Tumor of the small intestine. Small bowel cancer

The structure of the small intestine is divided into three sections:

the duodenum, the shortest, received its name because of its length, equal to the length of 12 fingers in diameter;
the jejunal section in the anatomy of the small intestine is due to its relatively small diameter;
The iliac region is located near the iliac fossa, and therefore is called so to speak because of the area of location.

The small intestine, in which food is exposed to intestinal juice, bile, and pancreatic juice, is located in the middle region of the abdomen, downward from the stomach and transverse colon. In the small intestine, digestion products are also absorbed into the blood and lymphatic vessels. The length of the small intestine ranges from 2.2 to 4.4 m, its thickness is from 4.5 to 6 cm. The small intestine begins from the pylorus of the stomach and flows into the cecum in the region of the right iliac fossa. The structure of the human small intestine is divided into the duodenum, jejunum and ileum.

Small intestine cancer and tumor location

Small intestine cancer accounts for 1-2% of malignant tumors of the digestive tract. According to ICD-10 it has code C17.

Due to the vagueness of the first symptoms, small intestine cancer is diagnosed accidentally, very often during an X-ray examination or surgery on the abdominal organs during the treatment of another disease. In this case, metastasis begins, due to which secondary intestinal cancer develops.

The most common tumors of the small intestine are:

duodenal cancer (about 50% of cases);
jejunal cancer (30%);
ileal cancer (20%).

It is worth noting! Small intestinal cancer primarily affects men over the age of 60 and almost never occurs in people under 50.

Why are malignant tumors in the small intestine so rare? The contents of the small intestine have a liquid consistency and move very quickly, so they do not irritate the mucous membrane. Carcinogens ingested from food do not have time to cause harm. The small intestine contains very few bacteria but a lot of lymphoid tissue. Alkaline pH and the enzyme benzopyrene hydroxylase are considered protective factors.

Metastases reach regional lymph nodes and other distant parts of the intestine, so the following may develop:

Causes of small intestine cancer

Specific direct causes of small intestinal cancer have not yet been discovered. Attention is always paid to chronic enzymatic or inflammatory bowel disease; cancer symptoms may be hidden behind signs of diseases such as diverticulitis, ulcerative colitis, enteritis, Crohn's disease, duodenal ulcer. Often a tumor develops against the background of adenomatous tumors, which are prone to degeneration into oncogenic ones.

The duodenum is often affected due to the irritating effect of bile. The initial part of the small intestine is due to the juice of the pancreas and active contact with carcinogenic substances from food, fried foods, alcohol and nicotine.

Other reasons for the appearance of a tumor include:

Peutz-Jeghers syndrome;
duodenitis;
celiac disease;
gene pathologies;
benign tumors;
metastasis of the malignant process of other organs.

The first symptoms and signs of small intestine cancer in men and women

If duodenal cancer is suspected, the first symptoms will be similar to gastric and duodenal ulcers and will manifest as aversion to food, dull pain in the epigastric zone radiating to the back. At a late stage, duodenal cancer exhibits symptoms associated with poor patency of the bile ducts and intestines due to tumor growth. The patient will suffer from endless nausea and vomiting, flatulence and manifestations of jaundice.

The jejunum and ileum signal about oncology with the first local signs and general dyspeptic disorders:

nausea and vomiting;
bloating;
pain in the intestines;
spasms in the navel and/or epigastrium;
frequent loose stools with mucus.

It has been proven that symptoms of small intestinal cancer appear more often in men than in women. This fact is associated with the lifestyle of men, nutrition and abuse of malicious habits: alcohol, smoking and drugs. In addition, small intestinal cancer develops slightly differently in men due to the different structure of the genitourinary system.

Very often, signs of bowel cancer appear in women. When the tumor metastasizes, symptoms of bowel cancer in men may appear. If the tumor compresses neighboring organs, this leads to the development of pancreatitis, jaundice, ascites, and intestinal ischemia.

The tumor grows, so the symptoms of cancer in the small intestine intensify:

pain during bowel movements;
intestinal patency is impaired;
obvious or hidden intestinal blood loss appears;
perforation of the intestinal wall develops;
the contents enter the peritoneal cavity and peritonitis begins;
intoxication (poisoning) of the body increases due to ulcers and intestinal fistulas;
iron deficiency increases;
the functions of the pancreas and liver are impaired.

Cancer is not gender specific, so the symptoms of bowel cancer in women and men are largely the same:

increasing weakness;
weight loss;
malaise;
anemia, rapid and unexplained fatigue;
neurosis;
anorexia;
difficulty with defecation accompanied by pain;
frequent urge to go to the toilet;
anemia;
pale skin;
dizziness and migraine;
temperature rise.

It is worth noting! Unlike small intestine cancer, symptoms of colon cancer can be detected in a person regardless of gender and age. The disease is diagnosed even in children, although it is quite rare.

Symptoms and signs of small intestine cancer in women and men

The development of tumors in the early stages in women and men occurs almost equally. The progression of the tumor and its growth into nearby organs makes a distinction in the symptoms. When cancer spreads, it initially affects the vagina of women and the prostate organs of men. Afterwards, the cancer affects the rectum and sphincter canal, causing complaints in both sexes. Pain appears in the area of the anus, lumbar spine, coccygeal region and sacrum. Men experience problems urinating, which indicates damage to the bladder. Body temperature rises significantly, and ureteral infections are likely to develop.

Symptoms at stages 3 and 4

Detection of cancer in the final stages of development significantly complicates the treatment process. The disintegration of the tumor leads to complete intoxication of the body. Patients feel severe pain that radiates to the lumbar region, sacrum, and anus.

At stage 4, symptoms appear such as:

incessant vomiting;
increased gas formation;
development of jaundice;
intestinal ischemia;
pancreatitis.

