Will I need chemotherapy or radiation therapy after surgery?
In most cases radiation therapy and conventional chemotherapy are not given after surgery for carcinoid tumors. If the tumor is completely removed these would be of little or no benefit. Your doctor will want to follow the same blood tests that were done as part of your diagnostic evaluation to look for evidence of recurrence of the tumor. If the tumor made ACTH or GH these would be followed as well. A repeat bronchoscopy might be done to examine the site where the tumor was removed to make sure the tumor is gone. Most often a CT scan and or an octreoscan will be performed to look for evidence of the tumor coming back or spreading elsewhere. If the tumor does re-occur, the first choice of treatment will usually be to try to remove the tumor again. If this cannot be done because it is unsafe or the tumor is too extensive, the tumor may then be shrunk by burning or freezing the tumor in the operating room or under x-ray guidance. In addition, Octreotide injections may be given to decrease the chemicals produced by the tumor and to slow its growth. This may give very good results controlling symptoms and growth for many years or decades. When these fail, chemotherapy or experimental therapies may be considered. Some newer agents are being designed to block very specific parts of the tumor cells biology to disrupt growth or chemical production or to impair the growth of new blood vessels (anti-VEGF) needed for the growth of the tumor. Conventional chemotherapy use remains controversial. Radiation therapy may be used when a tumor cannot be completely removed from vital structures surgically, but these tumors often do not respond to radiation treatment.