Methods Of Treating Zollinger-Ellison Syndrome

September 12, 2023

Zollinger-Ellison syndrome causes a singular tumor or multiple tumors to form in the upper portion of a patient's small intestine. The tumors, otherwise known as gastrinomas, create excess gastrin. This is a necessary hormone for individuals, but in excess amounts, it destroys the balance of the gastrointestinal system. The stomach produces too much acid. Since there's more acid than the body can handle, patients experience diarrhea and peptic ulcers. Though the disease can develop at any time, most patients initially develop symptoms between twenty and fifty years old.

There are multiple treatment options for Zollinger-Ellison syndrome. The mildest focus on symptom management, while more heavy-duty treatments attack the disease at its source. Learn about these options now.

Tumor Debulking

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Tumor debulking is a treatment that addresses the tumors causing Zollinger-Ellison syndrome. Debulking is often recommended in cases where complete tumor removal is impossible. Removing the tumors is a difficult undertaking, especially in cases where multiple tumors are present. For patients with only one tumor, surgical removal may be an option, but for patients with liver tumors or multiple tumors, debulking is an alternative to full removal. The goal of debulking is to surgically excise as many tumors as possible, or as much of a tumor as can be safely removed. Though the tumor will grow back if left alone afterward, debulking is usually coupled with radiation therapy or chemotherapy. Debulking the tumors makes it much more likely that chemotherapy will destroy everything left. If chemotherapy treatment is used without debulking, there's no guarantee all the tumors will be broken down.

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Embolization

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Embolization is another treatment designed to attack and destroy tumor cells. Rather than using radiation or chemicals to harm the cells, this treatment involves cutting off the supply of blood to the tumors. Arterial embolization is a medical procedure where tiny pieces of material are injected into the main blood vessel. These pieces clog the vessel, which deprives the tumor of oxygen needed to thrive. It also keeps the tumor from utilizing components of the blood that encourage growth. In most cases, this treatment is meant to destroy the tumor. Sometimes the procedure will be done before a tumor removal surgery, ensuring a much easier surgical procedure. For patients whose tumors cannot be removed, this treatment can also be used to provide pain relief if the tumors themselves are causing discomfort.

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Liver Transplant

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Depending on the severity of the symptoms and the systems they affect, a liver transplant may be a necessary treatment option. Though the initial tumors form outside the liver, it's common for the growths to spread to the liver. The tumors are cancerous and malignant. Once they've spread to the liver, the overall condition becomes harder to treat due to the multiple organ systems affected. A transplant involves the removal of the diseased liver. A healthy liver from a donor is then transplanted. Most patients will only need a lobe from a living donor rather than a whole liver from a deceased donor. Liver transplants are typically recommended when the liver is too damaged to function properly. Some patients may struggle to qualify for transplant lists when multiple systems are affected by the tumors.

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Medication To Treat Excess Acid

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Though it can be difficult to treat the cancerous aspects of the disease, a patient can nearly always find medication to treat excess acid. There are a few different medications that may help. The first ones recommended tend to be proton pump inhibitors, which block the acid-secreting cells from pumping out excess acid. However, long-term use of these medications may make a patient more susceptible to bone fractures.

Another medication option is to use medications that mimic the natural hormone somatostatin. When introduced to the body, the medicine has been shown to counteract the physical effects of gastrin in some patients. Excess acid contributes to the majority of uncomfortable gastrointestinal symptoms patients experience, and though it's a byproduct of the underlying illness rather than a disease by itself, it must be managed for an ideal quality of life.

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Radiofrequency Ablation

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Radiofrequency ablation is a cancer treatment method often recommended for patients with Zollinger-Ellison syndrome. Unlike chemotherapy, which floods the whole body, this treatment focuses on one spot. Rather than using radiation, radiofrequency ablation involves a combination of heat and electrical energy. A radiologist inserts a thin needle into the cancerous tissue, using imaging technology to ensure accuracy. Once the needle is positioned, electrical energy passes through the needle and heats it. The heat spreads to the surrounding tissue, killing the cancer cells. This treatment method is rarely used as a primary form of cancer treatment, but it does help address liver and pancreas tumors causing discomfort. Most doctors will look for surgical options first. This treatment method is used in patients who have many small tumors that cannot be excised or debulked with surgery.

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