Compression of neighboring organs by the tumor leads to the formation of fistulas and provokes the appearance of the following symptoms of cancer:

intestinal bleeding;
pain during bowel movements;
disruption of the gastrointestinal tract;
sudden changes in mood and neuroses;
severe fatigue;
peritonitis;
exhaustion;
dry skin;
disorders of the functioning of neighboring organs;
low protein levels in the blood.

Where does small intestinal cancer metastasize?

There are many important organs located near the small intestine, and when the cancer spreads, their damage begins.

Also, cancer cells spread through the blood throughout the body to distant lymph nodes; in this case, the following are affected:

lungs;
ovaries and uterus in women;
mammary gland;
prostate;
kidneys and adrenal glands;
bladder;
pancreas;
colon;
liver;
peritoneum.

Classification of small intestinal cancer

Depending on their growth characteristics, malignant neoplasms are conventionally divided into the following types:

Exophytic - grows inside the intestinal lumen. Cancer processes provoke stagnation of feces in the affected areas of the jejunum, which, with the development of the disease, turns into obstruction. The tumors resemble fungi or polyps with well-defined, structured boundaries, becoming saucer-shaped when ulcerated.
Endophytic, or infiltrative. Neoplasms without clearly defined edges are distributed along the walls of the intestine, gradually growing into a distant organ through the lymphatic system. Tumors can lead to rupture of the intestinal wall and hemorrhage.

According to histological classification, oncological formations of the small intestine are:

- develops from glandular tissue next to the major papilla of the duodenum. The tumor is ulcerated and covered with a fleecy surface.
– develops in any part of the intestine, most often in the appendix. Less often - in the ileum, very rarely - in the rectum. The structure is similar to the epithelial form of cancer.
– a rare tumor formation (18%) and combines lymphosarcoma and ().
– large tumor formation, more than 5 cm in diameter, can be palpated through the peritoneal wall. The tumor creates intestinal obstruction and wall perforation.

Lymphoma of the small intestine can be primary or secondary. If primary lymphoma of the small intestine is confirmed, the symptoms are characterized by the absence of hepatosplenomegaly, enlarged lymph nodes, changes on the sternum x-ray, CT scan, in the blood and bone marrow. If the tumor is large, disturbances in the absorption of food will be observed.

If the retroperitoneal and mesenteric lymph nodes spread tumor cells, then a secondary lymphoma forms in the small intestine. Types of small intestinal cancer include signet ring cell, undifferentiated and unclassified cancer. Growth form – exophytic and endophytic.

Classification of colon cancer according to the TNM system

According to the clinical and anatomical classification according to the international TNM system, the following stages are distinguished in the development of small intestinal cancer:

T - tumor:

Tis - preinvasive cancer;
T1 – tumor invasion of the submucosal layer of the intestine;
T2 – tumor invasion of the muscular layer of the intestine;
T3 is tumor invasion of the subserous layer of the intestine or retroperitoneal space. The tumor is no more than 2 cm;
T4 – tumor invasion of the visceral peritoneum, non-peritoneal areas over an extended period. The tumor is more than 2 cm.

N - damage to lymph nodes:

N0 - no lymph node involvement.
N1 – metastatic lesion of regional lymph nodes.

M – presence of distant metastases:

M0 – absence of isolated metastasis;
M1 - distant metastasis is present.

Stages of small intestine cancer

There are five stages of intestinal adenocarcinoma:

Stage 0 or cancer in situ. A single small tumor that is located on the surface of the mucous membrane and does not grow deeper. There are no metastases.
Stage 1 - the tumor has grown deeply into the intestinal wall, but has not spread to neighboring organs. There are no metastases.
At stage 2 of intestinal cancer, the tumor has grown through the entire thickness of the intestinal wall and has spread to neighboring organs.
At stage 3 of small intestine cancer, cancer cells have spread to regional lymph nodes. Germination into other organs and distant metastases are absent.
At stage 4 of small intestine cancer there are distant metastases. Most often they are found in the lungs and liver. bones and other organs.

Diagnosis of small intestine cancer

To recognize intestinal cancer at an early stage, it is necessary to conduct a number of diagnostic studies, which will determine what treatment will be used, the patient’s condition and the prognosis for survival.

Diagnosis of small intestinal cancer depends on the location of the tumor in the intestine itself:

Fibrogastroduodenoscopy and contrast fluoroscopy, using these methods, diagnose the duodenum.
Irrigoscopy and colonoscopy - performed to diagnose the ileum.
To identify stenosis and the presence of obstacles to the movement of barium sulfate suspension, the method of barium passage in the lumen of the tract is used.

During an endoscopy, samples of cancer cells are taken for further laboratory examination to confirm or refute the diagnosis.

Metastasis and spread of a cancerous tumor is detected using:

Ultrasound of the peritoneum;
CT scan of the intestinal tract;
chest x-ray;
bone scintigraphy.

If there is any doubt about the diagnosis, laparoscopy is performed along with surgical intervention.

For malignant tumors, the following laboratory tests are performed:

A blood test reveals a decrease in hemoglobin and an increase in ESR, which is typical for any cancer.
Biochemistry – when carcinoembryonic antigen is detected in the plasma, a tumor is diagnosed and its stage of development is established.
A toxic compound occurs in the intestinal tract - the substance indican; it can be detected using a urine test.
Blood for the presence of jejunal cancer is likely to be accompanied by markers,.

Based on stool analysis, the presence of occult blood in the patient’s waste products is revealed.

How to identify intestinal cancer, the symptoms of which do not manifest themselves in anything specific? During this period, it is very important to confirm or refute the suspicion of cancer, because the sooner treatment begins, the easier it is for the patient to endure its stages, the greater the chance of a positive result. When symptoms appear, the oncological process can be considered advanced, and the moment of early treatment will be missed.

