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Small Intestine Cancer
Summary Type: Treatment
Summary Audience: Patients
Summary Language: English
Summary Description: Expert-reviewed information summary about the treatment of small intestine cancer.
Small Intestine Cancer
General Information About Small Intestine Cancer
Small intestine cancer is a rare disease in which malignant (cancer) cells form in the tissues of the small intestine.
The small intestine is part of the
body’s digestive system , which also includes the
esophagus ,
stomach , and large
intestine . The
digestive system removes and processes nutrients (vitamins , minerals ,
carbohydrates , fats, proteins , and water) from foods and helps pass waste
material out of the body. The small intestine is a long tube that connects the stomach to the large intestine. It folds many times to fit inside the abdomen . Anatomy of the lower digestive system, showing the colon and other organs.
There are five types of small intestine cancer.
The types of cancer found in the small intestine are adenocarcinoma , sarcoma , carcinoid tumors , gastrointestinal stromal tumor , and lymphoma . This summary discusses adenocarcinoma and leiomyosarcoma (a type of sarcoma).
Adenocarcinoma starts in glandular cells in the lining of the small intestine and is the most common type of small intestine cancer. Most of these tumors occur in the part of the small intestine near the stomach. They may grow and block the intestine.
Leiomyosarcoma starts in the smooth muscle cells of the small intestine. Most of these tumors occur in the part of the small intestine near the large intestine.
Refer to the following PDQ summaries for more information on small intestine cancer:
- Adult Soft Tissue Sarcoma Treatment
- Childhood Soft Tissue Sarcoma Treatment
- Adult Non-Hodgkin’s Lymphoma Treatment
- Childhood Non-Hodgkin’s Lymphoma Treatment
- Gastrointestinal Carcinoid Tumor Treatment
Diet and health history can affect the risk of developing small intestine cancer.
Risk factors include the following:
Possible signs of small intestine cancer include abdominal pain and unexplained weight loss.
These and other symptoms may be caused by small intestine cancer or by other conditions. A doctor should be consulted if any of the following problems occur:
- Pain or cramps in the middle of the abdomen.
- Weight loss with no known reason.
- A lump in the abdomen.
- Blood in the stool .
Tests that examine the small intestine are used to detect (find), diagnose, and stage small intestine cancer.
Procedures
that create pictures of the small intestine and the area around it help diagnose small intestine cancer and show how far the cancer has spread. The process used
to find out if cancer cells have spread within and around the small intestine is
called staging .
In order to plan treatment, it is important to know the type of small intestine cancer and whether the tumor can be removed by
surgery . Tests and procedures
to detect, diagnose, and stage small intestine cancer are usually done at the same
time. The following tests and procedures may be used:
- Physical exam and history. An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Blood chemistry studies : A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.
- Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign of liver disease that may be caused by small intestine cancer.
- Abdominal x-ray : An x-ray of the organs in the abdomen. An x-ray is a type of energy beam that can go through the body onto film, making a picture of areas inside the body.
- Barium enema : A series of x-rays of the lower gastrointestinal (GI) tract . A liquid that contains barium (a silver-white metallic compound) is put into the rectum . The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series. Barium enema procedure. The patient lies on an x-ray table. Barium liquid is put into the rectum and flows through the colon. X-rays are taken to look for abnormal areas.
- Fecal occult blood test : A test to check stool (solid waste) for blood that can only be seen with a microscope. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing. Fecal Occult Blood Test (FOBT) kit to check for blood in stool.
- Upper endoscopy : A procedure to look at the inside of the esophagus, stomach, and duodenum (first part of the small intestine, near the stomach). An endoscope (a thin, lighted tube) is inserted through the mouth and into the esophagus, stomach, and duodenum. Tissue samples may be taken for biopsy .
- Upper GI series with small bowel follow-through: A series of x-rays of the esophagus, stomach, and small bowel. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus, stomach, and small bowel. X-rays are taken at different times as the barium travels through the upper GI tract and small bowel.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. This may be done during the endoscopy. The sample is checked by a pathologist to see if it contains cancer cells.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
- Laparotomy : A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken for biopsy.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
- The type of small intestine cancer.
- Whether the cancer has spread to other places in the body.
- Whether the cancer can be completely removed by surgery.
- Whether the cancer is newly diagnosed or has recurred .
Stages of Small Intestine Cancer
Tests and procedures to stage small intestine cancer are usually done at the same time as diagnosis.
Staging is used to find out how far the cancer has spread, but treatment decisions are not based on stage . See the General Information section for a description of tests and procedures used to detect, diagnose , and stage small intestine cancer.
Small intestine cancer is grouped according to whether or not the tumor can be completely removed by surgery.
Treatment depends on whether the tumor can be removed by surgery and if the cancer is being treated as a primary tumor or is metastatic cancer .
Recurrent Small Intestine Cancer
Recurrent small intestine cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the small intestine or in other parts of the body.
Treatment Option Overview
There are different types of treatment for patients with small intestine cancer.
Different types of treatments are available for patients with small intestine cancer . Some treatments are standard (the currently used treatment), and some are being tested in clinical trials . Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Three types of standard treatment are used:
Surgery
Surgery is the most common treatment of small intestine cancer.
One of the following types of surgery may be done:
- Resection : Surgery to remove part or all of an organ that contains cancer. The resection may include the small intestine and nearby organs (if the cancer has spread). The doctor may remove the section of the small intestine that contains cancer and perform an anastomosis (joining the cut ends of the intestine
together). The doctor will usually remove lymph nodes near the small intestine and examine them under
a microscope to see whether they contain cancer.
- Bypass : Surgery to allow food in the small intestine to go around (bypass) a tumor that is blocking the intestine but cannot be removed.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy .
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells . There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy ). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen , the drugs mainly affect cancer cells in those areas (regional chemotherapy ). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Other types of treatment are being tested in clinical trials. These include the following:
Biologic therapy
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Radiation therapy with radiosensitizers
Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment Options for Small Intestine Cancer
Small Intestine Adenocarcinoma
When possible, treatment of small intestine adenocarcinoma will be surgery to remove the tumor and some of the normal tissue around it.
Treatment of small intestine adenocarcinoma that cannot be removed by surgery may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about these and other ongoing clinical trials is available from the NCI Web site.
Small Intestine Leiomyosarcoma
When possible, treatment of small intestine leiomyosarcoma will be surgery to remove the tumor and some of the normal tissue around it.
Treatment of small intestine leiomyosarcoma that cannot be removed by surgery may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about these and other ongoing clinical trials is available from the NCI Web site.
Recurrent Small Intestine Cancer
Treatment of recurrent small intestine cancer that has spread to other parts of the body is usually a clinical trial of new anticancer drugs or biologic therapy .
Treatment of locally recurrent small intestine cancer may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about these and other ongoing clinical trials is available from the NCI Web site.
Changes to This Summary (10/18/2006)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
To Learn More
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For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
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The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.
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The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
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About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
2004-03-242006-10-18
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