Small intestine cancer

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Small intestine cancer
Other namesSmall bowel cancer, cancer of the small bowel
Multiple Carcinoid Tumors of the Small Bowel 2.jpg
Picture of a carcinoid tumour that encroaches into lumen of the small bowel. Pathology specimen. The prominent folds are plicae circulares, a characteristic of small bowel.
Specialty Gastroenterology, general surgery, oncology
Symptoms vomiting blood, blood in the stool

Small intestine cancer is a cancer of the small intestine. It is relatively rare compared to other gastrointestinal malignancies such as gastric cancer (stomach cancer) and colorectal cancer. [1] [2]

Contents

Small intestine cancer can be subdivided into duodenal cancer (the first part of the small intestine) and cancer of the jejunum and ileum (the latter two parts of the small intestine). Duodenal cancer has more in common with stomach cancer, while cancer of the jejunum and ileum have more in common with colorectal cancer. Five-year survival rates are 65%. [3]

Experts[ which? ] believe that small intestine cancer develops much like colorectal cancer. It first begins as a small growth on the inner lining of the intestine (polyp), which over time becomes cancer. ( American Cancer Society 2023 )

Approximately 50% of adenomas of the small intestine arise in the duodenum even though this location comprises only 4% of the length of the small intestine. These adenomas occur mainly close to the ampulla of Vater, the outlet of the common bile duct from which bile acids are released. [4] This area is also closely associated with the pancreas, so they are treated as pancreatic cancer.

The small intestine works by mixing food and gastric juices into a thick fluid in the stomach and then emptied into the small intestine. It then continues to break down and absorb the nutrients. Although it is referred to as the small intestine, it is the longest section of the GI tract being approximately 20 feet long. The length of the small intestine comprises 75% of the length of the entire gastrointestinal tract [5]

There are three parts of the small intestine. The duodenum is the 1st section of small intestine and only about a foot long. The jejunum and ileum make up most of the small intestine. Most of the nutrients in food are absorbed into the bloodstream in these two parts. ( American Cancer Society 2023 )

Histopathologic types

Relative incidence of histopathologic types of small intestine cancers, and their prognoses Small intestinal cancers by incidence and prognosis.jpg
Relative incidence of histopathologic types of small intestine cancers, and their prognoses

Subtypes of small intestine cancer include:

Most small intestine cancers (especially adenocarcinomas) develop in the duodenum. Cancers developed in the duodenum are often found at the ampulla of Vater. (American Cancer Society, 2023)

Risk factors

Endoscopic image of adenocarcinoma of duodenum seen in the post-bulbar duodenum Duodenal adenocarcinoma.png
Endoscopic image of adenocarcinoma of duodenum seen in the post-bulbar duodenum

Risk factors for small intestine cancer include: [7] [8]

Additional images

Related Research Articles

<span class="mw-page-title-main">Gastrointestinal tract</span> Organ system within humans and other animals

The gastrointestinal tract is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as faeces. Gastrointestinal is an adjective meaning of or pertaining to the stomach and intestines.

<span class="mw-page-title-main">Duodenum</span> First section of the small intestine

The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In mammals, it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest part of the small intestine.

<span class="mw-page-title-main">Ileum</span> Final section of the small intestine

The ileum is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may be used instead of ileum. Its main function is to absorb vitamin B12, bile salts, and whatever products of digestion that were not absorbed by the jejunum.

<span class="mw-page-title-main">Small intestine</span> Organ in the gastrointestinal tract

The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pancreatic duct to aid in digestion. The small intestine is about 5.5 metres long and folds many times to fit in the abdomen. Although it is longer than the large intestine, it is called the small intestine because it is narrower in diameter.

<span class="mw-page-title-main">Bile duct</span> Type of organ

A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior).

<span class="mw-page-title-main">Meckel's diverticulum</span> Birth defect of a bulge in the small intestine

A Meckel's diverticulum, a true congenital diverticulum, is a slight bulge in the small intestine present at birth and a vestigial remnant of the vitelline duct. It is the most common malformation of the gastrointestinal tract and is present in approximately 2% of the population, with males more frequently experiencing symptoms.

<span class="mw-page-title-main">Digestive enzyme</span> Class of enzymes

Digestive enzymes take part in the chemical process of digestion, which follows the mechanical process of digestion. Food consists of macromolecules of proteins, carbohydrates, and fats that need to be broken down chemically by digestive enzymes in the mouth, stomach, pancreas, and duodenum, before being able to be absorbed into the bloodstream. Initial breakdown is achieved by chewing (mastication) and the use of digestive enzymes of saliva. Once in the stomach further mechanical churning takes place mixing the food with secreted gastric acid. Digestive gastric enzymes take part in some of the chemical process needed for absorption. Most of the enzymatic activity, and hence absorption takes place in the duodenum.

