A rare type of cancer that begins to develop in the gastrointestinal tract is called small intestine cancer. These include carcinoid tumors, adenocarcinomas, sarcomas, and lymphomas. This type of cancer often requires multiple procedures and tests. Usually, the prognosis is different among people with this type of cancer because it depends on multiple factors. These include the severity and type of the cancer, the exact location where the tumor begins to develop, overall health, and others.
The small intestine is a part of the digestive system that also includes the following organs. For example, the liver, pancreas, gallbladder, and gastrointestinal (GI) tract. However, the small bowel is a part of the GI tract that involves a pathway of organs. These include the esophagus (a tube that carries drinks and food from the mouth to the stomach), stomach, small and large intestines. In addition, the small bowel connects the stomach with the large intestine. Generally, the small intestine consists of 3 parts. For example:
- Duodenum – This is the first part of the small bowel, and it is located near the stomach.
- Jejunum – The middle part of the small bowel.
- Ileum – this is the last part of the small intestine. Moreover, it is the largest part of the intestine.
Most diagnosed small intestine cancers are in the duodenum or the ileum.
Additionally, this type of cancer accounts for approximately 3% of all diagnosed gastrointestinal cancers in the U.S. Esophageal, stomach, and colon cancers occur more frequently than small intestine cancer.
Types of Small Intestine Cancer
Healthcare professionals have divided this condition into several types according to the type of affected cells. For example:
- Carcinoid tumors – These tumors begin to develop in the neuroendocrine cells. However, these types of cells produce hormones that help produce and release digestive juices in the small bowel. Less than 50% of all small intestine cancers involve carcinoid tumors.
- Adenocarcinomas – This type begins in the glandular epithelial cells (glands) that line your small intestine. About 30% of all diagnosed small intestine cancers are adenocarcinomas.
- Sarcomas – In such cases, the tumor begins to grow in the connective tissues, including cartilage or muscles. One of the most common types of sarcoma that negatively affects the small bowel is gastrointestinal stromal tumor (GIST). Formerly, GISTs were known as leiomyosarcomas.
- Lymphomas – When they occur, the tumor grows in a type of white blood cell (lymphocytes) in the lymphatic system. However, the lymphatic system is an important part of the immune system that helps fight viruses, bacteria, and other germs that can make you ill.
Symptoms
Usually, people who develop this type of cancer experience different symptoms because it depends on several factors. These include the severity, type, and exact location of the tumor, existing health problems, age, and others. However, in some cases, carcinoid tumors may not cause symptoms at all (asymptomatic tumors). In such cases, these tumors are accidentally found during imaging tests done for other reasons. Check below some symptoms that people with small intestine cancer often experience:
- Unusual weight loss
- Anemia
- Jaundice (yellowing of the eyes and skin)
- Bloody stools
- Flushed skin
- Nausea
- Vomiting
- Diarrhea
- A lump in the belly (abdominal area)
- Pain in the abdomen
Do not hesitate to see a doctor if you notice any of the previous symptoms.
Causes
Experts do not know what triggers DNA changes that eventually lead to this type of cancer. In normal circumstances, DNA contains instructions that tell cells when to grow, multiply, and die. However, a mutated DNA gives the cells different instructions that make them grow and multiply abnormally. When these abnormal cells become too numerous, they form a mass called a tumor. Over time, this tumor may grow large enough to break and spread throughout the body. In such cases, the condition is called metastatic small intestine cancer.
Risk Factors
While it is not possible to determine what exactly causes small intestine cancer, doctors have identified some factors that could elevate your risk of developing it. Check below some examples:
- Age – Older adults (over 65 years old) are more prone to this type of cancer compared to younger adults.
- Sex – This type of cancer is slightly more common in men.
- Race – In the United States, Black people are more likely to develop small intestine cancer. However, lymphoma is more commonly diagnosed in white people.
- Inherited genetic disorders – If you have a parent or sibling with any of the following conditions, your risk of developing small intestine cancer increases. These include adenomatous polyposis (FAP), Peutz-Jeghers syndrome, hereditary nonpolyposis colorectal cancer (HNPCC), and Lynch syndrome.
- Inflammatory diseases – Any health condition that causes chronic inflammation increases the risk of developing small intestine cancer. These include celiac disease, Crohn’s disease, and others.
- Autoimmune disorders or weakened immune system – There are some treatments and health conditions that may affect your immune system. For example, HIV/AIDS, radiation therapy, immunosuppressants, and others.
According to some recent studies, a poor diet (including salty or smoked foods and red meat), smoking, and alcohol could play a role in an increased risk of small intestine cancer. It is recommended to see a doctor if you think you are at increased risk of developing this type of cancer.
What Happens if Small Intestine Cancer is Left Untreated?
Those who develop this condition and do not have symptoms or do not get treatment may experience some complications. However, cancer treatments may also cause some complications. These include:
- Bleeding
- An increased risk of other cancers
- Blood clots
- Jaundice
- Malabsorption
- Infections
- Digestive changes
- Adverse reactions to anesthesia
- Anastomotic leaks
This article does not contain a full list of complications. However, you can talk with your physician about ways to reduce the risk of developing previous complications.