Important! Early symptoms include a “young” state, which should alert any person - this is a reluctance to work or do household chores due to increased weakness and fatigue. The skin becomes pale and “transparent”. The patient constantly has heaviness in his stomach, he does not feel like eating at all. Following this, dyspeptic disorders appear: nausea, vomiting, pain and heartburn even from water.

Where does the diagnosis of small intestinal cancer begin?

When visiting a doctor, a blood test is immediately prescribed and examined, which is mandatory if bowel cancer is suspected. A general basic blood test can reveal anemia, the patient's condition, and the presence of inflammation.

Then, based on the results of the blood test, a blood test for small intestinal cancer is performed, if necessary. The most informative and common tumor markers are alpha-fetoprotein, total/free PSA, CEA, CA 19-9, and cytokeratin.

For example, with the help of tumor markers CA 19-9 and CEA (carcinoembryonic antigen), screening diagnostics of colon cancer is carried out. If CEA is determined, then you can find out the staging before surgery and monitor the patient diagnosed with colorectal cancer after it. If the disease progresses, then the level of CEA in the serum will increase. Although it may grow not in connection with a tumor, in later stages colorectal cancer can be detected without an increase in CEA in the blood.

Endoscopic diagnosis and open intestinal biopsy are the main methods for confirming small intestinal oncology.

Treatment of small intestine cancer

Treatment of cancer of the small intestine, namely the duodenum, jejunum and ileum, is carried out depending on the type of tumor and stage. The main method is bowel resection and removal of tumor formation.

The extent of surgical intervention depends on the stage of tumor development, its location and the degree of damage to surrounding tissues, organs and systems. Early stage cancers are removed using laparoscopic surgery. Surgery to remove a tumor of the small intestine is performed through several punctures in the anterior abdominal wall. A laparoscope with an LED is inserted through the puncture; a video camera is also inserted into the puncture, transmitting the entire operation process to the computer screen, with its help the surgeon performs surgical manipulations.

If the tumors are large, which indicates late stages of cancer development, then in this case extensive operations are used, which include:

resection of the small intestine, in which the affected part of the small intestine is removed along with the lymph nodes and part of the healthy surrounding tissue;
radical surgery in which huge tumors and all tissues affected by metastases are removed;
contactless operation. It is carried out by blocking all blood and lymphatic vessels around the tumor. Resection is performed to prevent malignant cells from dispersing throughout the body;
duodenectomy, an operation that is performed for duodenal cancer by resection of the affected area of the small intestine with the subsequent restoration of continuous intestinal patency. The operation is performed independently, as well as in combination with pancreatoduodenectomy, when resection of the pancreas is performed for cancer of the head of the pancreas. Along with surgery on a segment of the small intestine, gastrectomy can be performed. For advanced ileal cancer, a hemicolectomy of the right side of the colon is performed.

With a confirmed diagnosis of small intestinal cancer, surgery reduces symptoms and increases life expectancy. If it is not possible to remove a malignant tumor of the small intestine at a late stage or it is determined that the tumor is sensitive to chemotherapy, drugs that prevent the growth of cancer cells are used.

Chemotherapy for small intestinal cancer

Chemotherapy for small intestine cancer as an independent method of therapy is considered ineffective. It is prescribed as an additional treatment to reduce the risk of developing metastases and as for. Chemotherapy is used before surgery to reduce tumor size and inhibit the development of cancer cells, and after surgery to reduce the risk of tumor recurrence.

After palliative surgery (alleviating the patient's suffering), treatment is carried out with chemotherapy (polychemotherapy), but without radiation.

After the operation, intestinal motility is additionally diagnosed using electrogastroenterography to prevent the development of a dangerous complication - intestinal paresis.

To alleviate the patient's condition after surgery and chemotherapy, the following are introduced into complex therapy: alcohol tinctures, infusions and decoctions of medicinal herbs, mushrooms and berries. The corresponding prevents paresis, nausea and vomiting, improves gastrointestinal motility.

Prevention of small intestine (bowel) cancer

It is impossible to reduce the risk of small intestinal cancer, but there are a number of preventive measures that help avoid the formation of tumors in the intestine:

undergo regular preventive examinations;
adhere to the principles of a healthy lifestyle and proper nutrition;
promptly treat diseases of the gastrointestinal tract;
have an annual stool test for occult blood (the Colon View test, which can detect occult blood in the stool and detect bowel cancer at an early stage);
do not delay and consult a doctor if any alarming symptoms from the digestive system appear.

What is the prognosis for life with small intestinal cancer?

A favorable outcome of the disease directly depends on the stage at which the diagnosis was made, as well as on the location of the tumor in the intestine.

If the tumor is located regionally and does not have metastases, then after surgery the number of survivors for 5 years is 40 - 50%. Each subsequent stage reduces the percentage of positive outcomes in patients by 15 - 20%.

Cancerous tumors can form in virtually any organ and system of the human body. Their proliferation leads to functional disorders and destructive tissue changes, which without proper treatment almost always ends in death. There are a number of dependencies between certain types of disease regarding the likelihood of their development at a given age or condition. Thus, small intestinal cancer is a fairly rare disease, but this does not reduce its danger.

What is small intestinal cancer

Small intestinal cancer is an oncological disease localized in the digestive tract. In most cases, the tumor begins to grow from epithelial cells, gradually filling the intestinal lumen. This type of cancer occurs infrequently; metastases primarily spread through the lymphatic system, affecting the liver, adrenal glands, kidneys, lungs and bones.

As for the frequency of diagnosis of this type of tumor, it is worth noting that the data differs slightly among different authors. For example, a number of experts claim that such diseases are detected on average in 10% of cases, however, according to summary statistics, small intestinal cancer accounts for approximately 3% of all cases of malignant tumors detected in the digestive system.

Specialist note: the largest number of cases of the disease is observed in Asian countries that are at the stage of development, and the smallest number is in developed European countries. Men are more predisposed to developing this type of cancer: compared to women, there are one and a half times more male patients with this diagnosis. Age-related characteristics are also noted - the largest number of cases occurs over the age of 60 years.

Classification

Depending on which intestinal cells were affected, several types of cancer are distinguished.

Table: types of small intestine cancer

	Characteristic
Carcinoma	The carcinoid type of tumor develops most often, and the lesions are multiple. This formation is formed on the layers of squamous epithelium. Like any other type, it can grow unlimitedly, while affecting other organs and systems.
Adenocarcinoma	Unlike the previous type, it is formed from altered cells of the glandular epithelium. A feature of the cells that serve as the basis for the development of neoplasms is their ability to produce mucus. The size and shape of the tumor can be very different.
	Sarcomas are formed from connective tissue. This type of small intestinal cancer is characterized by rapid growth and a tendency to relapse. It has no clear boundaries and smoothly passes into healthy tissues. Often this type of tumor develops together with another malignant formation in the intestine.
	The elements of the lymphatic system located in the small intestine are affected. Easily and quickly spread throughout the body.

Causes

To date, doctors cannot name the exact reasons that would directly influence the formation of a cancerous tumor in the small intestine. In approximately half of the cases, the neoplasm is localized in the area of the duodenum, which is explained by the location of the department - it is the first to come into contact with aggressive substances that enter the body. There are a number of factors that contribute to the emergence and development of this disease:

hereditary predisposition;
pathological changes resulting from poor nutrition;
frequent stress, states of nervous tension;
work that involves contact with toxic chemicals;
long-term development of chronic diseases of the gastrointestinal tract (for example, Crohn's disease, the presence of ulcerative formations, diverticulitis, etc.);
benign tumor;
irritating effects of bile and stomach juice on parts of the small intestine;
sporadic polyposis of the adenomatous type is an increased risk factor;
the person has bad habits (smoking, alcoholism);
contact with radiation;
some genetic diseases;
oncological diseases of other organs of the digestive system.

Symptoms

Manifestations of the disease develop gradually; at the first stage, the tumor usually does not give any symptoms, which is the main danger - patients often come in at later stages, when the likelihood of recovery is extremely low or completely absent.

The most common symptoms are the following:

the appearance of periodic pain in the intestinal area, they are of the nature of spasms;
nausea and vomiting;
weight loss;
loss of appetite;
Bleeding is often observed in the presence of sarcoma;
the stool becomes unstable;
if the tumor grows strongly, the intestinal lumen may become blocked, causing obstruction to develop;
in the presence of metastases, symptoms associated with disruption of the functioning of other affected organs occur.

Diagnostics

Making a diagnosis requires a thorough examination of the patient's condition. The range of necessary activities includes:

examination of family medical history;
collection of patient complaints;
medical examination;
blood test to determine the current state of its components;
analysis of stool for the presence of occult blood;
examination of the duodenum using an endoscope;
ultrasonography;
CM (computed tomography), MRI (magnetic resonance imaging);
tissue biopsy of the detected tumor.

Doctor's note: Of particular importance when diagnosing cancer is taking blood and urine to identify tumor markers - special protein formations that are released during the development of a malignant tumor in the body.

Stages of the disease and treatment prognosis

The success of treatment for cancer largely depends on the speed of the patient’s response to the identified signs and the condition of the tumor at the time of initiation of treatment.

Table: stages of cancer

	Tumor status
	The tumor is concentrated within the lumen or walls of the small intestine and does not spread beyond the organ.	The first two stages of cancer are considered the most favorable in terms of prognosis for recovery. The tumor in such a situation is localized, which makes it possible to effectively influence it.
	The formation begins to extend beyond the intestinal walls, being at the stage of spread, but not yet metastasizing.
	There are metastases, but they are located in close proximity to the tumor (for example, in several lymph nodes near the intestine).	The prognosis is considered unfavorable, but with active therapy with aggressive techniques there is a chance of recovery.
Fourth	Metastases have spread to distant organs	The process is uncontrollable and irreversible, recovery is impossible. However, at this stage, all possible methods are used to improve the patient’s quality of life and prolong it as much as possible. The five-year survival rate reaches approximately 5%.

Treatment

Treatment of a cancerous tumor is a complex and multifactorial process, which is quite difficult for the patient to tolerate due to the use of aggressive techniques. However, it is precisely this approach that allows you to fight the disease and achieve positive results.

Surgical

To date, the only treatment method that gives real results is intestinal resection, that is, surgical removal of the affected area. The scope of a particular operation and the techniques used during it are completely determined by the current condition of the patient and the extent of the cancer. In general, two types of intervention can be distinguished:

radical operations (their main goal is to completely remove the source of the problem, namely the affected part of the intestine and nearby tissues damaged by the process);
palliative procedures are necessary to alleviate the patient's condition.

Chemotherapy

If the tumor cannot be removed or the formation is considered sensitive to chemicals, then chemotherapy must be included in the course of treatment. The procedure involves the introduction of powerful toxins into the body, which are designed to have a destructive effect on tumor cells. Unfortunately, such treatment is very difficult, often affects the cells of healthy organs, and has a large list of side effects:

baldness;
damage to mucous membranes;
death of some blood cells (that is, weakening of the immune system);
nausea and vomiting.

It is worth noting that even the presence of pronounced side effects is not a reason to stop therapy with this method.

Radiation therapy is an additional method that is used to enhance the effect of chemotherapy and surgery. The procedure is carried out using special devices with ionizing radiation, the source of which is a radioactive substance.

Diseased cells die due to radiation from a radioactive substance

The action is based on the fact that cancer cells are more susceptible to this type of radiation; under its influence, multiple mutations develop in them, which is why diseased cells die. Healthy cells have greater resistance to such radiation, so they usually cannot be destroyed. In some cases, radiation therapy can minimize the symptomatic manifestations of developing cancer.

