|
1
|
Marasco M, Romano E, Arrivi G, Prosperi D, Rinzivillo M, Caruso D, Mercantini P, Rossi M, Faggiano A, Panzuto F. Exploring Carcinoid Syndrome in Neuroendocrine Tumors: Insights from a Multidisciplinary Narrative Review. Cancers (Basel) 2024; 16:3831. [PMID: 39594786 PMCID: PMC11592972 DOI: 10.3390/cancers16223831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 11/10/2024] [Accepted: 11/12/2024] [Indexed: 11/28/2024] Open
Abstract
Carcinoid syndrome (CS) is a rare condition associated with neuroendocrine tumors (NETs), particularly those originating in the gastrointestinal tract, which secrete bioactive substances like serotonin. The management of CS requires a multidisciplinary approach due to its complex clinical manifestations, including flushing, diarrhea, bronchospasm, and carcinoid heart disease. Optimal care involves collaboration between several professional figures like oncologists, endocrinologists, gastroenterologists, surgeons, and dietitians. Currently, a wide range of treatments are available, focused on both symptom control and tumor burden reduction. Somatostatin analogs (SSAs) are the first-line therapy for symptom relief. Still, in patients with progressive disease or refractory CS, other options include targeted therapies, peptide receptor radionuclide therapy (PRRT), liver-directed therapies, and surgical resection, when feasible. Furthermore, management of complications related to prolonged serotonin release and malnutrition as a result of exocrine pancreatic insufficiency, post-surgical conditions, vitamin deficit, and chronic diarrhea often requires early detection to mitigate symptoms and improve the quality of life in these patients. The complexity of CS necessitates individualized care and continuous coordination among specialists to optimize outcomes and enhance patient well-being.
Collapse
Affiliation(s)
- Matteo Marasco
- Digestive Disease Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy; (M.M.); (E.R.); (M.R.)
- PhD School in Translational Medicine and Oncology, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Elena Romano
- Digestive Disease Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy; (M.M.); (E.R.); (M.R.)
| | - Giulia Arrivi
- Oncology Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy;
| | - Daniela Prosperi
- Nuclear Medicine Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy;
| | - Maria Rinzivillo
- Digestive Disease Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy; (M.M.); (E.R.); (M.R.)
| | - Damiano Caruso
- Radiology Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy;
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy; (P.M.); (M.R.)
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy; (P.M.); (M.R.)
- Surgery Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy
| | - Michele Rossi
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy; (P.M.); (M.R.)
- Interventional Radiology Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy;
| | - Francesco Panzuto
- Digestive Disease Unit, Sant’ Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy; (M.M.); (E.R.); (M.R.)
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy; (P.M.); (M.R.)
| |
Collapse
|
|
3
|
Soeder M, Turshudzhyan A, Rosenberg L, Tadros M. High-Quality Colonoscopy: A Review of Quality Indicators and Best Practices. GASTROENTEROLOGY INSIGHTS 2022; 13:162-172. [DOI: 10.3390/gastroent13020017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Colorectal cancer (CRC) continues to be the third leading cause of cancer-related deaths in the US. Colonoscopy remains the best preventative tool against the development of CRC. As a result, high-quality colonoscopy is becoming increasingly important. Specifically, recent guidelines have highlighted pre-procedural, peri-procedural, and post-procedural practices, which promise to improve patient outcomes and reduce the mortality and interval cancer rates in patients undergoing colonoscopies. Despite the guidelines and advances in modern endoscopy, the procedure remains provider-dependent, which results in differences in outcomes. As a result, incorporating high-quality colonoscopy approaches early in training is key to improving patient outcomes. Additionally, ensuring that high-quality colonoscopy is practiced widely by endoscopists can lead to the most cost-effective care.
Collapse
Affiliation(s)
| | - Alla Turshudzhyan
- Department of Internal Medicine, University of Connecticut, Farmington, CT 06030, USA
| | - Lisa Rosenberg
- Department of Internal Medicine, Albany Medical College, Albany, NY 12208, USA
| | - Micheal Tadros
- Department of Gastroenterology and Hepatology, Albany Medical College, Albany, NY 12208, USA
| |
Collapse
|