Diagnosis
Usually, it is difficult to diagnose this condition because it occurs rarely, and some tumors may not cause symptoms. That’s why to confirm this condition, you may need multiple procedures and tests. These include:
Physical Examination
Physicians usually begin the diagnosis of this condition with a physical examination to check for irregularities linked to the disease. They may also ask some questions about your medical history and symptoms.
Blood Tests
These tests are used to check your general health and get more clues about the disease. These include:
- Blood chemistry studies – This test is used to measure the amount of some substances that are released by organs and other tissues in the body. Sometimes, doctors may identify an increased level of a certain substance that may indicate health problems.
- Complete blood count (CBC) – Usually, doctors perform this test to get more information about your blood cells. For instance, tumors may cause bleeding that reduces the red blood cell count and cause anemia.
Imaging Tests
These include:
- Endoscopy – This test uses a small and flexible tube with a light and lens (endoscope) to examine the gastrointestinal (GI) tract. Physicians may also take a small amount of affected tissue or tumor for a biopsy. During this test, doctors will check the sample under a microscope for cancerous cells.
- Capsule endoscopy – During this procedure, the patient will swallow a capsule that contains a camera. It allows your doctor to see inside the GI tract while it travels through the body.
- CT (computerized tomography) scans – This imaging test is used to get cross-sectional images of different structures and organs in the body. Sometimes, physicians may inject a dye before this test to help the organs and tissues show up more clearly.
- MRI (magnetic resonance imaging) scans – This is another imaging test that uses radio waves and a magnetic field to produce detailed images of areas inside the body.
- Abdominal X-ray – This test is used to get pictures of organs and tissues inside the body.
- Barium X-ray – This imaging test involves a chalky substance known as Barium that allows for easier examination of your GI tract during an X-ray.
Surgery
When previous tests do not provide enough information to diagnose small intestine cancer, doctors may perform surgery to examine the organs directly and take samples for biopsy. The procedures include:
- Laparoscopy – During this procedure, doctors will insert a laparoscope (a flexible and thin tube) into the abdomen (belly) through a cut (incision). It helps examine the small intestine directly for signs of cancer.
- Laparotomy – This test also involves an incision in the abdominal wall that allows your doctor to examine the organs.
In addition, once you are diagnosed with small intestine cancer, physicians may perform additional imaging tests to determine the extent (stage) of the cancer. It helps make the best treatment plan for you.
Treatment
The treatment is often different among people with small intestine cancer. Check below the most common options often recommended for people with this type of cancer:
Surgery
This is the most common treatment for people who develop small intestine cancer. It is used to remove the tumor. It may include:
- Resection – During this procedure, surgeons will remove a part of the affected organ. In some cases, they can remove nearby tissue or organs if the cancer has spread. Thereafter, surgeons may perform an anastomosis (a procedure in which the cut ends are joined together).
- Bypass – This surgery helps food move around the tumor that blocks the intestine. It is often done when the tumor cannot be removed.
Chemotherapy
This treatment involves strong medications that help destroy cancer cells throughout the body. Usually, this option is recommended in the following cases. For example, before surgery to shrink a large tumor, after surgery to destroy cancer cells that may remain, or when surgery is not an option. In most cases, these medicines are given to the patients intravenously (IV), but a pill form is also available. Sometimes, it may be prescribed along with radiation therapy.
Radiation Therapy
This treatment uses powerful energy beams to kill cancer cells. This energy often comes from X-rays, protons, or other sources. Commonly, doctors prescribe radiation therapy in advanced stages of cancer or when surgery is not an option.
Somatostatin Analogs
Your physician may also recommend Somatostatin analogs to treat carcinoid tumors that develop in the small intestine. This medicine is used to interrupt the body’s production of too many hormones, which helps relieve the symptoms and control the cancer. In most cases, doctors prescribe Lanreotide and Octreotide.
Targeted Therapy
Healthcare professionals may also recommend this treatment that blocks certain substances in a cancer cell, causing it to die. Usually, doctors perform some tests to determine whether targeted therapy will be effective for you or not.
Immunotherapy
Most cancerous cells produce substances that help them hide from the immune system. Therefore, doctors prescribe immunotherapy to boost the immune system to find and destroy these abnormal cells. This treatment is also prescribed when the cancer metastasizes or when surgery is not an option.
Frequently Asked Questions
What is the survival rate for intestinal cancer?
Generally, the 5-year survival rate for intestinal cancer that has not spread is approximately 84%. If the cancer has spread to nearby tissues (such as lymph nodes), this survival rate decreases to roughly 78%.
What are the early signs of small intestine cancer?
Check below for the most common symptoms of this type of cancer:
- Jaundice
- Anemia
- Dark-colored stools
- Unexplained weight loss
- Nausea
- Vomiting
- Abdominal pain
Immediately contact your physicians if any of the symptoms listed above occur.
Is cancer in the small intestine curable?
Yes, but only when the tumor is localized. It means the tumor has not spread to other tissues and organs in the body. In such cases, doctors recommend surgery to remove the tumor. Ask your healthcare provider if you have additional questions.
