Therapeutic principles in the management of metastasising carcinoid tumors: drugs for symptomatic treatment.

Malignant carcinoid syndrome is characterized most commonly by flushing and diarrhea of varying severity when tumors metastasize to the liver. Besides supportive measures for mild symptoms, the pharmacological management includes drugs to inhibit synthesis, release or peripheral actions of the circulating tumor products either alone or in combination. Among those agents octreotide, a synthetic long-acting analogue of somatostatin, is the drug of choice because it has proved useful for ameliorating symptoms in most patients with this syndrome. Although there is a multitude of potential and actual side effects, this antihormonal drug is very well tolerated and is a significant advance in therapy.