What is Small Bowel Cancer? Symptoms, Causes, & Treatment

Small bowel cancer is a rare type of cancer that develops in your small intestine, the long tube that connects your stomach to your large intestine. While it accounts for less than 5% of all digestive system cancers, understanding this condition can help you recognize potential symptoms and seek appropriate care when needed.

Your small intestine plays a crucial role in digesting food and absorbing nutrients. When cancer cells form in this area, they can disrupt these important functions and may spread to other parts of your body if left untreated.

What are the symptoms of small bowel cancer?

Small bowel cancer symptoms often develop gradually and can be subtle at first. Many people don't notice signs until the cancer has grown larger or begun affecting normal digestive processes.

The most common symptoms you might experience include:

• Persistent abdominal pain or cramping that doesn't go away
• Unexplained weight loss over several weeks or months
• Nausea and vomiting, especially after eating
• Changes in bowel movements, including diarrhea or constipation
• Bloating or feeling unusually full after small meals
• Fatigue that doesn't improve with rest
• Blood in your stool, which may appear dark or tarry

Some people also experience less common symptoms like a lump you can feel in your abdomen or jaundice (yellowing of skin and eyes) if the cancer affects bile flow. These symptoms can come and go, which sometimes makes the condition harder to recognize early.

Keep in mind that these symptoms can also indicate many other, less serious conditions. Having one or more of these signs doesn't necessarily mean you have cancer, but they do warrant a conversation with your healthcare provider.

What are the types of small bowel cancer?

Small bowel cancer isn't just one disease. There are several different types, each starting from different kinds of cells in your small intestine.

The main types include:

• Adenocarcinoma - The most common type, starting in the cells that line the inside of your small intestine
• Neuroendocrine tumors - Develop from hormone-producing cells and can be slow-growing or more aggressive
• Lymphoma - Cancer of the immune system cells within the small intestine wall
• Sarcoma - Forms in the muscle or connective tissue of the small intestine wall

Adenocarcinoma accounts for about 40% of small bowel cancers and typically occurs in the duodenum, the first part of your small intestine. Neuroendocrine tumors are the second most common type and often develop in the ileum, the last section of the small intestine.

Each type behaves differently and may require specific treatment approaches. Your doctor will determine the exact type through biopsy and other tests, which helps guide your treatment plan.

What causes small bowel cancer?

The exact cause of small bowel cancer isn't fully understood, but it happens when normal cells in your small intestine develop genetic changes that cause them to grow uncontrollably. These cellular changes can accumulate over time due to various factors.

Several factors may increase your risk of developing this cancer:

• Genetic conditions like familial adenomatous polyposis (FAP) or Lynch syndrome
• Inflammatory bowel diseases such as Crohn's disease
• Previous radiation treatment to your abdomen
• Celiac disease that hasn't been properly managed
• Immune system disorders or medications that suppress immunity
• Age, as most cases occur in people over 60
• Being male, as men are slightly more likely to develop small bowel cancer

Some rare genetic syndromes like Peutz-Jeghers syndrome can also significantly increase your risk. This condition causes polyps to form throughout your digestive tract, including the small intestine.

Having one or more risk factors doesn't mean you'll definitely develop small bowel cancer. Many people with risk factors never get the disease, while others with no known risk factors do develop it.

When to see a doctor for small bowel cancer?

You should contact your healthcare provider if you experience persistent digestive symptoms that last more than a few weeks, especially if they're getting worse or interfering with your daily life. Early evaluation can help identify the cause and provide appropriate treatment.

Seek medical attention promptly if you notice:

• Severe abdominal pain that doesn't respond to over-the-counter medications
• Vomiting that prevents you from keeping food or liquids down
• Blood in your stool or black, tarry stools
• Unexplained weight loss of 10 pounds or more
• Signs of intestinal blockage like severe bloating, inability to pass gas, or vomiting

If you have a family history of digestive cancers or genetic conditions that increase cancer risk, discuss screening options with your doctor. They can help determine if you need more frequent monitoring or genetic counseling.

