The carcinoid syndrome: a treatable malignant disease.

In the carcinoid syndrome, surgery is often curative when the disease is detected early and it may also provide palliation for some patients with metastatic disease. Often metastatic disease requires no treatment for months or years unless symptoms are serious or troublesome. Chemotherapy with either doxorubicin alone or streptozocin plus 5-FU achieves a response rate of about 23-33%. Hepatic artery occlusion followed by sequential chemotherapy has produced striking relief of symptoms, a higher percentage of regressions, and a longer duration of response. Somatostatin 201-995 is very effective in treating the syndrome and in preventing carcinoid crisis and has the advantage of producing virtually no significant side effects.