Description

Small bowel cancer is a type of cancer that begins as a growth of the cells in the small intestine. The small intestine, also called the small intestine is a long tube that carries digested food between the stomach and the large intestine.

The small intestine digests and absorbs the nutrients from the food that you eat. It produces hormones that help with digestion. The small intestine also plays a role in the body's germ-fighting immune system. Contains cells that fight bacteria and viruses that enter the body through the mouth.

Small bowel cancer treatment usually involves surgery to remove the cancer. Other treatments include chemotherapy and targeted therapy, that the use of drugs to kill cancer cells. The radiation therapy may also be used to reduce the size of the cancer before surgery.

Symptoms

The symptoms of small bowel cancer include:

  • The Abdominal pain.
  • Yellowing of the skin and the whites of the eyes, called jaundice.
  • Feeling very weak or tired.
  • Nausea.
  • Vomiting.
  • Losing weight without trying.
  • Blood in the stool, which may appear red or black.
  • The watery diarrhea.
  • Redness of the skin.

Causes

The cause of cancer of the small intestine is not known. What is known is that something happens to the cells in the small intestine that changes in the cancer cells.

Small intestine cancer occurs when cells develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. The changes that indicate cells that multiply rapidly. The cells continue living when healthy cells would die as part of their natural life cycle. This makes too many cells. The cells may form a mass called a tumor. The cells can invade and destroy healthy body tissue. At the time, cells can break away and spread to other parts of the body.

Types of small bowel cancer

The type of cancer of the small intestine that is based on the type of cell in which the cancer began. Examples of small intestine of the types of cancer include:

  • The Adenocarcinoma. Adenocarcinoma is the most common type of cancer of the small intestine. Adenocarcinoma starts in the cells of the glands that produce mucus.
  • Neuroendocrine tumors. Neuroendocrine tumors are cancers that originate in neuroendocrine cells. The neuroendocrine cells are found in many places in the body. They do a little bit of nerve cell functions, and some of the work of cells that produce hormones.
  • The lymphoma. Lymphoma is a cancer that begins in the cells of the immune system. The body's immune system fights germs. The cells of the immune system in the small intestine to combat bacteria and viruses that enter the body through the mouth. The majority of lymphomas in the small intestine are a type of non-Hodgkin's lymphoma.
  • Soft-tissue Sarcoma. Soft tissue Sarcomas are cancers that originate in the body of the connective tissues. One of the types of soft tissue sarcoma is a gastrointestinal stromal tumor, also known as a GIST. The GIST is started in special nerve cells that are found in the wall of the small intestine.

Your health care team considers that the type of cancer of the small intestine to create a treatment plan.

Risk factors

Factors that may increase the risk of small bowel cancer include:

  • The changes in the DNA that are run in families. Some changes in the DNA that is passed from parents may increase your risk of small bowel cancer and other types of cancer. Examples include Lynch syndrome, familial adenomatous polyposis, also called FAP and peutz-jeghers syndrome.
  • Other intestinal diseases. Other diseases and conditions that affect the intestines may increase the risk of cancer of the small intestine. These may include Crohn's disease, inflammatory bowel disease and celiac disease.
  • Weakened immune system. If your body's germ-fighting immune system is weakened, you may have an increased risk of cancer of the small intestine. Examples include people with HIV infection and those who take medications to control the immune system after an organ transplant.
  • What you eat and drink. Some studies have found an increased risk of cancer of the small intestine in which to eat and drink certain things. For example, the risk seems to be associated with the consumption of alcohol and eating a diet low in fiber and high in red meat, sugar, and salt-cured and smoked foods.

Complications

Cancer of the small intestine can cause complications, such as:

  • An increase in the risk of other cancers. People who have cancer of the small intestine run a greater risk of developing other types of cancers. These may include those affecting the colon, rectum, ovaries and the lining of the uterus, called the endometrium.
  • Cancer that spreads to other parts of the body. Advanced small bowel cancer can spread to other parts of the body. When cancer spreads, it is called metastatic cancer. Small bowel cancer most often spreads to the liver.

