April is Bowel Cancer Awareness Month : Symptoms of Neuroendocrine Cancer of the Small Bowel.
Small Bowel Neuroendocrine Cancer, in early stage disease, can be a very silent disease – in that symptoms may not be present, however, if symptoms do occur, they may be due to size and position of the cancer – and how it is growing:
- They may be acute (sudden and severe) – for example; signs of bowel obstruction – increasingly severe abdominal pain/cramping associated with vomiting.
- Or chronic (occur over time and change in severity and frequency) – for example may be similar to symptoms of Irritable Bowel Disease – abdominal discomfort/cramping, diarrhoea, bloating, altered bowel habit.
Although Carcinoid Syndrome may also occur at this point, it is more commonly associated with disease that has spread (metastasised) to the liver – symptoms include:
- ‘Dry’ flushing : a red ‘blush’ of the face, neck and chest (which can extend over the whole body), and may be associated with pins & needles in hands and feet, headache and / or palpitations (fast-beating, fluttering or pounding heart)
- Diarrhoea : watery, loose stools multiple times a day—sometimes associated with considerable urgency – that may be more urgent/frequent in early hours to mid morning
- Carcinoid / valvular heart disease
- Wheezing (bronchospasm) and / or shortness of breath
- And/or skin changes
The syndrome is caused by the Neuroendocrine Cancer: the abnormal neuroendocrine cells within it, can release higher than normal levels of the peptides and hormones they would normally produce – causing altered function, leading to the symptoms described above.
Later symptoms may include scaly, irritated skin (caused by a lack of the vitamin B3 – niacin), arthritis, muscular weakness (myopathy), and symptoms related to secondaries in the liver and / or Carcinoid Heart Disease.
Further information on Carcinoid Heart Disease and Neuroendocrine Cancer Associated Syndromes is available here.