Traditional methods

It is worth understanding that cancer is a very serious and dangerous disease, and that is why it requires active traditional treatment. Traditional methods in this case can only play a supporting role, strengthening the body and helping to alleviate symptomatic manifestations.

In various sources you can find the following recipes for patients with small intestinal cancer:

It is recommended to take 100 ml of cabbage juice daily for at least a month.
A decoction of buckthorn (2 parts) and chamomile (1 part). The composition is poured with hot water and boiled over low heat for about 10 minutes.
A decoction of calamus root (30 grams of the main ingredient will require a liter of water), which is drunk warm every morning.
As an immunomodulator, you can use a tincture from the pericarp of a regular walnut. To prepare the composition, the amniotic part of the nuts in the amount of 25 pieces is placed in 2 liters of sugar syrup and left for three days. Take the resulting infusion daily, two tablespoons before meals.
Pumpkin juice (you should drink half a glass a day to maintain immunity).

Photo gallery of folk remedies

Calamus roots for decoction Chamomile for decoction Buckthorn bark for decoction

Examples of treatment for small intestine cancer - reviews

There are many cancer patients in all age groups, and all their stories are different - some manage to cope with the disease, while others do not. You can find a huge number of real stories from people who have encountered small intestinal cancer in their lives.

Small intestinal cancer is the second case of cancer in the last 10 years. During the third stage, she underwent 8 courses of chemotherapy, several surgeries and radiation therapy. Today, the consequences of all this horror still remain, but thanks to the desire to live and the support of friends, I coped with the terrible diagnosis.

Svetlana

My father-in-law was 55 years old when he was diagnosed with stage 3 cancer. Despite undergoing chemotherapy, the body could not cope, everything ended after 2 years of struggle.

http://www.woman.ru/health/medley7/thread/4245436

The problem was discovered by chance during an abdominal ultrasound. We were caught at the first stage, so everything was done with one operation and concomitant therapy.

http://forumjizni.ru/showthread.php?t=12361

Possible complications and concomitant diseases

The most dangerous complication of the development of a cancer tumor in the small intestine is its metastasis. When the affected cells move to other organs and systems other than the place of their initial formation, a variety of consequences can be observed: jaundice, significant depletion, and others, depending on the organ affected by metastases. Without proper and active treatment, cancer gradually destroys the body, leading to death.

Prevention

Considering the fact that doctors cannot identify specific causes, all a person can do to prevent the occurrence of small intestine cancer is to minimize the number of negative factors in their life that increase the risk of the disease, namely:

rejection of bad habits;
rational healthy nutrition;
avoiding stress and nervous tension, visiting a specialist if necessary;
periodically undergoing a comprehensive examination of the body;
timely response to the presence of other diseases and their correct treatment.

If detected early, small intestinal cancer can be successfully treated; in general, it all depends on the condition of the patient’s body. Therapy for such a disease is complex and lengthy, but with the right approach it gives good results and allows you to prolong a person’s life.

Small intestinal cancer affects its sections, which include the duodenum, ileum, and jejunum. The disease is diagnosed quite rarely, in 1% of cases of the total number of gastrointestinal cancers. Mostly male patients aged 60 years or more are predisposed to it.

At the initial stage, the disease occurs without severe symptoms. In this regard, many patients seek medical help already in the most advanced stage. First of all, this threatens metastasis and, as a consequence, secondary oncology.

Causes of the disease and its varieties

Among the reasons for the development of oncology are:

chronic diseases of the gastrointestinal tract;
benign intestinal neoplasms and inflammation;
malignant tumors located in other organs;
Peutz-Jeghers syndrome and genetic abnormalities;
nicotine addiction and alcoholism;
frequent consumption of “heavy” foods;
consequences of radioactive radiation.

Experts believe that not the least important reason is a hereditary predisposition to cancer.

There are several types of intestinal tumors. Among these are adenocarcinoma (the tumor is covered with ulcers and has a fleecy surface), carcinoid (mainly localized in the appendix or ileum), leiomyosarcoma (one of the largest tumors, determined by palpation even through the peritoneal walls), lymphoma (the rarest tumor that combines signs of lymphosarcoma and diseases of lymphoid tissue).

Symptoms and stages

At the beginning of the disease, there are no obvious signs of small intestinal cancer. Phenomena such as nausea, periodic cramps and heaviness in the abdomen, heartburn, flatulence and stool disorders, irritability and general weakness rarely cause severe concern.

The manifestation of symptoms of oncology becomes obvious already at stages 3 or 4. Common symptoms of small intestine cancer include:

intestinal obstruction;
bleeding and damage to the intestinal walls;
formation of ulcers and fistulas;
disturbances in the functioning of the liver and pancreas;
pain during bowel movements;
general intoxication and accelerated weight loss;
lack of iron in the body.

Mostly, small intestine cancer occurs in the same way in both sexes. Additional signs of intestinal cancer in women include pale skin, menstrual irregularities and discomfort during urination.

Typical stages of disease development:

Stage 0

The onset of oncology is indicated by a few accumulations of atypical cells, their active degeneration and division. The onset of the disease at this stage can only be determined by examining the composition of the blood.

Stage 1

Characteristic is the location of the tumor within the small intestine and the absence of metastases.

Stage 2

The tumor can penetrate beyond the boundaries of the intestine and affect other organs. Metastases are not detected at this stage of the disease.

Stage 3

Metastases are found in nearby lymph nodes and organs. There is no distant metastasis yet.

Stage 4

Metastases penetrate through the lymphatic system to distant organs. Oncology can be found in the bones, adrenal glands, bladder, liver, pancreas, lungs, etc.

In rare cases, during the development of the disease, discomfort during swallowing food, a feeling of the presence of a foreign body in the abdominal cavity, and a false urge to defecate are noted. In each specific case, the symptoms of small intestine cancer are not the same and are determined by the influence of various factors.

