Definition Adenocarcinoma of the small intestine is a form of cancer that occurs in the part of the intestine that begins at the stomach. It is a rare form of cancer. This type of cancer makes up only a very small proportion of cancers in the digestive system.
What is going on in the body? The small intestine plays an important part in the digestion of foods. Many nutrients are absorbed by the small intestine as food passes through it. Adenocarcinoma occurs in the tissues that line the small intestine. Damage to a cell will cause the cell to grow and multiply out of control. These cells will form a tumour along the wall of the intestine. This tumour will begin to invade tissues around it. Eventually the tumour will grow through the intestinal wall. The tumour will then directly invade structures around the intestine. Cancer cells can break off from the tumour and spread through the bloodstream. Cancer cells can also spread through the system that drains into lymph nodes. Normally the lymph system helps prevent infection. When cancer cells enter lymph nodes, tumours will form in the nodes.
What are the signs and symptoms of the disease? With adenocarcinoma of the small intestine, the symptoms are often vague. Symptoms may not occur until the tumour is large. The tumour may block part or all of the small intestine. Some symptoms include:
anaemia, or lower-than-normal numbers of red blood cells because of slow blood loss. This can happen when the tumour invades a small blood vessel.
The person can have symptoms from specific organ damage if the cancer has metastasised, or spread to other parts of the body.
What are the causes and risks of the disease? The risk factors for adenocarcinoma of the small intestine are not well defined. It is a rare cancer. Diet may play a role in the development of this type of cancer, especially a diet high in nitrates. Some possible risk factors include:
What can be done to prevent the disease? There is no way to prevent this type of cancer.
How is the disease diagnosed? An upper GI x-ray study of the stomach and intestines will usually show a mass pressing on the intestine. A small tube, called an endoscope, can be passed into the intestine to help view the mass. The tube has a light and a camera on the end of it. This allows the doctor to see the inside of the intestine.
A small piece of the mass, or biopsy sample, will be removed and examined. This is very important in confirming that the mass is cancerous.
What are the long-term effects of the disease? This cancer is fatal if it is not treated successfully.
What are the risks to others? There are no risks to others from this cancer. Cancer does not spread from one person to another.
What are the treatments for the disease? The primary treatment is surgery to remove the tumour and the part of the intestine that is affected. Tissue near the tumour, including lymph nodes, will also be removed. Often, this may be the only treatment.
What are the side effects of the treatments? Removing a part of the small intestine will cause food to pass too quickly through the digestive system. The person may experience diarrhoea and cramping. Nutrients present in the food can not be absorbed adequately if the food passes too quickly through. Unless attention is paid to the diet, the person may become malnourished and lose weight.
What happens after treatment for the disease? Many times this cancer is found at a late stage of the disease. The cancer may have already spread. The person will be monitored closely by abdominal CT scans and special x-rays to check if the cancer has come back or spread. People with more extensive disease will need to be monitored more closely. If the cancer comes back or gets worse, chemotherapy may help to improve the person's quality of life. Once this type of cancer spreads beyond the small intestine, it cannot be cured.
How is the disease monitored? This type of cancer is monitored with abdominal CT scans. A CT scan allows a doctor to see a picture of the tissue near the intestine where the tumour was located. If the cancer has spread to other organs, these organs will be closely studied as well.
Author: Miriam P. Rogers, EdD, RN, AOCN, CNS Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 1/03/2005 Contributors Potential conflict of interest information for reviewers available on request
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