Small bowel cancer starts in the small intestine. Find out more about symptoms and treatments, including surgery, chemotherapy and targeted therapy.
Small bowel cancer is an uncommon type of cancer that occurs in the small intestine. Your small intestine, which is also called the small bowel, is a long tube that carries digested food between your stomach and your large intestine (colon).
The small intestine is responsible for digesting and absorbing nutrients from the foods you eat. It produces hormones that help with digestion. The small intestine also plays a role in your body's germ-fighting immune system, as it contains cells that fight bacteria and viruses that enter your body through your mouth.
Types of small bowel cancer include:
What treatment options are best for you depend on the type of small bowel cancer you have and its stage.
The small intestine, also known as the small bowel, runs from your stomach to your large intestine (colon). The small intestine has three sections: the duodenum, the jejunum and the ileum.
Signs and symptoms of small bowel cancer include:
Doctors aren't certain what causes most small bowel cancers.
In general, small bowel cancer begins when healthy cells in the small bowel develop changes (mutations) in their DNA. A cell's DNA contains a set of instructions that tell a cell what to do.
Healthy cells grow and divide in an orderly way to keep your body functioning normally. But when a cell's DNA is damaged and becomes cancerous, cells continue to divide — even when new cells aren't needed. As these cells accumulate, they form a tumor.
With time, the cancer cells can grow to invade and destroy normal tissue nearby. And cancerous cells can spread (metastasize) to other parts of the body.
Factors that may increase the risk of small bowel cancer include:
Small bowel cancer can cause complications, including:
It's not clear what may help to reduce the risk of small bowel cancer, since it's very uncommon. If you're interested in reducing your risk of cancer in general, it may help to:
Small bowel cancers are difficult to diagnose. For this reason, people suspected of having small bowel cancer often undergo multiple tests and procedures to locate the cancer or rule out a cancer.
Imaging tests use machines to create pictures of the body in order to look for signs of small bowel cancer. Imaging tests used to diagnose small bowel cancer include:
Endoscopic tests involve placing a camera inside your small intestine so that your doctor can examine the inside walls. Endoscopic tests may include:
Endoscopic tests, other than the capsule endoscopy, allow doctors to pass special tools into the small intestine to remove tissue samples for testing.
Sometimes small bowel cancers are located in places that make them very difficult to see with other tests. In these cases, your doctor may recommend surgery to examine your small intestine and the surrounding area for signs of cancer.
Surgery can involve one large incision in your abdomen (laparotomy), or it can involve several small incisions (laparoscopy).
During laparoscopy, your surgeon passes special surgical tools through the incisions, as well as a video camera. The camera allows the surgeon to guide the tools and see inside your abdomen.
Treatment for small bowel cancer depends on the type of cancer you have and its stage. Options might include:
Surgery. Surgeons work to remove all of the small bowel cancer, when possible. If cancer affects a small portion of the small intestine, surgeons may remove only that section and rejoin the cut ends of the intestine. In some cases, all of the small intestine may need to be removed.
If a small bowel cancer can't be removed, surgeons might perform a bypass to relieve a blockage in the small intestine.
Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. Chemotherapy usually involves a combination of medications that kill fast-growing cells, including cancer cells. It's typically given through a vein in your arm, but can also be in pill form.
For small bowel cancer, chemotherapy might be recommended after surgery if there's a risk that the cancer could return. For advanced cancer, chemotherapy might help relieve signs and symptoms.
With time, you'll find what helps you cope with the uncertainty and distress of a small bowel cancer diagnosis. Until then, you may find it helps to:
Find someone to talk with. Find a good listener who is willing to listen to you talk about your hopes and fears. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your doctor about support groups in your area. Other sources of information include the National Cancer Institute and the American Cancer Society.
Make an appointment with your doctor if you have any signs or symptoms that worry you. If your doctor suspects you might have cancer, you may be referred to a specialist.
Here's some information to help you get ready for your appointment.
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:
Consider bringing a family member or friend to help you remember the information you're given.
For small bowel cancer, some basic questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you several questions, such as: