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National Cancer Institute

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Small intestine cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the small intestine?
STAGE EXPLANATION
Stages of cancer of the small intestine
Adenocarcinoma
Lymphoma
Leiomyosarcoma
Recurrent
TREATMENT OPTION OVERVIEW
How cancer of the small intestine is treated
Treatment by stage
SMALL INTESTINE ADENOCARCINOMA
SMALL INTESTINE LYMPHOMA
SMALL INTESTINE LEIOMYOSARCOMA
RECURRENT SMALL INTESTINE CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is cancer of the small intestine?

Cancer of the small intestine, a rare cancer, is a disease in which cancer (malignant) cells are found in the tissues of the small intestine. The small intestine is a long tube that folds many times to fit inside the abdomen. It connects the stomach to the large intestine (bowel). In the small intestine, food is broken down to remove vitamins, minerals, proteins, carbohydrates, and fats.

A doctor should be seen if there are any of the following: pain or cramps in the middle of the abdomen, weight loss without dieting, a lump in the abdomen, or blood in the stool.

If there are symptoms, a doctor will usually order an upper gastrointestinal x-ray (also called an upper GI series). For this examination, a patient drinks a liquid containing barium, which makes the stomach and intestine easier to see in the x-ray. This test is usually performed in a doctor's office or in a hospital radiology department.

The doctor may also do a CT scan, a special x-ray that uses a computer to make a picture of the inside of the abdomen. An ultrasound, which uses sound waves to find tumors, or an MRI scan, which uses magnetic waves to make a picture of the abdomen, may also be done.

The doctor may put a thin lighted tube called an endoscope down the throat, through the stomach, and into the first part of the small intestine. The doctor may cut out a small piece of tissue during the endoscopy. This is called a biopsy. The tissue is then looked at under a microscope to see if it contains cancer cells.

The chance of recovery (prognosis) depends on the type of cancer, whether it is just in the small intestine or has spread to other tissues, and the patient's overall health.


STAGE EXPLANATION


Stages of cancer of the small intestine

Once small intestine cancer is found, more tests will be done to find out if cancer cells have spread to other parts of the body. Although there is a staging system for cancer of the small intestine, for treatment purposes this cancer is grouped based on what kind of cells are found. Four types of cancer are found in the small intestine: adenocarcinoma, lymphoma, sarcoma, and carcinoid tumors. If a tumor called a carcinoid tumor is found, see the PDQ patient information summary on gastrointestinal carcinoid tumor. If a patient has lymphoma, more information can be obtained from the PDQ patient information summary on adult or childhood non-Hodgkin's lymphoma. If a tumor called a sarcoma is found, see the patient information summary on adult soft tissue sarcoma for more information than is given here.


Adenocarcinoma

Adenocarcinoma starts in the lining of the small intestine and is the most common type of cancer of the small intestine. These tumors occur most often in the part of the small intestine nearest the stomach. These cancers often grow and block the bowel.


Lymphoma

A lymphoma starts from lymph tissue in the small intestine. Lymph tissue is part of the body's immune system, which helps the body fight infections. Most of these tumors are a type of lymphoma called non-Hodgkin's lymphomas.


Leiomyosarcoma

Leiomyosarcomas are cancers that start growing in the smooth muscle lining of the small intestine.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the small intestine or in another part of the body.


TREATMENT OPTION OVERVIEW


How cancer of the small intestine is treated

There are treatments for all patients with cancer of the small intestine. Three kinds of treatment are used:

Surgery to remove the cancer is the most common treatment. Lymph nodes in the area may also be removed and looked at under a microscope to see if they contain cancer. If the tumor is large, a doctor may cut out a section of the small intestine containing the cancer and reconnect the intestine.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Drugs that make the cancer cells more sensitive to radiation (radiosensitizers) are sometimes given along with radiation. Radiation can be used alone or in addition to surgery and/or chemotherapy.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put in the body through a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the intestine.

If the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation is called adjuvant chemotherapy.

Biological therapy (using the body's immune system to fight cancer) is being studied in clinical trials. Biological therapy tries to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.


Treatment by stage

Treatments for cancer of the small intestine depend on the type of cancer, how far it has spread, and the patient's general health and age.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in some parts of the country for patients with cancer of the small intestine. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


SMALL INTESTINE ADENOCARCINOMA

Treatment may be one of the following:

1. Surgery to cut out the tumor.

2. Surgery to allow food in the small intestine to go around the cancer (bypass) if the cancer cannot be removed.

3. Radiation therapy to relieve symptoms.

4. A clinical trial of radiation plus drugs to make cancer cells more sensitive to radiation (radiosensitizers), with or without chemotherapy.

5. A clinical trial of chemotherapy or biological therapy.


SMALL INTESTINE LYMPHOMA

Treatment may be one of the following:

1. Surgery to remove the cancer and nearby lymph nodes.

2. Surgery followed by adjuvant chemotherapy or radiation therapy.

3. Chemotherapy with or without radiation therapy.

See the PDQ patient information summary on adult or childhood non-Hodgkin's lymphoma for more information.


SMALL INTESTINE LEIOMYOSARCOMA

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery to allow food in the small intestine to go around the cancer (bypass) if the cancer cannot be removed.

3. Radiation therapy.

4. Surgery, chemotherapy, or radiation therapy to relieve symptoms.

5. A clinical trial of chemotherapy or biological therapy.

See the PDQ patient information summary on adult or childhood soft tissue sarcoma for more information.


RECURRENT SMALL INTESTINE CANCER

If the cancer comes back in another part of the body, treatment will probably be a clinical trial of chemotherapy or biological therapy.

If the cancer has come back only in one area, treatment may be one of the following:

1. Surgery to remove the cancer.

2. Radiation therapy or chemotherapy to relieve symptoms.

3. A clinical trial of radiation with drugs to make the cancer cells more sensitive to radiation (radiosensitizers), with or without chemotherapy.

See the PDQ patient information summary on adult or childhood non-Hodgkin's lymphoma for treatment of recurrent small intestine lymphoma or the summary on adult or childhood soft tissue sarcoma for treatment of recurrent small intestine sarcoma.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about small intestine cancer, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with a trained information specialist who can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 07/1998


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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