If your doctor suspects you have a carcinoid tumor or if one has been found during another procedure, the first step will be a thorough physical exam and medical history. Your doctor will ask questions about your general health, your medical history and your family history, and your smoking habits.
Tests to diagnose a carcinoid tumor or find out if it has spread may include one or more of the following. These tests also may be used to find out if treatment is working.
Blood and urine tests, which may include:
- Complete blood count (CBC)
- Blood chemistry studies to check certain substances in the blood
- 24-hour urine collection for 5-HIAA (metabolite of serotonin)
- Measurement of serotonin levels in blood
Imaging tests, which may include:
- Esophagastrodoudenoscopy (upper endoscopy)
- Endoscopic ultrasound (EUS)
- CT or CAT (computed axial tomography) scans, including high-resolution CT scans
- MRI (magnetic resonance imaging) scans
- Octreotide scan or somatostatin receptor scintigraphy (OctreoScan™): This is the most common imaging test to diagnose carcinoid tumors. Octreotide, a radioactive substance, is injected into a vein. As it travels through the body, it attaches to carcinoid tumor cells that have somatostatin receptors. A radiation-measuring instrument shows where the octreotide has collected.
- Angiogram: In this test to examine blood vessels and flow, a dye is injected into a blood vessel. X-rays are taken as the dye moves through the vessel.
- Barium swallow or upper gastrointestinal (GI) series: You swallow a radioactive substance. X-rays are taken as it moves through body.
- Barium enema or lower GI series: You are given an enema that contains barium. X-rays are taken as it spreads into the colon. After the enema, air may be sent into the colon to help spread the barium to get a more accurate image.
- Enteroclysis: A tiny tube is inserted through the mouth or nose into the small intestine. Barium contrast, as well as a substance that makes air in the intestines and causes them to expand, is put through the tube. X-rays are taken.
- I-131 MIBG scan: A chemical called MIBG with radioactive iodine is injected into a vein. As it moves through the body, images are taken with a special camera.
- Capsule endoscopy: You swallow a capsule with a light and tiny camera. As the capsule moves though the digestive system, it takes thousands of photographs. The doctor looks at the images on a computer.
- Double balloon enteroscopy: This test uses a special endoscope that is one tiny tube inside another. The doctor can biopsy any abnormal areas.
- Proctoscopy: A hollow tube (proctoscope) with a light on the end of it is inserted into the anus. The doctor can view the lining of the rectum and anus.
Biopsy: Methods to biopsy carcinoid tumors include:
- Needle biopsy: A needle is inserted into the tumor. Ultrasound or CT scan may be used to guide the needle.
- Surgery: A tissue sample is taken from the abdomen during surgery
If you are diagnosed with a carcinoid tumor, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much disease is in the body when it is diagnosed. This helps the doctor plan the best way to treat the cancer.
Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.
(source: National Cancer Institute)
Localized: Cancer is found only in the appendix, colon, rectum, small intestine, and/or stomach.
Regional: Cancer has spread from the appendix, colon, rectum, stomach, and/or small intestine to nearby tissues or lymph nodes.
Metastatic: Cancer has spread to other parts of the body.