Small Intestine Cancer

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Small intestine cancer, a very rare cancer, affects the small intestine, an organ involved in the early stages of digestion, located between the stomach and large intestine, helping to break down food into essential nutrients, sugars, carbohydrates, and waste. In this cancer, malignant (cancerous) cells are found within the tissues of the small intestine. Since the small intestine is folded many times within the abdomen, it is very hard for doctors to locate and remove all the malignant cells.

Only 5,300 people are diagnosed with small intestine cancer in the United States every year (compared to lung cancer with 170,000 diagnoses a year).

If you have pain or cramps in the stomach area, weight loss without dieting, a noticeable lump in your abdomen or blood in your excrement, you may have small intestine cancer. However, this is not always the case. My grandfather lost over 100 pounds unexpectedly, had some stomach discomfort, and was suspected of having small intestine cancer. However, it turned out what was causing his problems was a virus called cardiomyelitis that eats away at the heart muscle. But by that time, it was too late.

The complications of the cancer include improper digestion due to small intestine tissue being damaged, causing an inability to break down food into the nutrients required. Spreading of the cancer to other organs (metastasis) is another major complication, due to difficulties with destroying the entire population of malignant cells. The most serious complication can be death.

The Cause (genetic v. environmental)
This cancer is so rare that I have not been able to determine an exact cause. However, “having a risk factor makes the chances of getting this disease higher, but does not always lead to it.” ( Some of the risk factors include:
Do you or your family have:
- Crohn’s disease?
- Celiac disease?
- Polyposis syndromes?

Are you:
- Male?
- Suffering from Crohn’s disease for a long time?
- Someone who has had part of your bowel surgically removed?
- Someone with a weakened immune system?

If you have said yes to several of these questions, you may have a higher risk of developing this rare cancer. Therefore, I conclude that this cancer has somewhat of a genetic connection and does not appear to have an environmental connection.

How is it diagnosed?
A diagnosis can be made one of several ways:

- Ultrasound uses sound waves to make pictures inside the body. If the doctor sees a tumor, small intestine cancer is diagnosed.
- Endoscopy and biopsies are used together. A long tube, or endoscope, slides down the throat of the patient, through the stomach, and into the first part of the small intestine. It takes pictures inside the intestine. If the doctor sees a suspicious picture, s/he will perform a biopsy (snipping out of small piece of tissue) using the same endoscope. S/he will then check the sample tissue under a microscope to detect cancer cells. If cancerous cells are found, small intestine cancer is diagnosed.
- The most common type of diagnosis is done via an upper gastrointestinal x-ray (often called a GI series). A patient will drink barium, a liquid that absorbs x-ray waves and make the intestine easier to see in the x-ray. A picture will be made of the small intestine via x-ray. If the doctor finds a tumor in the x-rays, small intestine cancer is diagnosed.
- Magnetic Resonance Imagery scanning (MRI) uses magnetic to make a picture much more accurate than ultrasound. If a tumor is found through the MRI, then cancer is diagnosed.
- A laparotomy is a surgical procedure in which the doctor makes an incision in the abdomen to do a biopsy. If the cells are cancerous, then cancer is diagnosed.

Post-diagnosis, extra tests will be performed to determine the type of malignant cell present. This is absolutely required information, since different malignant cells require different treatment. There are three types of malignant cells in small intestine cancer:
- Adenocarcinoma: most common type, generally found nearer to stomach – typically grows fast and blocks bowel
- Sarcoma: a.k.a. leiomyosarcoma, less common type of cell, starts in smooth muscle lining
- Carcinoid: tumor cells, easiest to remove completely due to fact that they clump together

How is it treated?
Many treatments are available, including surgery to remove the tumor or even small intestine resection; irradiating the cells with radiation; electrosurgery; removal of cells via lasers; and chemotherapy (strong drugs that kill cancer cells, taken by pills or via an IV).

If the cancer cannot be removed, special surgery can be performed to permanently bypass the small intestine so that food moves around the unmovable tumor.

There is also a new type of treatment, immunotherapy. Immunotherapy is when special drugs are inserted into the patient to boost the person’s immune system. However, this treatment is still experimental.

How can it be prevented? What is the prognosis?
Through my research, it seems to me that it cannot be physically prevented since it has no biological cause, but it can be defeated after diagnosis and appropriate treatment. There are many different factors to prognosis (chances on survival), but on average there is a 79% survival rate. Prognosis can be improved depending on the type of malignant cell (best is carcinoid), whether the cancer has not metastasized to other organs, if surgery can completely remove all cancerous cells, or if this is not a recurring cancer, but a first-time diagnosis.

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