Small intestine cancer is curable or not. Small intestinal cancer: how to recognize it at the initial stage? Photo gallery of folk remedies

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;
• skinny section in anatomy small intestine 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, pancreatic juice, is located in the middle region of the abdomen, downward from the stomach and transversely 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 organ surgery abdominal cavity during 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 60 years of age and almost never occurs in people under 50 years of age.

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. Cancer manifests itself at a late stage duodenum symptoms associated with poor patency biliary tract and intestines due to tumor growth. The patient will suffer from endless nausea and vomiting, flatulence and manifestations of jaundice.

Skinny and ileum signals 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;
• pallor 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

Tumor development on early stages in women and men it happens almost the same way. 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 a lesion 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 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 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:

1. 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.
2. 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:

1. Tis - preinvasive cancer;
2. T1 – tumor invasion of the submucosal layer of the intestine;
3. T2 – tumor invasion of the muscular layer of the intestine;
4. T3 is tumor invasion of the subserous layer of the intestine or retroperitoneal space. The tumor is no more than 2 cm;
5. 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:

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

• M – presence of distant metastases:

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

Stages of small intestine cancer

There are five stages of intestinal adenocarcinoma:

1. 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.
2. Stage 1 - the tumor has grown deeply into the intestinal wall, but has not spread to neighboring organs. There are no metastases.
3. At stage 2 of intestinal cancer, the tumor has grown through the entire thickness of the intestinal wall and has spread to neighboring organs.
4. At stage 3 of small intestine cancer, cancer cells have spread to regional lymph nodes. There is no growth into other organs or distant metastases.
5. 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 intestine cancer depends on the location of the tumor in the intestine itself:

1. Fibrogastroduodenoscopy and contrast fluoroscopy, using these methods, diagnose the duodenum.
2. Irrigoscopy and colonoscopy - performed to diagnose the ileum.
3. 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, 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, since the sooner treatment begins, the easier it is for the patient to endure its stages, the greater the chances of positive result. When symptoms appear, the oncological process can be considered advanced, and the moment early treatment will be missed.

Important! TO early symptoms refers to a “malignant” state that 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 with a diagnosis of “ colorectal cancer"after her. 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. Cancerous tumors on initial stage 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. Carried out by blocking all blood vessels 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 intestinal cancer independent method 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 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 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 intestines:

• undergo regular preventive examinations;
• adhere to principles healthy image life and proper nutrition;
• treat diseases in a timely manner gastrointestinal tract;
• undergo an annual stool test for occult blood (Colon View test, which can be used to determine occult blood in stool and detect colon cancer at an early stage);
• do not delay and consult a doctor if any alarming symptoms from the digestive system.

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%.

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 care already in its 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 Intestinal oncology in women is characterized by pallor of the skin, malfunctions menstrual cycle 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 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 is observed when swallowing food, a feeling of presence foreign body in the abdominal cavity, false urge to defecate. 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 is carefully examined internal organs most susceptible to metastasis. Chest radiography, multislice computed tomography of the abdominal cavity (MSCT), radiology diagnostics bones (scintigraphy). To clarify some data, it may be necessary to carry out such diagnostic methods such as laparoscopy or irrigography.

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 focuses on differentiating cancer from tumors of 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. TO effective methods Treatments 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 of 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 additional method treatment of 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 mandatory assistance from qualified specialists and effective ways treatment. 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 aggressive cancer treatment 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 the tumor and surgery to remove it significantly increases the likelihood complete cure 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.

The length of the loop-shaped small intestine reaches 4.5 m. It consists of intestines: duodenum, jejunum and ileum. In each of these components, under favorable conditions, small intestinal cancer can degenerate from a normal cell.

Malignant tumor of the small intestine

The absence of obvious specific primary symptoms forces patients to seek help from a doctor in the later stages of the disease. In this case, metastasis begins, due to which secondary intestinal cancer develops.

Metastases reach regional lymph nodes and other distant parts of the intestine, so the following cancers can 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 can be hidden behind signs of diseases such as diverticulitis, ulcerative colitis, enteritis, Crohn's disease, duodenal ulcer. Often the tumor develops against the background of adenomatous polyps, 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.

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 small intestinal cancer symptoms and manifestations occur 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; signs and symptoms manifest themselves somewhat differently due to the different structure of the genitourinary system.

Very often, with breast, cervical and ovarian cancer, signs of intestinal cancer appear in women. For tumor metastases prostate gland, testicles may appear symptoms of bowel cancer in men. If the tumor compresses neighboring organs, this leads to the development of pancreatitis, jaundice, ascites, and intestinal ischemia.

Small intestine cancer: symptoms and manifestations

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

• 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 the breakdown of tumor cells, ulcers and intestinal fistulas appear;
• iron deficiency increases;
• the functions of the pancreas and liver are impaired.

Cancer does not have a gender identity, so the symptoms of bowel cancer in women and men are largely the same: increasing weakness, weight loss, malaise, anemia and rapid and unexplained fatigue, nervousness, anorexia, difficulty defecating, accompanied by pain, itching , frequent urges.

Classification of stages of small intestinal cancer. Types and Types of Small Bowel Cancer

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

• adenocarcinoma - develops from glandular tissue next to the major papilla of the duodenum. The tumor is ulcerated and covered with a fleecy surface;
• carcinoid - 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.
• lymphoma is a rare tumor (18%) and combines lymphosarcoma and lymphogranulomatosis (Hodgkin's disease);
• leiomyosarcoma is a large tumor, more than 5 cm in diameter, that 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. Growth form – exophytic and endophytic.

