Small Intestine Cancer

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Cancerous cells are mutated cells that turn malignant in the small bowel. The signs are similar to other bowel inflammation diseases and should be diagnosed if you want to be treated on time to get rid of complications and aid survival. The small intestine, also called the small bowel, is a part of the digestive […] Read More

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Small Intestine Cancer

What is a small intestine cancer?

Small intestine cancer involves mutated cells that can cause cancer in the small bowel. The signs are similar to other bowel inflammation diseases and should be diagnosed if a person wants to be treated on time to eliminate complications and aid survival.

The small intestine, also called the small bowel, is a part of the digestive system which breaks down the food and absorbs the necessary nutrients needed in the body.

Small intestine cancer happens when the cells or tissues of the linings in the small bowel begin to alter their form and grow malignant. These malignant cells swell into a mass of tumors and spread to other parts of the intestine. 

small intestine cancer
Picture Courtesy: medindia

What are the types of small intestinal cancer?

types of small intestine cancer
Picture Courtesy: jnccn.org

Based on location, small intestine cancer has five major types. They include:

  • Adenocarcinomas

The cancer starts with the cells in the lining tissues of the small intestine called the secretory cells. These cells, responsible for producing digestive juices, begin to develop polyps, which are small, noncancerous growths, and as they keep growing, they become cancer.

  • Sarcomas

This type of cancer starts in the soft tissues of the small intestine. Cancerous cells grow in the bones and soft tissues like muscles, cartilage, and fibrous connective tissues.

  • Carcinoid Tumors

This type of cancer grows in the lower section of the small bowel and, in critical cases, affects the rectum and/or appendix. It may also spread to the liver and other parts of the body. Cancer consists of slow-growing tumors and expels the chemicals that can harm the body.

  • Lymphomas

This cancer begins in the lymph nodes–which are the cells of the immune system–in the small intestine. The nodes swell and become cancerous. It often occurs in people with immunity deficiencies and a weakened defense system that cannot fight against infections.

  • Gastrointestinal stromal tumors . 

This type of cancer forms in the inner walls of the stomach. However, not all of these tumors are cancerous and are the rarest form of small bowel cancer.

Causes

Generally, small bowel cancer is caused by the mutation in the DNA of healthy cells in the small bowel. The DNA of these cells suddenly gets damaged, and they begin to grow and divide when they aren’t needed and in an unhealthy manner. They grow into tumors and a mass, becoming cancerous, then spreading out into other parts by destroying other healthy tissues.

What are the risk factors associated with small intestine cancer?

The factors that are likely to increase the risk and chances of getting small intestinal cancer include:

  • Family Trait

Most times, gene mutations are inherited and passed through the family via genetic strands. This can be why a person has a high risk of cancer.

  • Bowel Diseases

Diseases that attack the digestive tracts and intestines, like inflammatory bowel disease, can increase the risk of having small bowel disease.

  • Immunodeficiency

Suppose a person has a weakened immune system. In that case, the chances of developing small bowel cancer are high since the body’s immune system is too weak to fight against bacteria and viruses that can cause inflammation or cell mutation. Like in the case of HIV or as a result of the anti-rejection drugs taken by the patient after an organ transplant.

  • Age

Small bowel cancer is usually diagnosed in people more than 60 years of age.

  • Gender

This cancer happens more in males than in females.

  1. Smoking and alcoholic drinks can cause inflammation.
  2. High fat and calorie intake.
  3. Working or living in areas with plenty of chemical substances.

Symptoms

The signs of small intestine cancer include:

  • Abdominal pains and cramps
  • Appetite loss
  • Exhaustion/Fatigue
  • Nausea
  • Weight loss
  • Bloated stomach or lumps on the stomach
  • Diarrhea
  • Bloody stools
  • Anemia
  • Jaundice; characterized by yellowing skin and eyes.

How is small bowel cancer diagnosed?

The symptoms mentioned above can often be confused with other gastrointestinal diseases like inflammatory bowel disease. Whenever the patient notices any abnormal signs, the patient should consult the doctor immediately.

During the consultation, the doctor will go through the medical and family history to determine the chances of the patient noticing, but these are assumptions. The doctor will have to carry out some tests to confirm cancer.

