The Clinton Herald, Clinton, Iowa

September 9, 2013

Carcinoid tumor usually benign

Dr. Keith Roach
Clinton Herald

CLINTON — DEAR DR. ROACH: I am confused. I was diagnosed with a neuroendocrine tumor in my rectum two years ago. When I asked if it was cancer, I was told no, it was a carcinoid. The tumor was successfully removed with TEMS surgery. When I went to the doctor's office recently (it wasn't my regular doctor), he read my chart and asked about my carcinoma. Was it cancer or not? Does having this tumor exclude me from donating my organs in the future? — M.K.

    ANSWER: It's understandable that you're confused, as the terminology is confusing. A carcinoid tumor is a type of neuroendocrine tumor. ("Neuroendocrine" means that the cells get input from nerves, and in response secrete hormones.) These are usually benign tumors, and usually occur in the GI tract or in the lungs. It is only rarely the case that neuroendocrine tumors are truly cancerous. (The word "carcinoma" is used only for malignant tumors. It confusingly sounds a lot like "carcinoid.") In the case of malignant carcinoid, the tumor spreads usually first to the liver, and may then cause carcinoid syndrome, which is a syndrome of flushing, diarrhea and other symptoms caused by the effects of the hormone-like substances released by the tumor.

    Only the pathology report can answer your question about whether your tumor was malignant. I think it's very unlikely that it was cancer. There should be no issue with donating organs in the (far) future.

    DEAR DR. ROACH: I am perplexed. For years I have been using white Vaseline at night to coat the inside of my nose as the veins dry, out break open and bleed. This keeps the area moist.

    Of late I have been hearing that this can cause cancer or ruin your lungs or bronchial tubes. What is the truth? — A.M.H.

    ANSWER: Petrolatum, sold as Vaseline and other brands, generally is considered a safe product. There are two potential health concerns. The first is that petrolatum can be contaminated with toxic substances. This seems to me to be unlikely, but you can be sure of its purity by looking for "white petrolatum USP" as the ingredient, meaning it has been tested free of dangerous impurities.

    The second concern with using an oil-based product in the nose is that it may be accidently inhaled. Inhaled oil causes lipoid pneumonia. This has happened with mineral oil, but I have a hard time imagining it happening with petrolatum.

    In summary, petrolatum is an inexpensive and effective treatment for dry skin, keeping the body's own moisture inside.

    DEAR DR. ROACH: I live in the state of Maine. My parents warned me about needing iodine in our diet due to not having much iodine in our soil. They told me to buy iodized salt to prevent thyroid problems. I think you can get iodine from seafood, too, but I don't know which kinds. If people throw out the saltshaker, what should they do to ensure they are getting enough iodine? — L.C.

    ANSWER: We almost never see iodine deficiency where I have practiced; however, you are quite right that many areas, especially the Northern United States and most of Canada, have low iodine levels in the soil. If you don't use table salt (and good for you if you don't), then you can get iodine from most dairy products, from saltwater fish and shellfish, from seaweed (think of nori, the wrapping of sushi) or from supplements.

    READERS: The booklet on restless leg syndrome and nighttime cramps offers tips on dealing with this perplexing condition. Readers can obtain a copy by writing: Dr. Roach -- No. 306, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.