Diagnosis and treatment methods for oncology

Diagnosis of small intestinal cancer is carried out using fibrogastroduodenoscopy and contrast fluoroscopy. Doctors can resort to irrigoscopy to identify tumors in the ileum.

No less important in the process of diagnosing the disease is radiography of the barium passage. Selective angiography of the abdominal organs can provide significant benefits for the correct diagnosis and further treatment of cancer.

The ultrasound method significantly helps to identify metastases and the degree of their development in other organs. To do this, the condition of the internal organs most susceptible to metastasis is carefully examined. Chest radiography, multislice computed tomography of the abdominal cavity (MSCT), and radiological bone diagnostics (scintigraphy) are performed. To clarify some data, diagnostic methods such as laparoscopy or irrigography may be indicated.

Enough attention is paid to the differential diagnosis of the disease. It is important to determine in time the differences between cancer and benign tumors, intestinal tuberculosis, obstruction of mesenteric vessels, Crohn's disease, kidney dystopia, and retroperitoneal tumors. Among female patients, special attention is paid to differentiating cancer from tumors of the internal reproductive organs, congenital small intestinal stasis and colon oncology.

Treatment of small intestinal cancer is complex and requires radical techniques. For this reason, it is often difficult for patients to tolerate. The main methods include:

surgical intervention;
drug treatment;
radiation therapy.

The most effective and frequently used method of treating the disease remains surgery. Resection, or removal of the affected area, can provide the best and most long-lasting results.

Traditionally, two types of surgical intervention are distinguished:

radical (the main goal is complete removal of the source of the lesion, including the problem area and the affected tissue adjacent to it);
palliative procedures (designed to alleviate the patient’s condition and improve the overall quality of his life).

The structure of the organ allows for radical action to remove a tumor that has spread to healthy tissue. Effective treatment methods include transplantation of donor intestinal fragments.

Drug treatment is used in situations where the tumor cannot be removed or is highly sensitive to the effects of chemicals. During chemotherapy, powerful toxins are introduced into the body, aimed at destructive effects on tumor cells. A significant disadvantage of this type of treatment for the disease is its severe course and the development of numerous side effects (death of cells of healthy organs, hair loss, weakened immunity, dyspeptic disorders).

Radiation therapy is an additional method of treating the disease, used to enhance the postoperative effect and course of chemotherapy. The procedure is carried out using special emitting devices. As a result, radiation-sensitive tumor cells are destroyed.

The method does not pose a significant danger to healthy cells of the body, since they have greater resistance to radioactive radiation and are able to effectively withstand it.

Traditional methods of fighting the disease

There is no doubt that small intestine cancer requires the mandatory assistance of qualified specialists and effective treatment methods. The use of traditional methods can play the role of an auxiliary stage aimed at overall strengthening the body and minimizing the manifestations of symptoms of the disease.

Traditional healers offer a variety of recipes to alleviate the condition of people diagnosed with cancer.

Recipe No. 1

It is recommended to use tincture from the pericarp of ordinary walnuts as an effective immunomodulator. To do this you will need 25 nuts and 2 liters of sugar syrup. All ingredients must be mixed, left for at least 3 days and taken two tablespoons daily before meals.

Recipe No. 2

An infusion of calamus root is useful. To prepare it, 30 grams of crushed raw materials must be brewed in 1 liter of boiling water. The warm infusion is taken every morning in small portions.

Recipe No. 3

No less effective is a decoction of buckthorn and chamomile in a ratio of 2 to 1. The mixture of herbs is poured with boiling water and simmered for 10 minutes over low heat. The finished product is taken up to 3 times a day after meals.

Recipe No. 4

Drinking fresh cabbage and pumpkin juice for a month can support the body during illness and treatment of oncology with aggressive chemicals. You must take at least half a glass of natural drink per day.

Such simple recipes can significantly strengthen the immune system and ease the course of the disease.

Prognosis and prevention

A favorable prognosis significantly depends on the period of contact with a medical institution, as well as the stage of development of the disease. Timely diagnosis of a tumor and surgery to remove it significantly increases the likelihood of a complete cure for the patient from oncology.

After surgical intervention at the earliest possible stage, pathological processes are eliminated for a long time. The main postoperative effect is secured by adequate chemotherapy. As a result, the chances of a favorable prognosis for the outcome of the disease increase significantly.

A simple set of preventive measures will help prevent small intestinal cancer. The following should be relevant:

active lifestyle and giving up bad habits;
minimizing stress, nervous exhaustion and physical fatigue;
the presence in the diet of plant foods with a high level of coarse fiber;
minimizing the consumption of foods containing animal fats;
visit a gastroenterologist at the slightest suspicion of manifestations of the disease;
regular visits to a gastroenterologist after 40 years.

Small intestinal cancer belongs to those forms of oncology that, with timely detection and a serious approach to treatment, can be eliminated forever. A considerable number of patients who have undergone an effective course of treatment for the disease continue to live full lives for many years.

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Initial signs, symptoms and diagnostic algorithm for small intestine cancer

Small intestinal cancer is a fairly rare disease that affects three parts of the intestine: the duodenum, jejunum and ileum. In the morbidity structure, tumors of the small intestine occur in 0.5% of cases. Small bowel cancer almost never occurs in people under 50 years of age. After this age, the risk of morbidity increases every year.

The tumor grows from the epithelial tissue of the folds (crypts) of the intestine, the glandular epithelium of the duodenum, and rarely the superficial epithelium can degenerate.

Small intestinal cancer can grow into the lumen of the organ, that is, it will have exophytic growth, and it will grow into the intestinal lining and surrounding tissues - endophytic growth.

Histologically, adenocarcinoma is distinguished in 60% of all cancers and signet ring cell carcinoma in 40%.