<span class="mw-page-title-main">Gastrointestinal disease</span> Illnesses of the digestive system

Gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum; and the accessory organs of digestion, the liver, gallbladder, and pancreas.

<span class="mw-page-title-main">Small intestinal bacterial overgrowth</span> Medical condition

Small intestinal bacterial overgrowth (SIBO), also termed bacterial overgrowth, or small bowel bacterial overgrowth syndrome (SBBOS), is a disorder of excessive bacterial growth in the small intestine. Unlike the colon, which is rich with bacteria, the small bowel usually has fewer than 100,000 organisms per millilitre. Patients with bacterial overgrowth typically develop symptoms which may include nausea, bloating, vomiting, diarrhea, malnutrition, weight loss, and malabsorption by various mechanisms.

<span class="mw-page-title-main">Pancreaticoduodenectomy</span> Major surgical procedure involving the pancreas, duodenum, and other organs

A pancreaticoduodenectomy, also known as a Whipple procedure, is a major surgical operation most often performed to remove cancerous tumours from the head of the pancreas. It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis. Due to the shared blood supply of organs in the proximal gastrointestinal system, surgical removal of the head of the pancreas also necessitates removal of the duodenum, proximal jejunum, gallbladder, and, occasionally, part of the stomach.

<span class="mw-page-title-main">Duodenal cancer</span> Medical condition

Duodenal cancer is a cancer in the first section of the small intestine known as the duodenum. Cancer of the duodenum is relatively rare compared to stomach cancer and colorectal cancer. Its histology is usually adenocarcinoma.

<span class="mw-page-title-main">Carcinoid</span> Slow-growing type of neuroendocrine tumor

A carcinoid is a slow-growing type of neuroendocrine tumor originating in the cells of the neuroendocrine system. In some cases, metastasis may occur. Carcinoid tumors of the midgut are associated with carcinoid syndrome.

Gastrointestinal cancer refers to malignant conditions of the gastrointestinal tract and accessory organs of digestion, including the esophagus, stomach, biliary system, pancreas, small intestine, large intestine, rectum and anus. The symptoms relate to the organ affected and can include obstruction, abnormal bleeding or other associated problems. The diagnosis often requires endoscopy, followed by biopsy of suspicious tissue. The treatment depends on the location of the tumor, as well as the type of cancer cell and whether it has invaded other tissues or spread elsewhere. These factors also determine the prognosis.

<span class="mw-page-title-main">Intestinal atresia</span> Medical condition

Intestinal atresia is any congenital malformation of the structure of the intestine that causes bowel obstruction. The malformation can be a narrowing (stenosis), absence or malrotation of a portion of the intestine. These defects can either occur in the small or large intestine.

<span class="mw-page-title-main">Enteroendocrine cell</span> Cell that produces gastrointestinal hormones

Enteroendocrine cells are specialized cells of the gastrointestinal tract and pancreas with endocrine function. They produce gastrointestinal hormones or peptides in response to various stimuli and release them into the bloodstream for systemic effect, diffuse them as local messengers, or transmit them to the enteric nervous system to activate nervous responses. Enteroendocrine cells of the intestine are the most numerous endocrine cells of the body. They constitute an enteric endocrine system as a subset of the endocrine system just as the enteric nervous system is a subset of the nervous system. In a sense they are known to act as chemoreceptors, initiating digestive actions and detecting harmful substances and initiating protective responses. Enteroendocrine cells are located in the stomach, in the intestine and in the pancreas. Microbiota play key roles in the intestinal immune and metabolic responses in these enteroendocrine cells via their fermentation product, acetate.

<span class="mw-page-title-main">Colorectal polyp</span> Growth found in bowel wall

A colorectal polyp is a polyp occurring on the lining of the colon or rectum. Untreated colorectal polyps can develop into colorectal cancer.

