

Cancer Medicine :: Small Intestine Cancer

Small Intestine Cancer

General treatment information


A surgeon: a doctor who uses surgery to treat cancers or other problems

A radiation oncologist: a doctor who uses radiation to treat cancer


A gastroenterologist: a doctor that specializes in diseases and problems of the digestive tract


After the small intestine cancer is found and staged, the cancer care team will suggest one or more treatment plans. Choosing a treatment plan is an important decision. It is also important for you to take time and think about all of your choices.

The main types of treatment used for small intestine adenocarcinoma are: Surgery, Chemotherapy, Radiation therapy

The main factors in selecting treatment options for small intestine adenocarcinoma are the size and location of the tumor, whether it has spread to lymph nodes, liver, bones, or other organs, whether there are any other serious medical conditions, and whether the tumor is causing bothersome symptoms. It is often a good idea to get a second opinion. A second opinion may give you more information and help you feel more confident about the treatment plan that is chosen.

Surgery for small intestine adenocarcinoma

Surgery is the main treatment for small intestine cancer and it is often the only treatment. At this time, surgery is the only treatment that can cure a cancer of the small intestine. The type of operation will depend on a number of factors, including the size and location of the tumor, and whether the patient has any serious diseases of other organs.

Resection:Usually this surgery is done through a cut made in the abdomen. This operation removes the piece of intestine that has the tumor and some of the normal tissue on either side of the tumor. The 2 cut ends of intestine are then sewn back together. Some nearby tissue containing lymph nodes will also be removed. After surgery, it can take a few days before the patient can eat and drink normally. Removing a small piece of intestine usually doesn't cause long-term problems with eating or bowel movements.

Pancreaticoduodenectomy (Whipple procedure):This operation is used to treat cancers of the duodenum, although it is more often used to treat pancreatic cancer. It removes the duodenum, part of the pancreas, nearby lymph nodes and part of the stomach. The gallbladder and part of the common bile duct are removed and the remaining bile duct is attached to the small intestine so that bile from the liver can continue to enter the small intestine.

This is a complex operation that requires a lot of skill and experience. It carries a relatively high risk of complications that could even be fatal. When the operation is done in small hospitals or by doctors with less experience, more than 15% of patients may die as a result of surgical complications. In contrast, when this operation is performed in cancer centers by surgeons experienced in the procedure, less than 5% of patients die as a direct result of complications from surgery. In general, people having this type of surgery do better when it is performed at a hospital that does at least 20 of these surgeries per year. Still, even in the best hands, many patients suffer complications from the surgery. These can include: Leaking from the various connections that the surgeon has to make, Infections, Bleeding,Trouble with the stomach emptying itself after eating. Most, if not all, patients who have this surgery lose a lot of weight.

Palliative surgery:If the cancer cannot be completely removed because it has spread too far in the abdomen, the surgeon may do an operation to help improve some of the symptoms that the cancer is causing. This is known as a palliative operation. Often, these surgeries are meant to relieve a blocked intestine, to decrease pain, nausea, and vomiting, and allow the patient to eat normally for some time. If possible, the surgeon will remove enough of the tumor and nearby intestine to allow digested food to pass through.

Sometimes, the surgeon will leave the tumor in place and route the normal small intestine around the tumor so that any blockage is relieved or prevented.

In very advanced situations, a fairly rigid tube (called a stent) is passed through the blocked area and left in place so digested food can pass. If this can’t be done, a tube may be placed in the stomach to drain it and decrease problems with nausea and vomiting.

Chemotherapy for small intestine adenocarcinoma



Some of the chemo drugs that can be used include: capecitabine (Xeloda®), 5-fluorouracil (5-FU), oxaliplatin, and irinotecan (Camptosar®, CPT-11). 5-FU is often given with a vitamin-like drug called leucovorin, which helps it work better.

Because small intestine cancer is rare, only a small number of patients have been treated with chemo. This makes it hard to know which drugs work best. Some of the drug combinations that seem to work in advanced small intestine cancer include capecitabine and oxaliplatin (called CAPOX), 5-FU and leucovorin with oxaliplatin (FOLFOX), and 5-FU and leucovorin with irinotecan (FOLFIRI). Oncologists often use combinations that are used to treat colon or stomach cancer.

Chemo drugs kill cancer cells but also damage some normal cells, causing some side effects. Your health care team will pay careful attention to try and avoid or lessen side effects. These depend on the type of drugs, amount taken, and length of treatment. Common temporary side effects might include: Nausea and vomiting, Loss of appetite, Loss of hair, Mouth sores, Low blood counts.





Other side effects that may occur depend upon the specific drugs used. For example, 5-FU and irinotecan often cause diarrhea. Capecitabine can cause painful reddening of the hands and feet (known as hand-foot syndrome). Oxaliplatin can damage nerves (called neuropathy) leading to numbness, tingling, or even pain in the hands and feet. This can last a long time or even be permanent. Oxaliplatin can also affect nerves in the throat, causing pain that is much worse when trying to eat or drink cold liquids or foods. This pain can lead to trouble swallowing or even breathing, and can last a few days after treatment.

Radiation therapy for small intestine adenocarcinoma

Radiation therapy uses high-energy radiation to kill cancer cells. Radiation therapy may be an option for those whose cancer cannot be removed with surgery and is causing symptoms − for example if a particular spot is painful because of the cancer.

External-beam radiation therapy is the type of radiation used most often for most types of gastrointestinal cancer. It is like having a regular x-ray except it takes longer and involves much higher amounts of radiation. Patients typically have treatments 5 days a week for several weeks. Radiation therapy is used primarily to treat pain from cancer that has spread to the bones or other parts of the body.

The main side effects of radiation therapy to the stomach and intestines include fatigue (tiredness), nausea, vomiting, diarrhea, and mild temporary, sunburn-like skin changes.

If treatment for small intestine adenocarcinoma stops working








What’s new in small intestine adenocarcinoma research and treatment?

There is always research going on in the field of gastrointestinal (GI) cancer. Scientists are looking for the causes of these cancers, as well as ways to prevent, and treat GI cancers. Small intestine adenocarcinoma is studied less often than some of the other GI cancers because it is so rare. Still, recent studies have looked at ways to treat this cancer with vaccines, chemotherapy, and surgery. Also, studies of patients with colon cancer other GI cancers may prove useful for people with small intestine adenocarcinoma. These studies involve early detection, drug treatment, surgical methods, and understanding the cause of these cancers.

Most small intestine cancers look very similar to colon cancers under a microscope, but detailed studies of the chromosomes and DNA in their cancer cells have found some differences. Researchers hope that these results, as well as other research into the molecular changes in small intestine adenocarcinomas will eventually lead to more effective treatments.

