### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My father in law was diagnosed with carcinoid tumor (bone mestasis) in march of last year the last dr appt he went to almost a week ago the doctor told him the chemo is no longer doing any good and the lesions are much biiger from 3cm to 4 and new lesions have appeared and that it is spreading rapidly and is very aggressive. He does not wish for hospice and I need to know what signs to look for and about how long he has after the chemo stopped working?

### output:

Hello, Sorry to hear about the condition of your father-in-law.  Let me tell you that there are multiple treatment options in carcinoid tumors.  1) He can be put on injection octreotide. Studies have shown that octreotide alone can reduce the tumor growth rate.  2) There is a form of treatment that uses radiation that can be targeted specifically to the carcinoid tumors. It is very effective. The survival of the patients with this form of treatment has been up to 40 months median in several studies in patients with metastatic disease. This treatment is called Peptide Receptor Radionuclide Therapy (PRRT). If you can let me know where you reside, I can possibly guide you in regard to who can provide you the service. I have myself worked in a center where several of the patients who had metastases and failed chemotherapy have taken this treatment and had a good response and survival.  In regard to the survival of the patients with carcinoid there are several factors that predict this. If he does not have the heart affected by the disease that is a good thing to start with.  There is a marker called as the Ki67 index. This will give an estimate of the growth rate of the tumor. If it is Kindly check with these results and discuss with oncologist or nuclear medicine physician, or you can contact me for further details.