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Adenocarcinoma of the Small Bowel - Risk Factors, Symptoms, Diagnosis, and Management

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Adenocarcinoma of the small bowel is an uncommon disease in which cancer cells form in the tissues of the small intestine.

Written by

Dr. P. Saranya

Medically reviewed by

Dr. Ghulam Fareed

Published At November 8, 2022
Reviewed AtOctober 5, 2023

Introduction:

The small intestine is a part of the digestive system. It breaks down foods and nutrients to be absorbed into the body. The small intestine refers to a long tube that connects the stomach to the large intestine. The small bowel is differentiated into three parts: the duodenum, the jejunum, and the ileum. Small bowel cancer develops when healthy cells in the lining of the small intestine change and grow out of control, forming a mass of cancer cells.

What Is Adenocarcinoma of the Small Bowel?

There are five types of cancers of the small bowel: adenocarcinoma, sarcoma, lymphoma, carcinoid tumors, and gastrointestinal stromal tumors. Adenocarcinoma is one of the most common types of small bowel tumors, and it begins in the glandular cells present in the lining of the small intestine. It usually occurs in the duodenum or jejunum.

What Are the Major Risk Factors for Adenocarcinoma of the Small Bowel?

The following factors increase the risk of small bowel cancer:

What Are the Signs and Symptoms of Adenocarcinoma of the Small Bowel?

What Is the Diagnosis for Adenocarcinoma of the Small Bowel?

The following tests are done for the diagnosis of adenocarcinoma of the small bowel:

  • A physical examination of the patient is done, and history is asked about the symptoms.

  • Blood Tests: Blood tests are done to see the red blood cell count to check whether the cancer is causing any bleeding.

  • Liver Function Test: Blood samples are taken and tested for substances that are released from the liver. Small bowel cancer can cause liver disease, which increases the amount of substances released from the liver.

  • Computed Tomography (CT) Scan: This procedure takes a series of pictures of the inside of the body, and the pictures are seen on a computer.

  • Magnetic Resonance Imaging (MRI): This procedure uses a magnetic field to show the inside of the body.

  • Biopsy: Biopsy refers to the removal of a small amount of tissue for examination in the laboratory. A biopsy can give a definitive diagnosis of cancer.

  • Barium Swallow: The patient drinks a liquid solution called barium which coats the lining of the small intestine, and a series of x-rays are performed.

  • Endoscopy: An endoscope refers to a thin and flexible tube attached with a camera inserted through the mouth into the esophagus, stomach, and duodenum. A tissue sample (biopsy) can also be removed during endoscopy for analysis.

  • Capsule Endoscopy: It is a newer technique in which a capsule (pill) attached with a camera is swallowed by the patient, which travels through the digestive tract and shows the inside of the small intestine. The capsule comes out of the body during a bowel movement.

  • Colonoscopy: A long, thin tube is inserted into the rectum and anus to view the entire colon and the last part of the small intestine.

  • Laparotomy: In this procedure, a small cut is made in the wall of the abdomen to check for the disease. Sometimes, organs, lymph nodes, or tissues are removed during the procedure.

  • Positron Emission Tomography (PET) Scan: A small amount of radioactive substance is injected into the body, and many images are taken to view the inside of the body.

How Is the Staging of Adenocarcinoma of the Small Bowel Done?

Staging is used to find how far cancer has spread. There are three ways through which cancer spreads in the body: tissue, blood, and lymph. When cancer spreads to other parts of the body, it is called metastasis. The metastatic tumor is similar to the primary tumor. Small intestine cancer is also grouped according to whether or not the tumor can be completely removed by the surgery. Small bowel cancer can recur even after it is treated. Cancer can recur in the small intestine or any other part of the body.

What Is the Treatment of Adenocarcinoma of the Small Bowel?

The common treatment methods are:

  • Surgery: Surgery is the most commonly preferred treatment of adenocarcinoma of the small bowel. Two types of surgery include:

  • Resection: Surgery to remove part or all of the small intestine. Part of the small intestine is removed, and the cut ends are joined (anastomosis). The doctor also removed the lymph nodes near the small intestine and checked them for cancer.

  • Bypass: If a tumor is blocking the intestine. Surgery is done to bypass and allow the food to pass through the small intestine,

  • Radiation Therapy: Radiation therapy uses high-energy x-rays to kill cancer cells. There are two types of radiation therapy:

  • External Radiation Therapy: Radiation is sent to the area of cancer from a machine outside.

  • Internal Radiation Therapy: Radioactive substance is placed directly into cancer which kills cancer cells.

  • Chemotherapy: In chemotherapy, drugs are used to kill cancer cells or stop them from growing.

  • Immunotherapy: In this type of treatment, the patient's immune system is used to kill the cancer cells.

  • Radiation Therapy With Radiosensitizers: Radiosensitizers refer to the drugs that make tumor cells more sensitive to radiation therapy. A combination of radiotherapy and radiosensitizers can kill more cancer cells.

What Is the Treatment Of Metastatic Small Bowel Cancer?

If cancer spreads to other parts of the body from the original place, it is called metastatic cancer. Diagnosis of metastatic cancer can be difficult sometimes. Often, chemotherapy is the first line of treatment recommended for metastatic cancer.