Small intestinal cancer can present with a variety of signs and symptoms, depending on the pattern of growth and damage to adjacent organs and structures.

Signs

A malignant neoplasm of this location is characterized by a long asymptomatic course. The first thing patients most often pay attention to is the tarry stool that forms when bleeding from the tumor vessels. When a large vessel is ulcerated, the patient develops melena – loose, foul-smelling black stool. This condition is an alarming sign because it can threaten the patient’s life without specialized help.

Bleeding may be hidden. In this case, the stool will be macroscopically unchanged, but anemia will gradually increase. Chronic blood loss leads to a decrease in the number of red blood cells and hemoglobin. The patient will complain of pallor, dizziness, fatigue, tachycardia.

As with all malignant diseases, asthenic syndrome and causeless weight loss will be observed. The patient complains of decreased physical and mental performance, loss of appetite. An increase in temperature to subfebrile levels is typical.

Symptoms

With an exophytically growing tumor, there is a risk of developing intestinal obstruction. Depending on the degree of obstruction of the intestinal lumen by the formation, the clinical picture of the condition will depend. With increasing mechanical obstruction, the patient will be disturbed by the following complaints:

Abnormal stool. Initially, diarrhea may develop, followed by constipation.
Pain syndrome. Characterized by a gradual increase in pain intensity, up to sharp paroxysmal colic
Nausea, belching with fecal odor
Bloating, distension of the intestines
Profuse vomiting of intestinal contents, followed by slight relief
In advanced cases - dilated intestine visible to the naked eye, paroxysmal severe pain, rumbling

With prolonged vomiting, dehydration occurs and symptoms of intoxication appear. If this condition is not treated, peritonitis may develop - a rupture of the intestinal wall with the release of intestinal contents into the abdominal cavity.

There are some differences in symptoms when the tumor is localized in the duodenum.

If small intestinal cancer forms near the papilla of Vater, the clinical picture will resemble duodenal ulcer. In this case, the patient is bothered by pain in the epigastric region. In this case, eating and drug therapy will not bring relief.

If the tumor completely blocks the lumen of the duodenum in the initial part, then the patient complains of distension in the epigastric region, profuse vomiting, after which relief comes. It is noteworthy that bile is not mixed with vomiting, since the common bile duct is located below the site of obstruction.

A tumor that develops in the periampullary portion of the duodenum will be characterized by symptoms of compression of the common bile and Wirsung ducts. Bile from the duct will not be able to enter the intestines, while the gallbladder will gradually fill, then the bile will begin to enter the bloodstream through the vessels in the liver. The skin becomes yellow in color and itching may occur. A biochemical blood test will show an increase in total and direct bilirubin.

Small intestinal cancer localized in the infraampullary part of the duodenum, jejunum and ileum will manifest itself only with the development of mechanical obstruction or with ulceration of the vessel with the development of bleeding.

With endophytically growing malignant neoplasms, the tumor grows through the thickness of the intestinal wall. Further development of the disease can follow several paths:

Perforation of the intestinal wall with the release of contents into the abdominal cavity leads to the development of peritonitis - inflammation of the peritoneum. This is a life-threatening condition. Only emergency laparotomy will save the patient from death.
A tumor that grows into the intestinal wall can form a narrowing of the lumen, which also leads to intestinal obstruction.
Tumor growth into neighboring organs. Most often, the head of the pancreas is involved in the process. Sometimes it is difficult for clinicians to determine which tumor was primary: intestinal or pancreatic. Only by performing an intraoperative biopsy and immunohistochemical study can the answer to this question be known.

Diagnostics

Diagnosing small intestinal cancer is not an easy task, requiring the doctor to have in-depth knowledge of the course of the pathological process. Diagnosis must be preceded by a correct history taking, indications of previous diseases, as well as a description of the onset of the existing disorder.

Initially, it is necessary to assess the general appearance of the patient, the color of his skin, behavior, and gait. If you are careful, even such minor details can point you in the right direction of your search.

Very often, a tumor can creep in or grow into a vessel, which gradually becomes the cause of the development of anemia.

Anemia is a condition caused by a decrease in the concentration of hemoglobin in the blood. Such patients will have pale skin and mucous membranes, they will feel constant weakness and cannot tolerate physical activity well. To compensate for the reduced level of partial pressure of oxygen, such patients will need to carry out a large number of respiratory movements, which is expressed in the form of shortness of breath.

If you use physical research methods, then upon palpation you can feel a tumor-like formation on the anterior abdominal wall. It is usually painful, has an irregular shape and is heterogeneous in its structure. With the help of palpation, one can only indirectly judge the size and consistency of the tumor, so this method is not specific and will only allow one to suspect the presence of an oncological process.

It is difficult to hear something special by auscultation and can only be achieved in the later stages of the disease. When the tumor reaches a large size and blocks the intestinal lumen, the noise of peristalsis of the digestive tract disappears and the so-called “falling drop” symptom appears. When “tapping”, you can listen to a dull percussion noise in the projection above the tumor.

Laboratory research

The diagnostic algorithm for a tumor of the small intestine includes:

Clinical analysis of blood, urine
Feces for occult blood
Blood chemistry
Tumor markers
X-ray of the abdominal organs with contrast enhancement
EFGDS
Colonoscopy and irrigoscopy
Biopsy and histological examination
CT scan
Magnetic resonance imaging

Laboratory research methods include a number of tests that help in diagnosing the disease. It should be said that there are simply no specific tests that speak in favor of the presence or absence of an oncological process. But there are several indicators that allow us to suspect the development of an oncological process.

A general blood test shows us the main indicators, the number of red and white blood cells, as well as their ratio. As mentioned above, anemia often occurs as the tumor grows; in tests, this is manifested by a decrease in hemoglobin concentration, as well as erythrocytopenia. All this speaks in favor of hemorrhagic anemia.

