What is the first-line treatment for carcinoid tumors?

The first-line treatment for carcinoid tumors, particularly those that are localized and have not metastasized, is surgical excision. However, in cases where surgery is not feasible or when there is metastatic disease, octreotide is often utilized as the initial pharmacological therapy.

Octreotide is a somatostatin analogue that inhibits the secretion of various hormones and growth factors. This treatment can help manage the symptoms of carcinoid syndrome, such as flushing and diarrhea, by reducing the release of serotonin and other vasoactive substances from the tumor. Octreotide can also slow the progression of the tumors and control symptoms even in cases of metastatic disease, making it a critical component of treatment.

Other treatment options like chemotherapy and radiation therapy may be considered in specific contexts or for more advanced disease, but they are not the first-line approaches for managing carcinoid tumors. Surgical excision is preferred when the tumors are localized due to the potential for complete removal and cure. Thus, while octreotide is a key management strategy for symptomatic relief and control, the best initial approach remains guided by the tumor's characteristics and overall treatment planning.