Malignant Neoplasms of the Small Intestine

Introduction

Malignancies of the small intestine are usually rare, affecting the intestines and spreading to surrounding organs. Small bowel cancers are often called small bowel cancers, affecting the intestines and spreading to surrounding organs. Malignant intestinal tumors are fast-growing (show metastasis). They can spread via blood and lymph nodes to other body regions, forming a secondary tumor at the new location. Diagnosis of small intestinal tumors is not easy and requires multiple diagnostic procedures.

What Are the Causes of Malignant Neoplasms of the Small Intestine?

There are no specific reasons behind developing malignant neoplasms of the small intestines. However, certain factors may increase the risk of developing cancer. These include:

• A person's age (the cancer is diagnosed at 60 and above).

• Genetics of a person (any disorders present since birth).

• High-fat diet.

• Sex of a person (males are more at risk than females).

• Alcohol use.

• Smoking habits.

• Lymphedema (blood vessel damage connecting to lymph nodes).

• Phenoxy acetic acid exposure.

• Colon cancer, Crohn’s, and celiac disease are certain conditions that may affect the gut and cause cancer.

What Are the Types of Malignant Neoplasms of the Small Intestine?

The types of malignant neoplasms of the small intestine are as follows:

• Sarcoma - These malignant cells mainly develop in muscles, connective tissues, and cartilage. Sarcomas can be found in the soft tissues of the small intestine.

• Adenocarcinoma - These malignant or cancerous cells originate from the small intestinal lining. Initially, they appear as a non-cancerous cell growth called polyps and later transform into cancer.

• Intestinal Lymphoma - This type of malignant neoplasm develops in the lymph nodes and is seen most commonly in people having immunodeficiency disorder or inability to fight infections. These lymphomas can be further subdivided into non-Hodgkin lymphoma and Hodgkin lymphoma.

• Carcinoid Tumors - These are slow-growing tumors affecting the small intestine's lower part, and their roots often spread into the appendix or rectum.

• Gastrointestinal Stromal Tumors (GISTs) - These are rare small intestine neoplasms or cancer. The GISTs are not usually cancerous; a significant part of this tumor develops in the abdomen.

What Are the Symptoms of Malignant Neoplasms of the Small Intestine?

The symptoms of malignant neoplasms of the small intestine:

• Nausea.

• Vomiting.

• Abdominal pain.

• Watery diarrhea.

• Tiredness or weakness.

• Skin flushing.

• Jaundice.

• Weight loss.

• Blood in the stool may be black or red.

• Anemia.

• Lump in the abdomen.

• Bloating.

• Fatigue.

How Are Malignant Neoplasms of the Small Intestine Diagnosed?

The malignant neoplasms of the small intestine are sporadic tumors with varying symptoms depending on the type. Therefore, the diagnosis of these tumors is very complicated. Thus, the following procedures are done to diagnose tumors of the small intestine:

1. The doctor examines the patient clinically to check the condition's symptoms and may ask about the previous medical history or any medication a person is taking.

2. The doctor also advises many blood tests to measure the levels of certain substances released by the body's tissues and organs. These tests include a liver function test to check for malignancy symptoms in the liver, a fecal occult blood test to check blood in stool, complete blood test for anemia (reduced red blood cells).

3. In addition, a lymph node biopsy is also done to check for cancer cells in lymph nodes by taking small lymph tissue.

4. Another method is laparotomy, in which the abdominal walls are surgically opened to check for the signs and symptoms of the disease.

5. Also, radiological screening or imaging is done to diagnose the disease. These include:

• Computed tomography (CT scan).

• Magnetic resonance imaging (MRI).

• Abdominal X-rays.

• Barium X-rays (gastrointestinal tract is coated with barium).

• Upper endoscopy.

• Capsule or pill endoscopy carries a tiny camera in the pill and travels through the gastrointestinal tract.

How Are Malignant Neoplasms of the Small Intestine Managed?

Small intestine neoplasms can be treated in the following ways:

Surgery: This is the most common treatment method for malignant neoplasms of the small intestine. The surgeries include:

• Bypass - This surgery allows the food in the intestine to bypass or go through the tumor that blocks the passage of the intestine and cannot be removed.

• Resection - In this surgical method, the doctor may remove the entire organ or a part of it that is affected by cancer. If cancer spreads to other organs, the healthcare provider pulls that part of the organ along with the affected intestinal segment. The cut ends are rejoined again by anastomosis. Lymph nodes around the intestine are also removed to check for cancer spread.

Radiation Therapy: This treatment involves high radiation or high-energy X-rays to eliminate the cancer cells or prevent them from growing. This method is opted for by the healthcare provider if cancer cannot be removed with surgery. Radiation therapy is also used to relieve symptoms through palliative care. The treatment is often combined with chemotherapy to kill or remove the remaining cancer cells.

Chemotherapy: This therapy uses drugs to prevent cancer cells from dividing and killing them altogether. Chemotherapy treatment drugs can be used to target specific organs of the body to kill cancer cells and are called regional chemotherapy. At the same time, systemic chemotherapy can be used to destroy the cancer cells of the entire body.

Targeted Therapy: This therapy aims to recognize the cancer cells' weaknesses and kill them accordingly. Further studies are undergoing to use this targeted therapy for lymphomas, GISTs, and adenocarcinomas.

Somatostatin Analogs: These drugs help to prevent the body from producing too many hormones and are mainly used to treat carcinoid tumors of the small intestine. Somatostatin analogs control the disease spread by easing the symptoms. Examples include octreotide and lanreotide.

Immunotherapy: This helps boost the body's immune system to fight malignancies. Immunotherapy helps the immune system of the body to identify cancer cells and eliminate them.

Conclusion

Malignant cancers of the small intestine can pose a severe threat to a person's life due to varying types, making the diagnosis challenging. However, many treatment options and methods are available to manage this rare disease. Also, early diagnosis of the disease and timely medical intervention by the healthcare provider can improve the prognosis and increase people's survival rate.