Small bowel cancer

lower digestive system body diagram showing Small Bowel Cancer

Facts and figures about small bowel cancer

Small bowel cancer is rare; only around 1,300 new cases a year are diagnosed in the UK. There is a very slightly higher incidence in men.

Age related, incidence rises after the age of 40 years with the highest incidence being in the 55-75 year age group. Approximately 40% are adenocarcinomas arising in the duodenum, 30% neuroendocrine commonly developing in the appendix or ileum, the remaining being much rarer lymphomas or sarcomas.

Risk factors include medical conditions such as Crohn’s disease, coeliac disease, Peutz-Jegher’s syndrome, previous colorectal cancer and familial adenomatous polyposis (FAP). Smoking and obesity are also possible risk factors.The symptoms are quite vague, so the disease is often advanced at diagnosis.

Small Bowel Cancer Symptoms

  • Dark or black stools.
  • Abdominal pain/cramps.
  • Anaemia.
  • Diarrhoea.
  • Nausea and vomiting.
  • Weight loss.

Diagnosis of small bowel cancer

Investigations may include:

  • Physical examination.
  • Endoscopy or colonoscopy – tissue samples may be taken for analysis.
  • Capsule endoscopy.
  • Chest X-ray.
  • CT scan.
  • MRI scan.

Small bowel cancer treatment

Depends on several factors:

  • The type of tumour.
  • The position of the tumour in the small bowel.
  • The stage of the cancer.
  • General health.

Surgery

Surgery is the main treatment for small bowel cancer. The tumour and an area of healthy surrounding tissue will be removed; the amount of bowel removed will depend on the size and position of the tumour.

Sometimes it is necessary to remove other organs such as the pancreas or part of the large bowel and lymph nodes near the tumour site will often be removed during the surgery.

In most cases the two sections of bowel either side of the resection can be joined together to enable normal bowel function to be maintained but occasionally this may not be possible and a section of the bowel is brought to the surface of the abdomen to form a stoma (Ileostomy), this is temporary sometimes to allow the bowel to heal and reversed later.

In advanced cases, surgical removal of the disease may not be possible but surgery may be performed to remove any blockage in the bowel.

Radiotherapy

Radiotherapy may be used to treat advanced small bowel cancer to help relieve or control symptoms such as a blocked bowel or it may be used if the disease recurs after surgery.

Chemotherapy

Chemotherapy can be used to treat advanced lymphomas of the small bowel or to help relieve symptoms in other forms of small bowel cancer. It is sometimes used in combination with radiotherapy (usually fluorouracil) to improve the effect of radiotherapy.

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