What is small intestine cancer?The small intestine is part of the gastrointestinal (GI) tract, also known as the digestive tract. The role of the GI tract is to process food as it passes through your body. Cancer occurs when part of the small intestine begins to grow out of control, leading to malignant (cancerous) cells forming. Small intestine cancers account for around 1 in 10 gastrointestinal tract cancers, and fewer than 1 in 100 cases of cancer overall. This makes the condition very rare.
Types of small intestine cancer:There are several different types of small intestine cancer. Different types of small intestine cancer spread at different rates is treated. Below are the most common forms of small intestine cancer:
- Carcinoid tumours: These tumours are the most common form of small intestine cancer. They are usually slow growing and form in the lining of the gastrointestinal (GI) tract.
- Adenocarcinomas: Accounting for 30 percent of small intestine cancers, adenocarcinomas start in the gland cells found throughout the inside of the intestine.
- Lymphomas: These cancers start in immune cells found throughout the small intestine. These cells are called lymphocytes.
- Sarcomas: Sarcomas form in connective tissues such as muscles and nerves surrounding the small intestine.
Causes and risk factors for small intestine cancer:A risk factor is something that increases the likelihood of small intestine cancer occurring. Risk factors do not guarantee that cancer will occur and a lack of risk factors does not guarantee that cancer won’t occur. Common risk factors associated with small intestine cancer include:
- Crohn’s disease – Crohn’s disease is a condition where the gastrointestinal tract is inflamed. It can cause diarrhoea, fever and fatigue. Inflammation of the small intestine can increase the likelihood of cancer forming.
- Dietary habits – People who eat lots of fatty food are at a higher risk of developing small intestine cancer. Some research has also suggested that people with diets consisting of lots of red meat or smoked foods are at higher risk.
- Age – Small intestine cancer usually occurs in older people. It is most often found in people aged between 60 and 70.
- Celiac disease – Celiac disease is a condition where eating gluten causes the immune system to attack the gastrointestinal tract. Celiac disease is liked to an increased likelihood of lymphoma occurring in the small intestine.
How is small intestine cancer diagnosed?In order to plan treatment, it is important that small intestine cancer is accurately diagnosed. There are several ways in which small intestine cancer can be diagnosed. When you initially visit a doctor, they will likely recommend a blood test and conduct a physical exam. The blood test allows them to check for abnormal levels that point towards an issue. Following initial examinations, a doctor may recommend one of the following: Endoscopy An endoscopy is a procedure where an endoscope is used to examine the insides of your body for irregularities. A common type of endoscopy is an upper endoscopy, where the endoscope is inserted down the throat, through the stomach and through duodendum. It has a lens which allows doctors to check for signs of cancer. It may also have a tool that can remove a sample of tissue for biopsy. Laparotomy A procedure where an incision is made through the surface of the abdomen to check for signs of cancer. Sometimes, tissue samples are removed to be further tested by doctors. Imaging A CT scan or MRI may be used so that doctors can see the insides of the body more clearly. Prior to the procedure, a dye may be injected or swallows which helps the organs and tissue to appear more clearly to doctors.
Symptoms of small intestine cancer:Below are some of the most common symptoms associated with small intestine cancer. If you are experiencing several of these symptoms, it is best to see a doctor as soon as possible. Early detection allows doctors to treat small intestine cancer more effectively.
- Abdominal pain – People with small intestine cancer will usually experience pain or cramps in the centre of their abdomen. This pain may become worse after eating. As the tumour gets larger, it can block the passage of digested food in the small intestine. This can lead to an obstruction, which causes pain and vomiting.
- A lump in the abdomen – Another common symptom is a noticeable lump around the abdomen. This is caused by the tumour swelling and growing over time. Unexplained lumps should be examined by a doctor as soon as possible.
- Weight loss – Small intestine cancer can result in an unexplained loss of weight. This can be accompanied by a loss of appetite, nausea and vomiting.
- Blood in stool – Small intestine cancer can cause intestinal bleeding, which can lead to blood in stools.
- Nausea and vomiting
- Fatigue and tiredness
- Yellowing of skin and eyes (jaundice)
- Reduced iron levels (anemia)
Treatment for small intestine cancer:There are several different available treatments for small intestine cancer. Each treatment comes with risks and side effects. For this reason, it is important that you consider all available options and work with your doctor to make an effective treatment plan. Below are some of the most common treatments:
Resection surgery:During resection surgery, surgeons will attempt to remove all traces of cancer from the small intestine. The surgeon may have to remove part of the small intestine and perform an anastomosis (joining the cut ends of the intestine together).
Bypass surgery:A bypass surgery is effective in reducing the symptoms of small intestine cancer, such as obstructions, weight loss and vomiting. A bypass surgery diverts the flow of digested food so that it bypasses the tumour. This prevents blockages from occurring. Bypass surgeries are ideal for cases where the tumour is too dangerous to remove in its entirety via resection. A bypass surgery will often be followed up by another treatment such as radiation therapy or chemotherapy. This will allow the tumour to be targeted and weakened without further surgical intervention.
Radiation therapy:During radiation therapy, a radiation oncologist will attempt to target the location of your tumour with high-energy x-rays or other types of radiation. External beam therapy is the most common form of radiation therapy and is used to treat small intestine cancer. It involves a machine sending radiation directly into the source of the tumour, weakening and destroying it. Radiation therapy is often used as a follow up to surgery so that all traces of cancer can be removed. Radiation therapy does cause side effects. These include:
- Fatigue and tiredness
- Red, irritated skin around the targeted area
- Loss of hair around the targeted area
Chemotherapy:During chemotherapy, patients will be given drugs that target and destroy cancer cells. The type of drugs used and method of chemotherapy depend on the nature of the tumour. Chemotherapy is usually given either intravenously (through the veins) or orally (via pils and other swallowed medication). Chemotherapy usually consists of several “sessions”. The time between sessions gives your body time to recover. Common side effects of chemotherapy include:
- Fatigue and tiredness
- Hair loss
- Increased risk of infection
- Appetite changes
- Nausea and vomiting