The small intestine consists of three distinct regions. The first one is the duodenum, it is connected to the stomach, followed by the jejunum and ileum. The development of a malignant tumor in one of these regions is called small bowel cancer. According to the histological structure, the most common tumor is adenocarcinoma (a tumor of glandular epithelium) - which is present in about 40% of all cases. The remaining 60% of cases are carcinoid tumors, sarcomas and lymphomas.
How does small bowel cancer manifest itself?
Small bowel cancer symptoms are nonspecific. A person may not have any reasons to establish or even suspect a diagnosis. Most likely, the patient will be examined for other more common diseases of the small intestine. During the diagnostic procedures, however, a tumor can be detected.
Small bowel cancer symptoms are as follows:
- Abdominal pain
- Weight loss
During the later stages, intestinal obstruction develops. There may be bleeding. If the tumor is located in the duodenum, there can be vomiting with blood. If the neoplasm is located in the lower region (ileum), black faeces can also be a symptom.
How is small bowel cancer diagnosed?
The diagnosis of small bowel cancer requires instrumental diagnostics. This includes:
- X-ray with contrast. It is minimally informative. In developed countries, this methodology is outdated. In developing countries it is sometimes used because of poorly equipped medical clinics.
- CT scan. With the help of a more progressive X-ray machine, layered pictures of the patient's body are created. The method is able to detect a tumor-like formation in the abdominal cavity and also metastases.
- Capsular endoscopy. The patient swallows the capsule with a video camera. It passes through the entire digestive tract. The image is broadcast to the monitor, allowing the doctor to visualize the tumor.
- FGDs. Fibrogastroduodenoscopy is a study whereby a patient swallows a tube with a camera. Unfortunately, this method can only diagnose cancer of the duodenum, because the device does not pass further.
- Double balloon enteroscopy. One of the best methods to detect small bowel cancer. It is similar to the FGD. However, a special structure of the endoscope enables the doctor to study other parts of the small intestine, in addition to the duodenum. It is usually performed under sedation (the patient is in a drowsy state).
- Colonoscopy. Endoscopic method, in which the tube is inserted into the anus. Such endoscopes can reach the small intestine. The procedure is poorly tolerated by patients, therefore it is carried out under sedation or anesthesia.
- Biopsy. This is the only reliable way to determine cancer of the small bowel. The sample tissue is taken for histological examination. A biopsy is taken during a vasodilator, enteroscopy or a colonoscopy. During the biopsy, the histological type of the tumor is determined, which determines the treatment tactics.
How to treat small bowel cancer?
The basis for treatment is a surgical method. The doctor removes part of the small intestine, a few centimeters from the edge of the tumor. Further chemotherapy and radiotherapy are carried out. This helps reduce the risk of relapse.
The prognosis for small bowel cancer is determined by a five-year survival rate. This is the percentage of people who survived 5 years after diagnosis.
Prognosis based stages for adenocarcinoma of the small intestine are:
- Stage 1 - 55%
- Stage 2 - 35-50%
- Stage 3 - 20-30%
- Stage 4 - 5%
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Author: Dr. Nadezhda Ivanisova