Prevention

It is not clear what that may help reduce the risk of cancer of the small intestine. If you are interested in reducing your risk of cancer in general, can help to:

  • Eat a variety of fruits, vegetables and whole grains. Fruits, vegetables, and whole grains contain vitamins, minerals, fiber and antioxidants, which can help reduce your risk of cancer and other diseases. Choose from a variety of fruits and vegetables so that you get different vitamins and nutrients.
  • Drink alcohol only in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Stop smoking. Talk with a health professional about ways to quit smoking that can work for you.
  • Exercise most days of the week. Try to do at least 30 minutes of exercise most days. If you've been inactive, start slowly, and gradually increase up to 30 minutes. Also, talk with your health care team before starting any exercise program.
  • Maintain a healthy weight. If you are at a healthy weight, work to maintain your weight by combining a healthy diet with daily exercise. If you need to lose weight, consult with your health care team about healthy ways to achieve your goal. Aim to lose weight slowly increasing the amount of exercise and reduce the number of calories that you eat.

Diagnosis

The small intestine cancers are difficult to diagnose. For this reason, persons suspected of having cancer of the small intestine, often the need for multiple tests and procedures to locate the cancer or to rule out a cancer. These may include:

  • Blood tests. Blood tests can't detect cancer of the small intestine, but which can give clues about your health. A blood test called a complete blood count, can detect a low red blood cell count. The red blood cells can be low if the cancer of the small intestine is causing the bleeding. Blood tests also can show how well the organs are working. For example, the results in the kidney or liver function tests could be a clue that the cancer has spread to organs.
  • Imaging tests. Imaging tests create pictures of the body. You can show the location and size of cancer of the small intestine. The tests may include magnetic resonance , computed tomography and positron emission tomography, also called PET scan.
  • The removal of a sample of tissue for testing, also called a biopsy. A biopsy is a procedure to remove a sample of tissue for testing in a lab. The tissue can be removed during a procedure to look inside the small intestine. During this type of procedure, special tools can be put in the small intestine to collect the sample. Sometimes surgery is necessary to obtain a tissue sample. The sample is analyzed in a laboratory to see if it is cancer. Other special tests to give more details on the cancer cells. Your health care team uses this information to make a treatment plan.

Tests to see the inside of the small intestine

Several tests allow doctors to examine the inside of the small intestine. Often, a tissue sample is collected during these tests. Which you need depends on where in the small intestine is localized cancer. The options include:

  • The upper gastrointestinal endoscopy. Endoscopy is a procedure to examine the inside of the esophagus, stomach, and first part of the small intestine. A thin, tube-like instrument with a light and a lens for viewing, called an endoscope, which is inserted through the mouth and throat. The tools are passed through the tube to remove a sample of tissue for analysis.
  • The capsule endoscopy. In a capsule endoscopy, also called pill of the camera, a pill the size of the capsule that has a camera and a light is swallowed. Take photos as it moves through the digestive system. The capsule, then exits the body during a bowel movement. This test may not collect a sample of tissue for analysis. If something is in a capsule endoscopy, you may need other tests to find out what that is.
  • Enteroscopia. Enteroscopy uses special devices to guide an endoscope into the small intestine. This helps the doctors to see more of the small intestine that cannot be seen with upper gastrointestinal endoscopy. A sample of tissue can be collected during enteroscopy. To get to the cancer, the scope can be passed through the throat, or through the rectum and the colon. How your enteroscopy is performed will depend on the cancer's location. Sometimes you need a medicine to you in a sleep-like state during enteroscopy.

Surgery

Sometimes the small intestine cancers in places that make them difficult to see with other tests. If this happens, your health care team may suggest surgery to examine the small intestine and the surrounding area for signs of cancer.

The surgery can involve a large incision in the abdomen, called a laparotomy. It may also involve multiple small incisions, called laparoscopy. During laparoscopy, a surgeon passes special instruments through the incisions, as well as a video camera. The camera allows the surgeon to guide the tools and see the inside of the abdomen. The tools can be used to collect a sample of tissue for analysis. Often, the cancer is removed during this procedure.

Treatment

The treatment for small bowel cancer usually involves surgery to remove the cancer. Other options include chemotherapy and radiation therapy. Your health care team considers the location of your cancer and its type when creating a treatment plan. They also consider your overall health and your preferences.

