About the disease
Duodenal cancer develops in the beginning sector of the small intestine. It is more rare than other cancer types of digestive system. Duodenum is located right after the stomach, so the processed food is mixed in this part of digestive system with bile, before it goes further to the intestine. Bile helps food digest faster. Because this cancer is so rare and it has not been researched enough yet, it is sometimes difficult to diagnose it and choose the right type of treatment. Usually during the first stages patient experiences no pain. There is only feeling of general intoxication and heaviness in the stomach.
Duodenal cancer most often appears after 55 years of age. It is equally common for men and women. 5-year survival rate after surgery ranges from 17 to 67% and success depends on the personal ability of patient's body to resist the effect of neoplastic cells in future. According to American medical site NCBI 20 to 60% of patients experience such symptoms as abdominal pain, 50% lose weight and 30% have jaundice.
- Severe pain in the abdomen
- Sudden loss of weight
- Blood during defecation
- Constant taste of acid in the mouth
- Heaviness in the upper abdomen
- Daytime sleepiness
- Insomnia at night
- Yellow skin
- Dryness in the mouth, nose and eyes.
- Increased body temperature 39 ° C
- Sweating (especially at night)
Jaundice is probably the most common duodenum cancer symptom as it appears in 90% of cases. The reason for that is that the bile, which is responsible for digestion, retains in the body, and the skin gradually accumulated the color of yellow. Usually jaundice develops over the course of several months. After that not only the skin gets yellow, but also the whites of the eyes and urine change color. As tumor progresses the skin may acquire the greenish color which is an indicator of the pathology. Jaundice is very often followed by severe itching of the skin. This itching may become so unbearable, that person is unable to sleep at night, as it affects the central nervous system. Patient can be overly agitated, suffer from chronic insomnia and over time develop depression. Itching can not be alleviated by painkillers or other usual methods. It can appear in particular parts of the body or simply develop suddenly almost everywhere. Patients scratch themselves to the point of bloody marks, which can later turn into permanent scars.
Pain originates in the epigastric area, but it may spread to adjacent organs. The level of pain is different for every patient and some of them do not even have it, while others experience extremely unpleasant sensations. In most cases patients complain of the stabbing pain close to the stomach.
All patients with Crohn's disease are required to undergo annual examination, because almost half of duodenum cancer cases originate as a consequence of Crohn`s disease.
- Endoscopy is a diagnostic procedure, during which special optical instrument (endoscope) is inserted into the stomach.
- Biopsy is in most cases a mandatory diagnostic measure for patients who have all duodenum cancer symptoms. In order to determine the structure of tissues and cells doctor takes a little part of the small intestine.
- In some cases X-Ray may show if there is any tumor growth. In order to see if there are metastases in the liver and pancreas which spread from the abdominal cavity doctors use ultrasound.
- Computed tomography helps to understand the actual size of the tumor and determine its stage. Diagnosis is usually carried out by a gastroenterologist.
Almost all cases of duodenal cancer require surgery. Standard surgery for duodenal cancer is a resection, when a surgeon removes lymph nodes, which are located close to the duodenum.
Usually before surgery patients undergo course of radioactive intervention to reduce the size of the tumor and make it more susceptible to surgery.
- Surgical partial bowel resection is performed if cancer effected only one part of bowel.
- Surgical complete resection is used if the whole bowel was damaged. In some cases, transplantation of healthy part of the liver into the intestine allows doctors restore the bowel function of patient's organism.
- Circular resection is a removal of the affected area, followed by restoration of function.
- Connection of two parts of the intestine can be performed after resection of part of bowel to retain patient's intestinal function.
- Chemotherapy uses drugs that destruct tumor cells. Chemotherapy stops or at least slows the growth of cancer cells that rapidly divide and grow further.
- Radiation therapy. Basically, it is used in conjunction with chemotherapy or surgical treatment.
Studies show that radiation therapy for this kind of cancer are ineffective and it is usually used only to reduce tumor size and to prevent further relapse. It may also help to stop the development of metastases in the liver.