signs of bowel cancer | Treatment of small bowel cancer (PDQ®) -Version for patients

Treatment of small bowel cancer (PDQ®) -Version for patients





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General information about small bowel cancer
Stages of small bowel cancer
Recurrent small bowel cancer
General aspects of treatment options
Treatment options for small bowel cancer
Additional information on small bowel cancer
Information about this PDQ summary
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General information about small bowel cancer
IMPORTANT POINTS
Small bowel cancer is a rare disease in which malignant (cancer) cells form in the tissues of the small intestine.
There are five types of small bowel cancer.
Food and health history can affect the risk of developing small bowel cancer.
The signs and symptoms of small bowel cancer include unexplained weight loss and abdominal pain.
To detect (find), diagnose and stage small bowel cancer, tests that examine the small intestine are used.
Certain factors affect the prognosis (probability of recovery) and treatment options.
Small bowel cancer is a rare disease in which malignant (cancer) cells form in the tissues of the small intestine.
The small intestine is part of the body's digestive system, which also includes the esophagus, stomach, and large intestine. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins and water) from the food and helps evacuate waste from the body. The small intestine is a long tube that connects the stomach with the large intestine. It folds several times to fit inside the abdomen.

EXTEND The drawing of the small intestine shows the duodenum, the jejunum and the ileum. The stomach, appendix, colon and rectum are also shown.
The small intestine connects the stomach and the colon. This includes the duodenum, the jejunum and the ileum.
There are five types of small bowel cancer.
The types of cancer found in the small intestine are adenocarcinoma, sarcoma, carcinoid tumors, gastrointestinal stromal tumor, and lymphoma. This summary is about adenocarcinoma and leiomyosarcoma (a type of sarcoma).

Adenocarcinoma originates in the glandular cells of the lining of the small intestine and is the most common type of small bowel cancer. Most of these tumors occur in the part of the small intestine near the stomach. They can grow and clog the intestine.

Leiomyosarcoma starts in the smooth muscle cells of the small intestine. Most of these tumors occur in the part of the small intestine near the large intestine.

For more information about small bowel cancer, see the following PDQ summaries:
Treatment of soft tissue sarcoma in adults
Treatment of soft tissue sarcoma in children
Treatment of non-Hodgkin's lymphoma in adults
Treatment of childhood non-Hodgkin's lymphoma
Treatment of gastrointestinal carcinoid tumors
Treatment of gastrointestinal stromal tumors
Food and health history can affect the risk of developing small bowel cancer.
Anything that increases the risk of developing a disease is called a risk factor. The presence of a risk factor does not mean that you will get cancer; But the absence of risk factors does not mean that you will not get cancer. Check with your doctor if you think you are at risk. Among the risk factors are the following:

A diet with a high fat content.
Crohn's disease
Celiac disease
Familial adenomatous polyposis (FAP).
The signs and symptoms of small bowel cancer include unexplained weight loss and abdominal pain.
These and other signs and symptoms may be due to small bowel cancer or other conditions. Check with your doctor if you have any of the following:

Pain or cramps in the middle of the abdomen.
Weight loss without known reason.
A mass in the abdomen.
Blood in the fecal matter.
To detect (find), diagnose and stage small bowel cancer, tests that examine the small intestine are used.
Procedures that create images of the small intestine and the surrounding area help diagnose small bowel cancer and reveal how far the cancer has spread. The process used to determine if cancer cells spread in and around the small intestine is called staging.

In order to plan the treatment, it is important to know the type of small bowel cancer and if surgery can be used to remove the tumor. Tests and procedures to detect, diagnose, and stage small bowel cancer are usually done at the same time. The following tests and procedures can be used:
Physical examination and history: examination of the body to check general signs of health and check signs of disease, such as masses or anything that looks unusual. They also record data on the patient's health habits, and the history of previous illnesses and treatments.
Blood biochemical tests: tests that examine a blood sample to measure the amount of certain substances that the body's organs and tissues release in the blood. An abnormal amount (greater or less than normal) of a substance is usually a sign of disease in the organ or tissue that makes it.
Liver function test: A procedure in which a blood sample is checked to measure the amounts of certain substances that the liver releases into the blood. A higher than normal amount of a substance may be a sign of liver disease that may be caused by small bowel cancer.
Endoscopy: A procedure in which the internal organs and tissues of the body are observed to identify abnormal areas. There are different types of endoscopy:
Upper endoscopy: A procedure to look inside the esophagus, stomach, and duodenum (the initial part of the small intestine near the stomach). An endoscope is inserted through the mouth into the esophagus, stomach, and duodenum. An endoscope is a thin tube-shaped instrument with a light and a lens to observe. You may also have an instrument to remove tissue samples, which is observed under a microscope to identify signs of cancer.
Endoscopy with capsule: procedure to observe the inside of the small intestine. The patient ingests a capsule that is almost the size of a large pill, containing a light and a miniature wireless camera. The capsule travels the digestive tract, including the small intestine, and sends several photos of the inside of the digestive system to a tape recorder that is attached to the waist or over the shoulder. The recorder sends the photos to a computer which is then observed by the doctor who is trying to identify signs of cancer. Then the body expels the capsule during a bowel movement.
Double balloon endoscopy: procedure to look inside the small intestine. A special instrument made up of two tubes (one inside the other) which is inserted through the mouth or rectum and into the small intestine. The inner tube (an endoscope with a light and a lens to observe) moves through a part of the small intestine and a balloon at the end of it, is inflated to keep the endoscope in place. Then, the outer tube travels through the small intestine to reach the end of the endoscope, and a balloon is inflated to the end of the outer tube to hold it in place. Then, the balloon at the end of the endoscope deflates and the endoscope moves to the next part of the small intestine. These steps are repeated multiple times as the tube moves through the small intestine. The doctor can see the inside of the small intestine through the endoscope and use an instrument to remove samples of abnormal tissue. Tissue samples are examined under a microscope for signs of cancer. This procedure can be carried out if the results of a capsular endoscopy are abnormal. This procedure is also called double balloon enteroscopy.
Laparotomy: surgical procedure in which an incision (cut) is made in the wall of the abdomen to check its interior for signs of disease. The size of the incision will depend on the reason for the laparotomy. Sometimes organs, lymph nodes or tissue samples are removed and examined under the microscope for signs of disease.
Biopsy: removal of cells or tissues for the purpose of observing them under a microscope to identify signs of cancer. This can be done during an endoscopy or a laparotomy. A pathologist reviews the sample to see if it contains samples of cancer cells.
Upper GI series with small bowel follow-up: series of x-rays of the esophagus, stomach, and small intestine. The patient drinks a liquid containing barium (a metallic, whitish-silver compound). The fluid lines the esophagus, stomach and small intestine. X-rays are taken at different times as the barium progresses through the upper GI tube and small intestine.
CT scan (CT scan): procedure by which a series of detailed images of internal areas of the body are taken from different angles. The images are created by a computer connected to an x-ray machine. A dye is injected into a vein or swallowed so that the organs or tissues are seen more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to create a series of detailed images of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI).
Certain factors affect the prognosis (probability of recovery) and treatment options.
The prognosis (probability of recovery) and treatment options depend on the following aspects:

Type of small bowel cancer.
If the cancer is only in the inner lining of the small intestine or has spread to the wall of the small intestine or beyond.
If the cancer has spread to other parts of the body, such as the lymph nodes, liver, or peritoneum (tissue that lines the wall of the abdomen and covers most of the organs in the abdomen).
If the cancer was completely removed by surgery.
If the cancer was recently diagnosed or relapsed.