The Five E’s of Carcinoid & Neuroendocrine Cancers

There are certain activities and situations that can trigger carcinoid syndrome, the worst case scenario being carcinoid crisis. Each person is different and one person’s trigger may not affect another’s. It’s wise to take note if certain foods or activities cause carcinoid symptoms to act up. In some cases it can be a combination of triggers that can cause a reaction. Keep a log book of foods, activities and medications if you are trying to find potential causes. Below are the five E’s:

  1. Epinephrine
    This medication which is commonly found in over the counter allergy and cold medications can be one of the worst triggers. It is often found in novacaine that is used in dentistry too. It is important that you make your friends and family aware that epinepherine (also known as EPI) can have serious side effects. If you wear a medical ID bracelet or bracelet, make sure that it displays No EPI.
  2. Eating
    Certain foods or large meals can be particularly difficult, especially if you have had any gastro-instestinal surgeries. There are certain foods that can be particularly hard for some carcinoid patients. Please see this important nutritional presentation from the Carcinoid Cancer Foundation web site.
  3. Emotions
    Stressful situations can cause symptoms to flare up. While it is difficult to avoid all stress – at work, home, etc., it is helpful to manage it. Again, one size doesn’t fit all. Meditation, prayer, massage, exercise, spending time with loved ones are all great ways to help manage stress.
  4. Exercise including trauma, surgery & anesthesia
    Exercise is extremely important for overall health and well-being. It can, however, trigger carcinoid symptoms. The best advice to to not overdo and when doing new workouts, build up to a pace you can tolerate. In this category we include trauma, anesthesia and surgery as they can all have strong effects on our physical nature. Be aware that any of these can cause symptoms.
  5. Ethanol (alcohol, liquor)
    Many NET patients have difficulty tolerating wine, beer and sometimes hard liquors. Again, there is no hard and fast rule, so you must be aware of what you are consuming and how it affects you.
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