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"Will Carcinoid Cancer Treatment Impact My Bovine Heart Valve Replacement?" Asks Barb

By Adam Pick on August 29, 2010

I just received a very unique question from Barb about carcinoid tumor injections and bovine heart valve replacements. Barb writes to me:

Bovine Aortic Valve Replacement

Hi Adam,

First, I'd like to express my appreciation to you for your very informative book and emails. I am a 54-year-old woman who was aware of aortic valve stenosis since the age of 16, and finally had an aortic bovine valve replacement in January 2009. I also had an aortic root aneurysm repair. I've done very well in my recovery, and found your book extremely helpful.

I was diagnosed with carcinoid cancer in 2001. Surgery was all that was required at that time. I know that carcinoid cancer and valve problems often go hand-in-hand, although I've been told by my doctor that it's not usually the aortic valve that is involved. In November 2009, my carcinoid cancer returned.

My personal feelings are that it was brought on by the stress of the open heart surgery. I've also been told that carcinoid tumours can often be successfully treated with a monthly injection of octreotide (a man-made growth inhibiting hormone).

Carcinoid Cancer In Small Intestine

My main concerns with starting the monthly injections are the effects that this medication may have on my bovine valve. I am really hoping that I get at least 10 years out of this valve. I would be very interested to learn if any of your readers also have carcinoid cancer, and if so, whether they take the monthly injections. If they do, have they found that it's affected their heart in any way. Thank you very much! Barb

In response to Barb's question...

Given the clinical nature of Barb's question, I knew that I would have to contact an aortic valve specialist to help Barb.

But first, I wanted to learn more about carcinoid tumors. According to the Mayo Clinic, Carcinoid tumors are a slow-growing type of cancer that can arise in several places throughout your body. Carcinoid tumors usually appear in the gastrointestinal tract (appendix, stomach, small intestine, colon, rectum) and in the lungs.

Specific to the heart, carcinoid tumors may secrete hormones that can cause thickening of the lining of heart chambers, heart valves and blood vessels. This can lead to leaky heart valves, an enlarged heart and heart failure. Carcinoid heart disease can usually be controlled with medications and surgery.

Now, that I understood Barb's situation a little better, I reached out to Dr. Allan Stewart, the Director of Aortic Valve Surgery program at NewYork-Presbyterian Hospital / Columbia Medical Center in New York City.

Dr. Stewart offered the following for Barb:

Carcinoid tumors generally affect the tricuspid valve, not the aortic. Neither the carcinoid tumor nor the octreotide will affect the function or longevity of the aortic protshesis. I agree, though, that the stress of surgery may have allowed the tumor to grow.

I hope that helps Barb (and all of us) learn more about carcinoid cancer and heart valves. Thanks to Barb for her question and thanks to Dr. Stewart for his answer.

Keep on tickin!
Adam

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Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

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