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Small Intestine (Small Bowel) Cancer

Name  l  Define  l  Risk  l  Detect  l  Treatment  l  Stage/Grade  l  Followup  l  Mets/Recur  l  Link

Names - Synonyms

Small intestine cancer, small intestine carcinoma, small intestine adenocarcinoma, small intestine sarcoma, small intestine lymphoma, small intestine carcinoid, small bowel cancer, small bowel carcinoma, small bowel adenocarcinoma, small bowel carcinoid, small bowel sarcoma, small bowel lymphoma, duodenal cancer, duodenal adenocarcinoma, duodenal sarcoma, duodenal carcinoid, duodenal lymphoma, ileal cancer, ileal carcinoma, ileal adenocarcinoma, ileal sarcoma, ileal carcinoid, ileal lymphoma, jejunal cancer, jejunal adenocarcinoma, jejunal carcinoma, jejunal sarcoma, jejunal carcinoid, jejunal lymphoma, cancer of the small intestine, cancer of the small bowel, cancer of the ileum, cancer of the jejunum, cancer of the duodenom.

Definition

Cancer Dictionary definition - aka: small bowel cancer - Small Intestine Cancer is a rare cancer based on the physical location of the cancer, not necessarily the cell type.  It is a cancer whose primary site is found in the small intestine, and it's sections; including the ileum, jejunum, or duodenum. The small intestine area of the digestive system can be found between the stomach and the large colon.

Risk Factors - Causes

Cancerous tumors in the small intestine (aka: small bowel) are very uncommon, occurring in fewer than 2 of 100,000 people in the United States each year. Adenocarcinoma is the most common histological (pathological) type of cancer of the small intestine. Others include carcinoid, gastrointestinal stromal tumors, lymphoma, and various sarcomas.

Irritable bowel syndrome (IBS), Crohn's disease, familial adenomatous polyposis (FAP) (polyposis coli), chronic ileitis, celiac disease, inflammatory bowel disease (IBD), Peutz-Jegher's syndrome, and colitis are diseases that may increase the risk of acquiring small intestine cancer.

Detection

Bloody stools, diarrhea, pain or cramping in the middle of the abdomen, unexplained weight loss, and a lump in the abdomen are symptoms of a possible small bowel cancer, especially if they are severe, worsen, or last for long periods of time.  Emergency treatment should be sought if you have an inability to have a bowel movement for an abnormal period of time.

Small intestine cancers are diagnosed by various methods. To internally view cancers of the duodenum and parts of the jejunum, endoscopy is commonly used. A flexible tube is passed through the mouth and down to the duodenum and parts of the jejunum. Precise images, along with biopsy samples, may be taken.  A laparotomy might also be done to take a look inside the abdominal cavity.

Colonoscopy may be used to detect or biopsy cancer of the ileum. Like endoscopy, a flexible tube is used, but for colonoscopy the tube is passed through the anus. To reach the ileum, the tube will have to be passed through the large intestine.

An abdominal x-ray, CT scan, or ultrasound may be ordered by your physician.  A barium x-ray can show the entire small intestine and may be used to outline the tumor. Arteriography might also be used, if internal bleeding is involved.  Fecal occult blood tests are commonly done, as well as normal blood sample testing for tumor marker levels and possible liver involvement.  

Treatment

Surgical excision, various forms of radiotherapy, and chemotherapy are the treatments commonly used for small intestine cancers.  

Surgical removal may require excising not only the tumor, but any non-life-threatening structures that may be involved.  Other surgical procedures including intestinal bypass surgery, ileostomy, pancreaticoduodenectomy, and choledochojejunostomy may be used.

Chemotherapy, or radiation therapy may be administered to allow for patient comfort.  Radiotherapy enhancing radiosensitizers may be administered prior to treatment. 

Depending on cancer histology, biological response modifiers, such as interferon, may be used.

Stage - Grade

The stage of the cancer may have some prognostic significance.  Early stage small bowel cancer, that is completely removed by surgery, and does not metastasize, may be survivable long-term.  With these cancers, however, there is a possibility of secondary cancers.

Stage I - The cancerous tumors remain within the lining of the small bowel or muscle wall, with no sign of lymph node involvement or metastatic spread.

Stage II - The cancer has spread through the muscle wall, possibly involving other nearby organs (like the pancreas).

Stage III -  There is lymph node involvement.

Stage IV - There is lymph node involvement and metastatic spread of the cancer.

Suggested Followups

Routine follow up visits might be done every 3 months, for a period of time.  A physical examination will be done, along with blood tests.  Abdominal imaging such as x-ray, CT, and MRI may be done.  Colonoscopy and/or endoscopy may be ordered by your physician.

Metastasis - Recurrence

Treatments that may be used for metastatic adenocarcinoma or leiomyosarcoma could include clinical trial agents or biologic agents.  For recurrent disease without metastasis, surgery, palliative radiotherapy or chemotherapy, or clinical trial agents may be administered.

Links

Small Intestine Support Forums - Small Bowel Support Forums

Small Intestine (Small Bowel) Online Support Group