Conclusion:

Adenocarcinoma of the small bowel is an infrequent disease. Early-stage cancers can be treated by surgery, chemotherapy, or radiation therapy. Late-stage or advanced cancers are difficult to control and cure, and the patient should be given treatment to relieve pain and emotional support.

Frequently Asked Questions

1.

What Is the Survival Outlook for Small Bowel Adenocarcinoma?

Small bowel adenocarcinoma survival prospects vary greatly depending on elements, including the diagnosis stage and treatment efficacy. Early-stage cases often have a better prognosis and a 60 to 80 percent five-year survival rate. Early detection and treatment are crucial because late-stage patients may have a poorer survival chance.

2.

Can Small Bowel Adenocarcinoma Be Effectively Treated?

Treatment for small bowel adenocarcinoma is successful, particularly when discovered early on. Surgery to remove the tumor is usually the first step in treatment, and chemotherapy or radiation therapy may follow. The stage, location, and general health of the patient affect how well the patient responds to treatment.

3.

Is There a Way to Remove Adenocarcinoma?

Adenocarcinomas are frequently removed surgically. For localized adenocarcinomas, surgery is a popular treatment option to remove the tumor and any potentially surrounding affected tissues. The tumor's location and size will determine the surgery's extent.

4.

What Are the Recommended Treatment Options for Adenocarcinoma?

The recommended adenocarcinoma treatments take a comprehensive approach. Depending on the stage and features of the cancer, surgery, chemotherapy, radiation therapy, targeted therapies, and immunotherapy can all be used as forms of treatment. Each patient's circumstances are considered when developing the appropriate treatment plan.

5.

Can Stage Four Adenocarcinoma Be Managed?

Although it is difficult to treat stage four adenocarcinoma, it can be treated to enhance the patient's quality of life and perhaps lengthen survival. Palliative care, chemotherapy, radiation therapy, and targeted therapies are all possible forms of treatment. Now, symptom management and slowing cancer progression are the main objectives.

6.

At What Age Is Small Bowel Adenocarcinoma Typically Diagnosed?

Adults over 60 or 70 are frequently diagnosed with small bowel adenocarcinoma. It is important to keep in mind that this cancer could develop in persons of any age group, especially when symptoms or risk factors are present, even though it is less common in younger people.

7.

Where Does Small Bowel Adenocarcinoma Most Commonly Originate?

The first section of the small intestine, the duodenum, is where small bowel adenocarcinomas most frequently develop. Though less frequently, it can also happen in other regions of the small intestine.

8.

Does Adenocarcinoma Have the Potential to Metastasize?

Adenocarcinoma can spread. In the later stages of the disease, it can spread to neighboring lymph nodes or distant organs. Routine monitoring and early intervention are essential to manage and treat metastatic adenocarcinoma.

9.

Why Is Adenocarcinoma Frequently Diagnosed?

Since adenocarcinoma can grow in a number of organs, including the lungs, colon, pancreas, and more, it is frequently diagnosed. Regular cancer screenings and enhanced diagnostic methods also aid in early detection.

10.

What Are the Advanced Stages of Adenocarcinoma?

Treatment becomes more difficult in the later stages of adenocarcinoma when the cancer has spread to neighboring lymph nodes or distant organs. At this point, the priority frequently changes to symptom management and improving the patient's quality of life.

11.

Is Chemotherapy a Necessary Treatment for Adenocarcinoma?

Chemotherapy is frequently used to treat adenocarcinoma, particularly when it is advanced or surgery is not an option. The accurate characteristics and stage of the malignancy will determine whether chemotherapy is necessary and whether treatment regimens are customized.

12.

How Rapidly Does Adenocarcinoma Spread?

Adenocarcinoma can spread at different speeds depending on the cancer's aggressiveness, stage, and response to treatment. It can move more slowly in some circumstances or more quickly in others. To monitor its progression, routine medical follow-ups and monitoring are necessary.

13.

What Dietary Choices Are Recommended for Individuals With Adenocarcinoma?

Adenocarcinoma patients' diets should complement their overall cancer management plans. A nutritious, well-balanced diet can support the immune system and general health. Healthcare professionals should be consulted on any specific dietary recommendations.

14.

Can Chemotherapy Provide a Cure for Adenocarcinoma?

In certain circumstances, particularly when the cancer is discovered in its early stages, chemotherapy can cure adenocarcinoma. Chemotherapy's efficacy, however, varies according to the features of the tumor and the patient's response to the medication.

15.

Is Adenocarcinoma a Malignant or Benign Condition?

Adenocarcinoma is a malignant condition. Adenocarcinoma is one type of malignant tumor that can infect neighboring tissues and spread to other areas of the body, posing a serious threat to health and even life.

16.

What Is the Rate of Progression for Adenocarcinoma?

Adenocarcinoma progression rates vary greatly from person to person and are influenced by the biology of the tumor, the stage upon diagnosis, and the effectiveness of the treatment. While some cases develop gradually over the years, others could do so quickly. Medical surveillance is essential for determining progress.

17.

What Is the Rate at Which Adenocarcinoma Spreads?

Adenocarcinoma spreads at varying rates depending on the individual. It varies on a number of variables, including the kind and stage of the adenocarcinoma, the patient's general condition, and how well the treatment worked. Adenocarcinoma can spread quickly in some instances while growing more slowly in others. To control its progression, early detection and prompt treatment are essential.
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Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology

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