<span class="mw-page-title-main">Periampullary cancer</span> Disease

Periampullary cancer is a cancer that forms near the ampulla of Vater, an enlargement of the ducts from the liver and pancreas where they join and enter the small intestine. It consists of:

  1. ampullary tumour from ampulla of Vater
  2. cancer of lower common bile duct
  3. duodenal cancer adjacent to ampulla
  4. carcinoma head of pancreas

Mouse models of colorectal cancer and intestinal cancer are experimental systems in which mice are genetically manipulated, fed a modified diet, or challenged with chemicals to develop malignancies in the gastrointestinal tract. These models enable researchers to study the onset, progression of the disease, and understand in depth the molecular events that contribute to the development and spread of colorectal cancer. They also provide a valuable biological system, to simulate human physiological conditions, suitable for testing therapeutics.

<span class="mw-page-title-main">Human digestive system</span> Digestive system in humans

The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion. Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. The process of digestion has three stages: the cephalic phase, the gastric phase, and the intestinal phase.

Intestinal bypass is a bariatric surgery performed on patients with morbid obesity to create an irreversible weight loss, when implementing harsh restrictions on the diets have failed. Jejunocolic anastomosis was firstly employed. Nonetheless, it led to some unexpected complications such as severe electrolyte imbalance and liver failure. It was then modified to jejunoileal techniques. Viewed as a novel form of treatment for obesity, many intestinal bypass operations were carried out in the 1960s and 1980s. Significant weight loss was observed in patients, but this surgery also resulted in several complications, for instance, nutritional deficiencies and metabolic problems. Due to the presence of surgical alternatives and anti-obesity medications, intestinal bypass is now rarely used.

References

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  2. "Colon Cancer Treatment (PDQ®)". NCI. May 12, 2014. Archived from the original on July 5, 2014. Retrieved June 29, 2014.
  3. "SEER Stat Fact Sheets: Small Intestine Cancer". NCI. Retrieved 18 June 2014.
  4. Ross RK; Hartnett NM; Bernstein L; Henderson BE. (1991). "Epidemiology of adenocarcinomas of the small intestine: is bile a small bowel carcinogen". British Journal of Cancer . 63 (1): 143–5. doi:10.1038/bjc.1991.29. PMC   1971637 . PMID   1989654.
  5. Maguire, A; Sheahan, K (2018). "Primary small bowel adenomas and adenocarcinomas-recent advances". Virchows Archiv . 473 (3): 265–73. doi:10.1007/s00428-018-2400-7. PMID   29998424.
  6. Qubaiah, O.; Devesa, S. S.; Platz, C. E.; Huycke, M. M.; Dores, G. M. (2010). "Small Intestinal Cancer: a Population-Based Study of Incidence and Survival Patterns in the United States, 1992 to 2006". Cancer Epidemiology, Biomarkers & Prevention. 19 (8): 1908–1918. doi: 10.1158/1055-9965.EPI-10-0328 . ISSN   1055-9965. PMC   2919612 . PMID   20647399.
  7. Delaunoit T, Neczyporenko F, Limburg PJ, Erlichman C (March 2005). "Pathogenesis and risk factors of small bowel adenocarcinoma: a colorectal cancer sibling?". Am. J. Gastroenterol. 100 (3): 703–10. doi:10.1111/j.1572-0241.2005.40605.x. PMID   15743371.
  8. Chen AC, Neugut AI. Malignant Neoplasms of the Small Intestine. eMedicine.com. URL: http://www.emedicine.com/MED/topic2651.htm. Accessed on: June 2, 2006.
  9. Cross AJ, Leitzmann MF, Subar AF, Thompson FE, Hollenbeck AR, Schatzkin A. A prospective study of meat and fat intake in relation to small intestinal cancer. Cancer Res 2008;68:9274–9
  10. Lagergren J, Ye W, Ekbom A. Intestinal cancer after cholecystectomy: is bile involved in carcinogenesis. Gastroenterology 2001;121:542–7

American Cancer Society. (2023). Key statistics for small intestine cancer. American Cancer Society. Retrieved April 3, 2023, from https://www.cancer.org/cancer/small-intestine-cancer/about/what-is-key-statistics.html

Cleveland Clinic. (2022). Small intestine cancer: Symptoms, causes, Prognosis & Treatment. Cleveland Clinic. Retrieved April 4, 2023, from https://my.clevelandclinic.org/health/articles/6225-small-intestine-cancer

Markman, M. (2022, July 20). Intestinal cancer: Causes, symptoms & treatments. Cancer Treatment Centers of America. Retrieved April 4, 2023, from https://www.cancercenter.com/cancer-types/intestinal-cancer

Radhakrishnan, R. (2021, May 6). Is small intestine cancer curable? MedicineNet. Retrieved April 4, 2023, from https://www.medicinenet.com/is_small_intestine_cancer_curable/article.htm