Small Intestine Cancer - Causes, Symptoms, and Management

Introduction:

The small intestine is one of the important parts of the body’s digestive system. The digestive system processes vitamins, minerals, carbohydrates, fats, and proteins from the food that is eaten and eliminates the waste products from the body. The small intestine is a long tube that is multi-folded and connects the stomach to the large intestine.

What Are the Parts of the Small Intestine?

The small intestine has three parts:

1. Duodenum.

2. Jejunum.

3. Ileum.

The different types of small intestine cancers include:

There are five types of small intestine cancers-

1. Adenocarcinoma.

2. Sarcoma.

3. Adenoid tumors.

4. Gastrointestinal stromal tumor (GIST).

5. Lymphoma.

Of all types, adenocarcinoma is common and starts in the lining of the small intestine. Most small intestine cancers occur near the stomach; as it grows, it blocks the intestine.

What Are the Symptoms of Small Intestine Cancer?

1. Cramps and pain in the middle of the stomach.

2. Nausea, vomiting.

3. The stool may consist of blood and diarrhea.

4. The patient can feel a lump in the abdomen.

5. Weight loss, weakness, and fatigue.

6. Sometimes jaundice can also be detected.

What Are the Causes of Small Intestine Cancer?

Generally, cancer develops in the small intestine when the cells in the small intestine change the DNA. A cell’s DNA instructs the cell what to do and what not to do. And when this DNA has been damaged, the cells divide continuously, accumulate and form a new growth called cancer. And the cells are called cancerous cells. These cancerous cells may sometimes migrate to other body parts and cause damage. This is called metastases or cancer spread.

What Are the Risk Factors for Small Intestine Cancer?

Anything which increases the chances of getting the disease is called a risk factor.

1. Genetic/family Inheritance: Cancerous genes have inherited the children from their parents, increasing the chances for small intestine and other cancers. Example: familial adenomatous polyposis(FAP).

2. Other Intestine Diseases: Other diseases of the intestine may also affect and increase the risk of small intestine cancer. Examples: Crohn’s disease and inflammatory bowel disease. Celiac disease.

3. Diet: High-fat diet may increase the risk.

4. Immunity: Persons with weak immune systems are at risk of cancers. Example: HIV patients.

How to Diagnose and Detect the Stage of Small Intestine Cancer?

Diagnosing small intestine cancer and detecting the stage can be done at the same time by following tests:

1. Physical/body examination.

2. Blood tests.

3. Liver function tests.

4. Endoscopy is a procedure in which organs and tissues inside the body, like the stomach, esophagus, and small intestine, are checked for any abnormal growth. Upper, capsule, and double balloon endoscopy are different types of endoscopy.

5. In Laparoscopy, a minor cut is made on the abdomen wall to check for any abnormal growth inside the stomach.

6. In a biopsy, a small tissue is cut and sent to the lab to view under a microscope for any cancerous cells.

7. CT (computed tomography) scans and MRI(magnetic resonance imaging) are done to diagnose and stage cancer.

How to Treat Small Intestine Cancer?

Treatment options mainly depend on the type and staging of cancer:

• Surgery: The doctor may remove the affected portion of the small intestine and rejoin the cut ends. Sometimes, the whole intestine is removed, or a bypass can be done in the small intestine to relieve the blockage.

• Chemotherapy: Medication is given to the patient to kill the fast-growing cancer cells. It can be given to vein or in the form of oral medication. Chemotherapy in advanced stages of cancer would relieve cancer signs, symptoms, and pain.

• Immunotherapy: This is a treatment in which drugs/medications are given to the immune system to strengthen and fight back cancer.

• Targeted Drug Therapy: It targets the weakness within the cancer cells. Targeted drug therapy aims to block these weaknesses and kill cancer cells.

Survival rates of small intestine cancer depend on the spreading of cancer like:

• Locally: cancer is limited to small intestine walls.

• Regional: cancer has spread out the intestine wall into nearby lymph nodes.

• Distant: cancer has spread to distant body parts like the liver and large intestine.

What Are the Complications?

Small intestine cancers are difficult to diagnose. A suspected patient must undergo various tests to know the location of cancer or rule out cancer. The delay in diagnosis can lead to complications in the disease, such as:

• Upper and lower gastrointestinal bleeding.

• Small intestine perforations.

• Obstruction in the small intestine.

• Peritonitis (caused by leakage or hole in the stomach or intestine).

Prognosis and recovery depend on factors like:

• Type and stage of cancer.

• Whether the cancer is within the lining of the small intestine or has spread beyond the wall.

• Did cancer spread to other parts of the body?

• Whether the treatment is for reoccurrence or primary small intestine cancer.

What Questions Should a Patient With Small Intestine Cancer Ask the Doctor?

• What type of small intestine cancer?

• Where is cancer located, and what is its stage?

• What tests should be done to plan for the treatment?

• What are the treatment options? And why they are recommended

• What is the time duration of the treatment?

• Any side effects of treatment, and how to deal with them?

• Will cancer come back after the treatment? And how can I prevent a recurrence?

• Any change to be done in lifestyle example: diet, exercise.

When the treatment gets completed, it does not indicate that the cancer is completely cured. There are chances for recurrence or secondary cancers. Hence one must be careful in follow-up checks regularly. Cancer survivorship programs can make patients feel that they are in safe hands.

Reducing the risk factors can prevent cancer to some extent.

1. Say NO to smoking, alcohol, and unsaturated fats.

2. Maintaining a healthy weight by exercising.

3. Maintaining a Healthy lifestyle by eating fruits, vegetables, etc.

Conclusion:

Early diagnosis and treatment of small intestine cancers require a multidisciplinary team approach of doctors for treatment planning. Due to less suspicion, diagnosis is often delayed. Once the small intestine cancer has been diagnosed, the disease outcome will improve if the treatment plan is well coordinated among the team of doctors. If the cancer is diagnosed in advanced stages, palliative care is given to improve the quality of life. The doctors' team approach will drive the patient toward improved outcomes.