Remember that most digestive symptoms have benign causes, but getting them evaluated gives you peace of mind and ensures you receive appropriate care if needed.

What are the risk factors for small bowel cancer?

Understanding risk factors can help you and your healthcare provider assess your individual risk and determine appropriate screening or monitoring strategies. Some risk factors you can control, while others are beyond your influence.

Non-modifiable risk factors include:

• Age over 60, when most small bowel cancers are diagnosed
• Being male, as men have a slightly higher risk than women
• Genetic conditions like Lynch syndrome, FAP, or Peutz-Jeghers syndrome
• Family history of digestive system cancers
• Personal history of other cancers, particularly colorectal cancer

Medical conditions that may increase your risk include:

• Crohn's disease, especially if it affects your small intestine
• Celiac disease, particularly if it's untreated or poorly controlled
• Previous radiation therapy to your abdomen or pelvis
• Immunodeficiency disorders or immunosuppressive medications

Some lifestyle factors may also play a role, though the evidence is less clear than with other cancers. These include a diet high in processed meats and low in fruits and vegetables, smoking, and excessive alcohol consumption.

Having multiple risk factors doesn't guarantee you'll develop small bowel cancer, and many people with no known risk factors are still diagnosed with the condition.

What are the possible complications of small bowel cancer?

Small bowel cancer can lead to several complications, both from the cancer itself and from treatment. Understanding these possibilities helps you work with your healthcare team to prevent or manage them effectively.

The most common complications include:

• Intestinal obstruction when the tumor blocks food from passing through
• Bleeding into the digestive tract, which can cause anemia
• Perforation or tearing of the intestinal wall
• Malnutrition due to poor absorption of nutrients
• Spread of cancer to nearby organs or distant parts of the body

Intestinal obstruction is one of the most serious immediate complications. It can cause severe pain, vomiting, and inability to pass stool or gas. This situation requires emergency medical treatment to prevent further complications.

Treatment-related complications can include surgical risks like infection, bleeding, or problems with wound healing. Chemotherapy may cause fatigue, nausea, increased infection risk, or nerve damage. Radiation therapy can lead to skin irritation, digestive problems, or long-term scarring.

Your medical team will monitor you closely for signs of complications and provide supportive care to minimize their impact on your quality of life.

How can small bowel cancer be prevented?

While there's no guaranteed way to prevent small bowel cancer, certain lifestyle choices and medical management strategies may help reduce your risk. Focus on overall digestive health and managing any underlying conditions you may have.

Steps that may help lower your risk include:

• Following a balanced diet rich in fruits, vegetables, and whole grains
• Limiting processed meats and excessive red meat consumption
• Managing inflammatory bowel disease with appropriate medical treatment
• Following a strict gluten-free diet if you have celiac disease
• Avoiding tobacco use and limiting alcohol consumption
• Maintaining a healthy weight through diet and regular exercise

If you have genetic conditions that increase your cancer risk, work closely with your healthcare provider to develop a personalized surveillance plan. This might include more frequent screening tests or genetic counseling for family members.

Regular medical care is essential, especially if you have conditions like Crohn's disease or a family history of digestive cancers. Your doctor can help monitor your health and catch any changes early.

How is small bowel cancer diagnosed?

Diagnosing small bowel cancer can be challenging because the small intestine is difficult to examine directly and symptoms often resemble other digestive conditions. Your doctor will use a combination of tests to get a clear picture of what's happening.

The diagnostic process typically begins with a thorough medical history and physical examination. Your doctor will ask about your symptoms, family history, and any risk factors you might have.

Common diagnostic tests include:

• CT scan of your abdomen and pelvis to look for tumors or abnormalities
• MRI scan for more detailed images of soft tissues
• Upper endoscopy to examine the first part of your small intestine
• Video capsule endoscopy, where you swallow a tiny camera that takes pictures as it travels through your digestive tract
• Barium X-ray studies that use contrast material to highlight your small intestine
• Blood tests to check for anemia, nutritional deficiencies, or tumor markers

If imaging suggests a tumor, your doctor will likely recommend a biopsy to confirm the diagnosis and determine the exact type of cancer. This might be done during an endoscopy procedure or sometimes requires surgery.

