I am Stage IV. I have spread to my Liver and most patients at some point will find themselves in the same situation. I am unable to work due to the unpredictability of my diarrhea. I cannot guarantee that I can go to work and not spend an entire morning in the bathroom. I also have fatigue, which is not one of the worst symptoms. I find that if I am physically busy for a few days one right after the other that by the 3rd or 4th day I need down time - a few days to slow down and rest. I have no idea how many people with Carcinoid Syndrome work.