available to treat the symptoms of carcinoid syndrome.7,8
Monitoring carcinoid syndrome
Carcinoid syndrome occurs when carcinoid tumors produce different hormones that end up circulating in the body. The increase in these hormones is what causes the symptoms of carcinoid syndrome.
One such hormone that is overproduced by carcinoid tumors is serotonin. Serotonin breaks down into smaller parts called metabolites. The most important serotonin metabolite is a substance called 5-hydroxyindoleacetic acid (5-HIAA). Doctors can measure 5-HIAA as a diagnostic test for carcinoid syndrome.9,10
Most doctors rely on tests to monitor carcinoid syndrome. They will also keep track of your disease by monitoring the intensity of symptoms you may experience (eg, diarrhea and flushing). This is why it is important for you to keep track of your symptoms and report any changes to your healthcare provider.
One common test measures the level of the serotonin metabolite 5-HIAA in your urine (see figure below). This test is highly useful because most patients with carcinoid syndrome overproduce serotonin and its metabolite, 5-HIAA.
Before getting tested for 5-HIAA
Some foods are rich in serotonin and the consumption of these foods can lead to a false-positive test. Please talk to your doctor or nurse who can advise you not to eat the following foods for 24 hours before taking a 5-HIAA test:
Selected foods that may alter 5-HIAA testing1,10
- Bananas
- Walnuts/Hickory nuts
- Tomatoes
- Pineapple
- Pecans
- Avocados
There are also certain medications that can affect your 5-HIAA test. Please consult your physician before taking the 5-HIAA test.
Sandostatin® LAR Depot (octreotide acetate for injectable suspension) is indicated for long-term treatment of the severe diarrhea and flushing episodes associated with metastatic carcinoid tumors and for the long-term treatment of the profuse watery diarrhea associated with VIP-secreting tumors in patients in whom initial treatment with immediate release Sandostatin® (octreotide acetate) Injection has been shown to be effective and tolerated.
Important Safety Information
As with immediate release Sandostatin® Injection, the most frequently reported drug-related adverse events were biliary disorders (62%), gastrointestinal disorders (14% to 38%), and injection-site pain (20% to 50%). Hypoglycemia (4%), hyperglycemia (27%), sinus bradycardia (19%), conduction abnormalities (9%), and arrhythmias (3%) have been reported.
The controlled clinical trials that support the marketing clearance for Sandostatin® LAR Depot did not include determination of effect on tumor size or rate of growth. Sandostatin® LAR Depot is not indicated for tumor shrinkage. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
