However, mitigation of the clinical picture of carcinoid syndrome can be achieved by excision of as much of the metastases as possible, thus reducing the total amount of serotonin-producing tissue.

If surgical intervention is not possible for any reason, radiotherapy can be used, the effectiveness of which, however, is low due to the resistance of carcinoid tumors to radiation exposure. After radiation therapy, no reliable data on an increase in life expectancy have been obtained. It is advisable to recommend that patients exclude serotonin-containing foods from food, which primarily include tomatoes, plums, walnuts, eggplants, pineapples and bananas.

Among the medications used in the treatment of carcinoid tumors, cyclophosphamide should be highlighted, the effectiveness of which, according to a number of authors, is about 50%. There are also reports that a good therapeutic effect is observed when prescribing serotonin antagonists, of which cyproheptadine and deseryl are the most widely used. Cyproheptadine has not only antiserotonin, but also antihistamine action. It is prescribed intravenously in a dose of 6 to 40 mg. Deseril is used orally at a dose of 6 to 24 mg and intravenously for 1-2 hours at a dose of 10-20 mg.

  • Some antidepressants - fluoxetine, sertraline, fluvoxamine, paroxetine can be used for symptomatic therapy.
  • Histamine H1 and H2 receptor blockers (cimetidine, ranitidine, diphenhydramine/diphenhydramine) are effective for carcinoids that produce predominantly histamine.
  • Loperamide (Imodium) is used to relieve diarrhea.
  • Synthetic analogues of somatostatin - octreotide (Sandostatin) and lanreotide (Somatulin) - are widely used to treat carcinoid syndrome.

Sandostatin, interacting with somatostatin receptors, suppresses the production of active substances by the tumor. The recommended regimen for the use of sandostatin (octreotide) in the treatment of carcinoid and neuroendocrine syndromes is 150-500 mcg subcutaneously 3 times a day. The drug increases the survival rate of patients with carcinoid tumors and the presence of metastases, improves the quality of life of patients, relieving or eliminating hot flashes, intestinal motor dysfunction, and diarrhea.