Several tests can be used to give diagnoses. They include:

  • Blood tests, liver function tests.
  • Imaging tests such as X-rays, MRI scans, and CT scans of the abdomen to look for tumor location, size, etc.
  • Biopsy; examine a small part of the intestine or lymph node after scraping it out.
  • Fecal occult Blood Test- To detect blood in the stool.
  • Endoscopic tests such as upper endoscopy, capsule barium, colonoscopy, etc.
  • Laparotomy.

How is small bowel cancer treated?

The treatment plan for small bowel cancer depends on factors such as the stage of cancer, grade of metastasis (spread of cancer) to other body organs, and the patient’s overall condition. However, early diagnosis and early treatment have a better prognosis and early recovery from cancer.

Before the treatment of small bowel cancer is given, some questions are put into consideration:

  1. Is cancer spreading to other areas of the body?
  2. Was cancer in remission or a new diagnosis?
  3. Is cancer removable?

The doctor can know what treatment to give based on the answers to these questions. The two main treatments are:

Surgery

This is performed to remove the cancerous tumors from the affected areas. Also, bypass surgery can be conducted when the tumors cannot be removed. This bypass surgery is used to change the direction of food around the tumor to prevent malnutrition. The kinds of surgery performed for the removal of cancer are listed below:

  1. Laparoscopic surgery or keyhole surgery- During this procedure, minor cuts (incisions) are made in the abdominal area, and a thin camera is placed inside the abdomen. The tumor is removed, and the incisions are sutured (stitch).
  2. Laparotomy- During this procedure, a long incision is made in the abdominal area, and the tumor is removed.

Chemotherapy

Chemotherapy can be given after the surgery to prevent the tumors from reoccurring or given after diagnoses to kill mutating cells and put cancer in remission.

A high-energy X-ray that kills cancerous cells.

  • Somatostatin analog- this treatment is used to treat carcinoid tumors of the small intestine. During this treatment, these medications are used to stop our bodies from making too many hormones. They can ease symptoms and help our body to control the disease. The most commonly used drugs are lanreotide and octreotide.
  • Targeted therapy
  • Immunotherapy  

Possible Complications

The main risk or complications that may arise if the small bowel intestine is not taken care of on time is the spread of cancer to other parts of the body. As the cells continue to mutate and spread out, damaging other healthy cells, these cells become cancerous, and with time, more body parts can be affected by cancer other than the small bowel.

What is the survival rate of small bowel cancer?

Research has kept the survival rate of small bowel cancer at five years, and the percentage of a victim surviving in 5 years depends on how early the cancer is diagnosed and treated.

If detected and treated early, the survival rate stands at 87%. If the cancer is discovered when it has spread to surrounding cells or organs, the survival rate stands at 76%. If found when it has spread too far areas of the body, then the 5-year chance is at 42%.

FAQ

What are the foods items that cause polyps?

Polyps are the first forms of cancer. They are not cancerous, but as mutated cells keep growing and forming polyps, with time, the amassed volume of these polyps turns cancerous.
Foods that cause cells to produce polyps include; fatty foods, foods with high cholesterol, red meats, and processed meats.

Do polyps grow back?

Whenever polyps are detected, it is advisable to operate on them and take them out before they turn cancerous. When a polyp is removed, it is hard for it to develop on the exact spot it was taken out. Instead, it can grow in other parts of the body. 

Can a person survive small intestine cancer?

Research has kept the survival rate of small bowel cancer at five years, and the percentage of a victim surviving in 5 years is dependent on how early the cancer is diagnosed and treated.
If detected and treated early, the survival rate stands at 87%. If the cancer is discovered when it has spread to surrounding cells or organs, the rate stands at 76%. If discovered when it has spread too far areas of the body, then the 5-year chance is at 42%

What percentage of the small intestine can you remove?

The small intestine is regenerating and very adaptable. Removing 40% of the organ changes little as the digestion process will still be possible. However, when more than 40% is removed, especially some crucial parts, complications can arise, leading to the intestine’s death.

How common is small intestine cancer?

Small intestine cancer is very rare. It accounts for only 3% of the total gastrointestinal cancers in the USA. The most common types of cancer that affect the small intestine are rectal cancer, colon cancer, esophageal cancer, and stomach cancer [1].

References

  1. https://my.clevelandclinic.org/health/articles/6225-small-intestine-cancer