The entire diagnostic process can take several weeks, which can feel stressful. Remember that thorough testing helps ensure you receive the most appropriate treatment for your specific situation.

What is the treatment for small bowel cancer?

Treatment for small bowel cancer depends on several factors, including the type and stage of your cancer, your overall health, and your personal preferences. Your healthcare team will work with you to develop a treatment plan that offers the best chance of success while maintaining your quality of life.

Surgery is often the primary treatment when the cancer is caught early and hasn't spread extensively. The type of surgery depends on the tumor's location and size. Your surgeon might remove just the tumor and some surrounding tissue, or you might need a larger section of small intestine removed.

Other treatment options may include:

• Chemotherapy to shrink tumors or kill cancer cells that may have spread
• Radiation therapy, sometimes used before surgery to shrink tumors
• Targeted therapy drugs that attack specific cancer cell features
• Immunotherapy to help your immune system fight the cancer
• Palliative care to manage symptoms and improve quality of life

For advanced cancers, treatment focuses on controlling the disease and managing symptoms. This might include combinations of chemotherapy, radiation, or newer targeted therapies.

Your treatment team will likely include several specialists, such as a gastroenterologist, oncologist, surgeon, and supportive care providers. They'll monitor your progress closely and adjust your treatment plan as needed.

How to manage symptoms at home during small bowel cancer treatment?

Managing symptoms at home is an important part of your overall care plan. Simple strategies can help you feel more comfortable and maintain your strength during treatment.

For digestive symptoms, consider these approaches:

• Eat smaller, more frequent meals instead of three large ones
• Choose easily digestible foods like rice, bananas, and toast
• Stay hydrated by sipping clear fluids throughout the day
• Avoid foods that seem to worsen your symptoms
• Keep a food diary to identify triggers

To manage fatigue and maintain your strength, try to stay as active as possible within your limits. Even gentle walks or light stretching can help. Make sure you're getting enough sleep and don't hesitate to ask for help with daily tasks when you need it.

Pain management is crucial for your comfort and well-being. Take prescribed medications as directed, and don't wait until pain becomes severe before taking action. Use heat or cold therapy as recommended by your healthcare team.

Keep track of your symptoms and any changes you notice. This information helps your healthcare team adjust your treatment plan and provide better support.

How should you prepare for your doctor appointment?

Preparing for your appointment helps ensure you get the most out of your time with your healthcare provider. Good preparation can help you feel more confident and ensure important topics are discussed.

Before your appointment, gather important information:

• Write down all your symptoms, including when they started and how often they occur
• List all medications and supplements you're taking
• Prepare your family medical history, especially any digestive or cancer history
• Note any recent changes in your weight, appetite, or bowel habits
• Bring previous test results or medical records if seeing a new doctor

Prepare a list of questions you want to ask. Some helpful questions might include asking about what tests you might need, what the results mean, what treatment options are available, and what to expect during treatment.

Consider bringing a trusted friend or family member to your appointment. They can help you remember information and provide emotional support during what might be a stressful conversation.

Don't hesitate to ask your healthcare provider to explain anything you don't understand. It's important that you feel informed and comfortable with your care plan.

What's the key takeaway about small bowel cancer?

Small bowel cancer is a rare but serious condition that requires prompt medical attention when symptoms develop. While it can be challenging to diagnose due to its location and subtle symptoms, early detection and appropriate treatment can significantly improve outcomes.

The most important thing to remember is that persistent digestive symptoms warrant medical evaluation, especially if they last more than a few weeks or are getting worse. Trust your instincts about your body and don't hesitate to seek care when something doesn't feel right.

If you're diagnosed with small bowel cancer, remember that you're not alone in this journey. Your healthcare team is there to support you every step of the way, and there are effective treatments available. Focus on taking care of yourself, following your treatment plan, and maintaining open communication with your medical providers.

With proper medical care and support, many people with small bowel cancer can maintain a good quality of life and continue doing the things they enjoy.