Cancer of the small intestine of the treatments may include:

  • Surgery.The surgeons work to remove all of the cancer of the small intestine, where possible. If the cancer affects a small part of the small intestine, the surgeon may remove only that section. Then, the surgeon rejoins the cut ends of the intestine. Sometimes all the small intestine must be removed. The surrounding lymph nodes may also be removed to see if there is a risk that the cancer will spread. If a cancer of the small intestine can not be removed, a surgeon may perform a shunt to relieve an obstruction in the small intestine.
  • Chemotherapy.Chemotherapy uses strong drugs to kill cancer cells. Chemotherapy usually involves a combination of medications that kill fast-growing cells, including cancer cells. It is normally given through a vein, but some medications come in pill form. For small bowel cancer, chemotherapy may be used after surgery if there is a risk of the cancer coming back. For advanced cancer, chemotherapy can help to relieve the symptoms. If the cancer is too large to remove with surgery, the first can be treated with chemotherapy to reduce its size.
  • The radiation therapy. Radiation therapy uses high-energy rays to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body. Radiation therapy is sometimes combined with chemotherapy before surgery to reduce the size of the cancer.
  • The targeted therapy. Targeted therapy uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die. Targeted therapy may be used for small bowel cancer when surgery is not an option, or when the cancer spreads to other parts of the body.
  • Immunotherapy. Immunotherapy is treatment with medicines that help your body's immune system to kill cancer cells. Your immune system fights diseases by attacking the germs and other cells that should not be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells. Immunotherapy may be an option for advanced cancer of the small intestine if the test shows that the cancer cells can respond to this kind of treatment.

Surgery. The surgeons work to remove all of the cancer of the small intestine, where possible. If the cancer affects a small part of the small intestine, the surgeon may remove only that section. Then, the surgeon rejoins the cut ends of the intestine. Sometimes all the small intestine must be removed. The surrounding lymph nodes may also be removed to see if there is a risk that the cancer will spread.

If a cancer of the small intestine can not be removed, a surgeon may perform a shunt to relieve an obstruction in the small intestine.

Chemotherapy. Chemotherapy uses strong drugs to kill cancer cells. Chemotherapy usually involves a combination of medications that kill fast-growing cells, including cancer cells. It is normally given through a vein, but some medications come in pill form.

For small bowel cancer, chemotherapy may be used after surgery if there is a risk of the cancer coming back. For advanced cancer, chemotherapy can help to relieve the symptoms. If the cancer is too large to remove with surgery, the first can be treated with chemotherapy to reduce its size.

Coping and support

With time, you will find what helps you to deal with the uncertainty and distress of a cancer of small intestine diagnosis. Until then, you can find help for:

  • Learn enough about the cancer of the small intestine to make decisions about your care. Ask your health care team about your cancer, including your test results, treatment options, and, if you like, your prognosis. As you learn more about cancer of the small intestine, you can be more confident in making treatment choices.
  • Keep friends and family close. Keep your close relationships strong will help you deal with your cancer of the small intestine. Friends and family can provide the practical support you need, such as help to take care of your house if you're in the hospital. And that you can serve as emotional support when you feel overwhelmed by the cancer.
  • Find someone to talk to.Find someone who is willing to listen to you talk about your hopes and fears. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful. Ask your health care team about support groups in your area. Other sources of information are the National Cancer Institute and the American Cancer Society.

Find someone to talk to. Find someone who is willing to listen to you talk about your hopes and fears. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful.

Ask your health care team about support groups in your area. Other sources of information are the National Cancer Institute and the American Cancer Society.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you. If your health care team to suspect you might have cancer, you may be referred to a specialist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test. Make a list of:

  • Its symptoms , including those that may not appear to be related to the reason for your appointment.
  • Key personal information , including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you are taking, including the dosage.
  • Questions to ask your health care team.

Consider bringing a family member or friend to help you remember the information they give you.

For cancer of the small intestine, some basic questions you can ask include:

  • What is likely causing my symptoms?
  • Other that the most likely cause, what are other possible causes of the symptoms?
  • What tests do I need?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions about your symptoms, such as:

  • When did your symptoms begin?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of small bowel cancer