OCTREOTIDE THERAPY IN CARCINOID DISEASE

Octreotide therapy is expensive, but at present it and other somatosta tin analogues appear to offer the best opportunity of controlling the symptoms of flushing and diarrhoea. It may also have other properties affecting general well-being. The question of whether it changes tumou r growth remains unanswered and there is no convincing evidence that i t alters survival. In all published studies the numbers of patients ar e small and there have been no control groups, However, since no other drug has yet proved effective against flushing, the somatostatin anal ogues, including octreotide, remain the treatment of choice for the sy mptomatic control of the carcinoid syndrome. Octreotide is of great th erapeutic value pre-operatively and intra-operatively and it is essent ial that all operating theatres have this drug available for immediate use. Surgical debulking, if feasible, provides the best outcome poten tial in carcinoid disease. Present evidence suggests that the place of octreotide and other somatostatin analogues is in controlling the sym ptoms of the disease rather than its progress and in ensuring cardiova scular and respiratory stability during surgical procedures.