Small Intestine Cancer

The small intestine is part of the digestive system. It is a long, folded tube that brings digested food from your stomach to your large intestine. There are many parts of the small intestine and cancer can develop in each one.

Small intestine cancer is rare; 0.3 percent of adults in the U.S. will be diagnosed with small intestine cancer during their lives.

Types & Stages

There are four major types of small intestine cancer:

• Adenocarcinoma. This type starts in the glands that line the inside of your intestine.
• Carcinoid tumor. This is a type of neuroendocrine tumor that tends to be slow growing and is the most common type of small intestinal tumor.
• Lymphoma. This type starts in immune cells called lymphocytes.
• Sarcoma. This type starts in connective tissues, such as muscle. The most common sarcomas in the intestine are called gastrointestinal stromal tumors (GISTs).

If you are diagnosed with small intestine cancer, your doctor will also run tests to find out what stage it is. The stage means how far tumors have spread within and outside of the small intestine. When the stage is early, the tumors haven’t spread outside of the small intestine. When the stage is later, they have spread outside of the small intestine.

Knowing whether the cancer has spread will help your doctor figure out if it can be removed with surgery.

Signs & Symptoms

Symptoms of small intestine cancer can include:

• belly pain or cramps
• unexplained weight loss
• yellowing of the skin and eyes (jaundice)
• nausea, vomiting, and diarrhea
• blood in your stool

Causes & Risk Factors

Conditions that cause chronic inflammation in the intestines can raise your risk of developing small intestine cancer. For example, if you have Crohn disease or celiac disease, your risk of getting small intestine cancer is higher than someone who doesn’t have one of these conditions.

If you were born with any of the following genetic diseases, your risk of getting small intestine cancer is higher:

• Familial adenomatous polyposis (FAP), a genetic disease that causes polyps to grow in the intestines.
• Lynch syndrome, a genetic disease that causes DNA mutations to build up and can cause cancer in multiple organs.
• Peutz-Jeghers syndrome, a genetic disease that causes polyps to grow in the intestines and other parts of the digestive tract.

There is also some evidence that what you eat and drink can change your risk of getting small intestine cancer. If you eat a diet that is high in red meat and salted or smoked foods, or you drink alcohol, your risk of getting small intestine cancer may be higher.

Not everyone with these risk factors will develop small intestine cancer. Sometimes people with no risk factors develop small intestine cancer.

Screening

If you don’t have any risk factors or signs of small intestine cancer, screening tests are not recommended for you.

If you are at higher risk for small intestine cancer, such as if you have a genetic disease that is linked with small intestine cancer, your doctor may recommend regular screening to look for small intestine cancer.

Diagnosis

At Stony Brook Cancer Center, our doctors use a combination of tests to diagnose small intestine tumors, such as:

• Blood tests to check the levels of your red blood cells or to check how well certain organs are working.
• Imaging tests, like MRI and CT, to take pictures of the intestines and nearby organs.
• Endoscopy, to look at the first part of your small intestine. For this test, a thin, flexible tube with a small video camera on the end (an endoscope) is inserted down your throat and into your small intestine. During an endoscopy, doctors can remove suspicious tissue to examine it under a microscope (a biopsy).
• Enteroscopy, to look at all of your small intestine. For this test, doctors use a special endoscope that is made of two tubes. It is inserted down your throat or through your anus. During an enteroscopy, doctors can remove suspicious tissue to examine it under a microscope (a biopsy).
• Surgery, to let your doctors see inside your intestines and look for cancer. Surgery is typically done if other tests couldn’t provide a diagnosis. During surgery, your surgeon can remove suspicious tissue to examine it under a microscope (a biopsy). If you do have cancer, they may be able to remove it right away.

Treatment

What treatment you will get depends on many factors, including the location of your cancer in your small intestine.

Your treatment may include:

• Surgery to remove part of the small intestine where the cancer is growing. If your tumor can’t be removed, your surgeon may create a bypass around the tumor so it no longer blocks the small intestine.
• Radiation therapy. At Stony Brook Medicine, most of our radiation treatments are given with x-rays and electron beams generated by machines called linear accelerators.
• Chemotherapy, a type of drug that stops the growth of cancer cells.

At Stony Brook Medicine, our Palliative Care Service is available to everyone, no matter the stage of your cancer. This specialized team helps patients and their families cope with the physical, emotional, and spiritual distress of cancer. They can provide relief from symptoms of small intestine cancer and/or its treatment, such as pain, nausea, fatigue and loss of appetite.