White blood cells can be either increased or decreased, or may even be normal; there is no definite dependence here, since this indicator is not specific to the tumor process.

Changes in the biochemical blood test begin with the development of complications of a tumor of the small intestine. Prolonged vomiting with intestinal obstruction leads to thickening of the blood - the hematocrit increases, changes in ionic ratios occur, and metabolic alkalosis develops in the body - a shift in pH to the alkaline side.

When the tumor obstructs the papilla of the common bile duct, obstructive jaundice develops. In a blood test, this will be manifested by an increase in the concentration of total and bound bilirubin.

When analyzing stool, hidden blood can be detected, which can lead us to the development of an oncological process.

For carcinoma, the detection of tumor markers is most indicative. Tumor markers are special biological compounds that are waste products of a neoplasm or synthesized by healthy tissues of the body as a response to a pathological process.

This indicator allows you to suspect the presence of a tumor and prevent further progression of growth with timely treatment. Tumor markers are a very convenient diagnostic method, especially when you need to examine a large number of people. Small intestinal tumors are characterized by CEA, ACE, CA 19-9, CA 242, CA 72-4, Tu M2-RK.

Instrumental methods

Instrumental methods are the most relevant and indicative today. There are many techniques that make it possible to visualize a tumor, but ultrasound is considered the simplest.

Using ultrasound, you can assess the size of the tumor, its density, shape and location. However, it should be said that no oncologist can make a correct diagnosis based only on these data. Ultrasound is only a screening diagnostic method in this matter, which will provide justification for further research.

Endoscopic imaging techniques play a leading role in detecting tumors in the upper digestive tract.

An endoscope is a special optical device, in the form of a tube, with a built-in camera that transmits an image to a screen. Using an endoscope, you can not only see the tumor, but also collect biological material for further research.

When tumor formation is localized in the upper gastrointestinal tract, esophagogastroduodenoscopy (EFGDS) is most relevant. To perform this procedure, the patient is asked to swallow the endoscope and lie on his side. The surgeon guides the device through the digestive tract, assesses the condition of the walls of the esophagus, their color, shine, shape of the folds and several other indicators; a similar assessment occurs in the stomach.

The duodenum interests us most of all. Using endoscopy, you can detect a tumor, evaluate the direction of its growth (endo- or exophytic), the degree of lumen overlap, and also take a sample for laboratory testing. Colonoscopy and irrigoscopy are considered the most useful for examining the terminal ileum.

Another value of endoscopic manipulation is small intestinal biopsy. A biopsy is a special technique that makes it possible to carry out intravital sampling of pathological and healthy tissues from the area of interest to us. In diagnosing small intestinal cancer, we may be interested in two types of small intestinal tumor biopsy - endoscopic and intraoperative.

With the endoscopic method, a tumor is visualized using an optical device, then biomaterial is taken, the endoscope is withdrawn, and the tumor cells undergo further examination in the laboratory. During pathohistological examination, the nature and structure of the biomaterial is assessed and on this basis a decision is made about the malignancy of the formation. In the future, based on this decision, further treatment tactics will be decided.

Intraoperative biopsy is one of the stages of surgical intervention. The surgeon gains access to the abdominal cavity, detects a tumor, collects biomaterial, then gives tumor samples to a laboratory assistant, and the histologist, after a rapid biopsy, renders his verdict. If the tumor is malignant, then several scenarios are possible.

For small tumors, the surgeon performs a resection of part of the intestine. The removed tissue is then also examined by a histologist to confirm the diagnosis. If the tumor is large and grows into neighboring organs, then the surgeon leaves the abdominal cavity, sutures the surgical wounds, and in the future such a patient will be treated by radiologists or chemotherapists.

Contrast fluoroscopy is also very useful in instrumental diagnostics. To carry it out, you will need an x-ray and a special contrast solution, usually barium sulfate. Contrast is used to obtain a clearer image, as well as to obtain clear contours of the walls of hollow organs. In the presence of a tumor, a narrowing of the lumen will be observed, looking like an isthmus in a certain area.

Additional instrumental methods such as computed tomography or magnetic resonance imaging are very convenient for searching for metastases. These techniques are very good and allow detailed visualization of the tumor, especially if it has a heterogeneous structure.

Symptoms and diagnosis of small intestinal tumors depend on the location of the cancer. If carcinoma grows in the upper parts of the duodenum, then, as a rule, the disease manifests itself in the early stages. When localized lower in the intestine, it may take a long time for pathognomonic symptoms to appear.

Ileal cancer is rare as an independent disease. As a rule, we are talking about metastases. Most often, malignant formations are represented by adenocarcinoma. There may also be lymphomas and sarcomas.

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Symptoms of ileal cancer

Clinical manifestations of cancer develop gradually. The first symptoms are dyspeptic symptoms: nausea, vomiting, impaired motor skills and severe spasmodic colic. The consequence is a decrease in appetite (aversion to food), and a rapid loss of body weight due to intoxication.

With multiple tumors, intestinal obstruction may occur, characterized by abdominal pain, vomiting, first gastric contents and then intestinal contents, bloating, dry skin and dehydration. With sarcomas, intestinal bleeding is often observed. As the tumor grows, it can compress neighboring organs, which can manifest itself in the development of pancreatitis, ascites, and intestinal ischemia.

Diagnosis of ileal cancer

endoscopy with biopsy;
fluoroscopy, MRI or CT scan with contrast agent;
laparoscopic endoscopy;
To diagnose tumors of the terminal ileum, colonoscopy and irrigoscopy can also be informative;
Ultrasound of the OBP is also performed.

Treatment of the disease

The approaches are standard: the tumor is removed, after which the remaining tumor cells are “polished” with chemotherapy.

Treatment of ileal cancer is usually surgical, that is, removal of the tumor. For inoperable tumors, chemotherapy is used with drugs that suppress the growth and further development of malignant cells.