Overview
Intestinal cancer happens when the cancerous cells form in the small intestine (or small bowel). Tumours in the small intestine may block the flow of food and affect digestion. As the tumour gets bigger, the blockages may cause pain in the abdomen.
The small intestine is divided into three sections namely, duodenum, jejunum and ileum. Most types of small intestine cancer develop in the duodenum.
Symptoms
The signs and symptoms of intestinal cancer are often vague and often resemble those of other less-serious health conditions. Therefore, intestinal cancers are often diagnosed several months after the symptoms start to appear.
Tumours growing in the lining of the small intestine tend to affect digestion by blocking the flow of food. As the cancer advances, these blockages cause pain in the stomach. In most cases, pain is the primary symptom.
Causes
Very little is known about the factors that cause intestinal cancers. However, certain factors might increase an individual’s risk of developing intestinal cancer.
A personal history of colorectal cancer or polyps: Polyps that are left untreated increase the risk of intestinal cancers. Benign polyps also become cancerous and pose a severe health risk, especially among those who are genetically predisposed to developing familial adenomatous polyposis.
Bowel inflammation: Chronic inflammation of the intestinal tract raises one’s risk of developing intestinal cancers. Those with conditions like Crohn’s disease and celiac disease should ensure that their condition is treated successfully with appropriate treatment.
Tobacco and alcohol consumption: Smoking and drinking are known to increase the risk of all forms of cancer, including small intestine cancer.
Family history of colon cancer: Having a family member suffering from intestinal cancer, increases the risk too.
Eating habits: Excessive consumption of foods that are smoked, cured and high in fat increase the risk of developing intestinal cancers.
Older age: The risk of developing intestinal cancer increases with age.
Gender: Men tend to be more at risk than women for developing this form of cancer.
A sedentary lifestyle: A sedentary lifestyle increases the risk of not just cancer, but various other health problems.
Diagnosis
If the signs and symptoms indicate that an individual could have intestinal cancer, the doctor may recommend one or more tests and procedures, including:
Gastroscopy: Gastroscopy uses a long, flexible and slender tube attached to a video camera and monitors to view the inner lining of the GI tract. If any suspicious areas are found, the doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis and remove polyps.
Blood tests: Intestinal cancers often lead to the abdominal area, which eventually causes anaemia. A CBC test is carried out to check if all the blood cells are in optimum quantities. Anaemia coupled with the symptoms of cancer experienced by the patient will alert the doctor to act carefully. Blood tests also help in checking whether or not cancer has spread to other organs
Imaging tests: Imaging tests like CT, MRI and PET scans are performed to have more information about the tumour such as its size, shape and exact location. These tests also help in determining if cancer has spread to other organs, if the treatment is working or if cancer has recurred
Biopsy: Biopsy is the only way to confirm a cancer diagnosis. A small sample of the tissue from the abnormal area is collected during the endoscopy or surgery and is examined under the microscope to see if the cells show cancerous activity.
Treatment
The treatments that are most likely to help the patient depend on his/her particular situation, including the location of the cancer, its stage and other health concerns of the patient. Treatment for intestinal cancer usually involves surgery to remove the cancer. Other treatments, such as radiation therapy and chemotherapy, might also be recommended.
Surgery: There are different types of surgical approaches and the method that a doctor chooses for his/her patients depends on the stage of the cancer and the overall condition of the patient.
Removing polyps during a gastroscopy (polypectomy: If the cancer is small, localised, completely contained within a polyp and in a very early stage, the doctor may be able to remove it completely during a gastroscopy.
Small Bowel Resection: During this procedure, the surgeon removes a piece of the small intestine containing the tumour, along with a margin of healthy tissue on either side of the tumour. Nearby lymph nodes and other surrounding tissues may also be removed if they contain cancer. Later, the surgeon reconnects the ends of the remaining healthy portions of the intestines. This procedure is called a small bowel resection.
Minimally invasive surgery (laparoscopic surgery): Polyps that cannot be removed during the gastroscopy can be removed through laparoscopic surgery. Laparoscopic surgery involves several small incisions in the abdomen. Through one incision the surgeon places a laparoscope, a lighted tube with a tiny camera that creates two-dimensional images of the cancer and the surrounding organs. The doctor places small surgical tools through the remaining incisions to perform the procedure.
Open surgery: Open surgery, which requires a large abdominal incision, may be necessary for larger tumours and for those that are near critical structures, such as the pancreas and liver. People with abdominal scar tissue from previous surgeries may also need an open procedure.
Chemotherapy:
Chemotherapy uses drugs to destroy cancer cells. Chemotherapy for intestinal cancer is usually given after surgery if the cancer is larger or has spread to the lymph nodes. In this way, chemotherapy may kill any cancer cells that remain in the body and help reduce the risk of cancer recurrence. Chemotherapy might also be used before an operation to shrink large cancer so that it’s easier to remove with surgery. Chemotherapy can also be used to relieve symptoms of intestinal cancer that can’t be removed with surgery or that has spread to other areas of the body. Sometimes it’s combined with radiation therapy.
Radiation therapy:
Radiation therapy uses powerful energy sources, such as X-rays and protons, to kill cancer cells. It might be used to shrink large cancer before an operation so that it can be removed more easily. When surgery isn’t an option, radiation therapy might be used to relieve symptoms, such as pain. Sometimes radiation is combined with chemotherapy.
