Surgical resection is the standard curative modality. Even in patients with distant metastasis, the disease is usually very indolent with median survivals of 2 years or more. For such patients, excellent palliation may be achieved by bypass surgery, or resection of large hepatic metastases that may produce the carcinoid syndrome. Radiation therapy has a minor role in patients with regionally unresectable disease and may palliate the pain of bone metastasis. Patients with carcinoid syndrome can usually be effectively palliated by injections of somatostatin analogue 2 to 3 times a day.
Some patients benefit from the use of interferon alfa.
Toxic effects associated with interferon treatment that frequently outweigh therapeutic gains can occur in some patients, but these effects are reversible once treatment has been discontinued and usually do not occur with smaller doses. Patients with asymptomatic metastases that cannot be resected for cure will often remain symptom-free for long periods of time. An odyssey in the land of small tumors. Williams Textbook of Endocrinology. Rubin J, Ajani J, Schirmer W, et al.