Stages of small intestine cancer:

1. Stage 1 cancer of the small intestine – tumor within the walls of the small intestine, no metastases;
2. Stage 2 of small intestine cancer – the tumor extends beyond the intestinal wall, begins to penetrate other organs, there are no metastases;
3. Stage 3 of small intestine cancer - metastasis to the nearest lymph nodes, germination to other organs, no distant metastases;
4. small intestine cancer stage 4 – metastasis in distant organs (liver, lungs, bones, etc.).

Diagnosis of small intestine cancer

How to recognize colon cancer at an early stage? This determines what treatment will be used, the patient’s condition and the prognosis for survival.

Diagnosis of small intestine cancer is carried out using popular methods:

• X-ray examination;
• fibrogastroscopy;
• angiography of the vessels of the peritoneal cavity;
• laparoscopy;
• colonoscopy;
• CT and MRI;
• biopsy examination: determine the type of cells and the degree of their malignancy;
• electrogastroenterography: detect disturbances in small intestinal motility characteristic of cancer.

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.

When visiting a doctor, a blood test for colon cancer is immediately prescribed and examined. A general basic blood test can reveal anemia, the patient's condition, and the presence of inflammation. According to the level of ESR and hemoglobin - problems in the liver, kidneys and blood. The composition of the blood may indicate certain diseases, including cancer.

Tumor markers for small intestinal cancer are detected in the blood. The most informative and common tumor markers are alpha-fetoprotein, total PSA/free PSA, CEA, CA-15.3, CA-125, CA-19.9, CA-72.4, CYFRA-21.1, hCG and cytokeratin .

For example, using the 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 small intestinal cancer: duodenal, jejunal and ileal intestines is carried out depending on the type of tumor and stage. The main method is bowel resection and removal of tumor formation.

With a confirmed diagnosis of small intestinal cancer, surgery reduces symptoms and increases life expectancy. If it is not possible to remove malignant tumors 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.

After a palliative operation (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, traditional medicine for intestinal cancer is introduced into complex therapy: alcohol tinctures, infusions and decoctions of medicinal herbs, mushrooms and berries. Appropriate nutrition for intestinal cancer prevents paresis, nausea and vomiting, and improves gastrointestinal motility.

Forecast and prevention of small intestine (bowel) cancer

Prevention of small intestinal cancer involves timely removal benign neoplasms, polyps, constant monitoring by specialists of patients with the presence of chronic inflammatory processes of the gastrointestinal tract, transition to healthy eating and lifestyle, giving up bad habits.

If treatment was given and bowel cancer was removed, how long do people live? If there are no regional or distant metastases, the tumor is removed, survival in the subsequent 5-year period can be 35-40%.

Conclusions! If the tumor is operable, a wide resection of a section of the intestine with lymph nodes and mesentery is performed within the boundaries of healthy tissue. To restore the integrity of the gastrointestinal tract, enteroenteroanastomosis is performed - small intestine into the small intestine or enterocoloanastomosis - small intestine into the large intestine.

For cancer of the duodenum, as part of the small duodenum, duodenectomy and sometimes distal resection of the stomach or pancreas (pancreaticoduodenectomy) are performed. In case of advanced oncology of the small intestine, a bypass anastomosis is performed between loops that remain unaffected. Surgical treatment is supplemented with chemotherapy.

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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 epithelial tissue folds (crypts) of the intestine, glandular epithelium of the duodenum, the superficial epithelium can rarely 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, there will be asthenic syndrome and causeless weight loss. 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:

1. Abnormal stool. Initially, diarrhea may develop, followed by constipation.
2. Pain syndrome. Characterized by a gradual increase in pain intensity, up to sharp paroxysmal colic
3. Nausea, belching with fecal odor
4. Bloating, distension of the intestines
5. Profuse vomiting of intestinal contents, followed by slight relief
6. 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. At the same time, food intake 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 total bile duct 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. At the same time, the skin acquires yellow, itching may occur. IN biochemical analysis blood there will be 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:

1. 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.
2. A tumor that grows into the intestinal wall can form a narrowing of the lumen, which also leads to intestinal obstruction.
3. 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 its course. 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.

First you need to evaluate general form the patient, the color of his skin, behavior, 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 have difficulty tolerating physical exercise. To compensate for the reduced level of partial pressure of oxygen, such patients will need to exercise a large number breathing 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 dullness of percussion noise in the projection above the tumor.

Laboratory research

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

1. Clinical analysis of blood, urine
2. Feces for occult blood
3. Blood chemistry
4. Tumor markers
5. X-ray of the abdominal organs with contrast enhancement
6. EFGDS
7. Colonoscopy and irrigoscopy
8. Biopsy and histological examination
9. CT scan
10. 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 products of the vital activity of a neoplasm or synthesized healthy tissues 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 if 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 endoscopic manipulations is a biopsy of the small intestine. 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 - using optical device The tumor is visualized, then biomaterial is collected, the endoscope is withdrawn, and the tumor cells are further examined 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 has big sizes and grows into neighboring organs, then the surgeon leaves the abdominal cavity and sutures 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 like a computer or magnetic resonance imaging 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.

Small bowel cancer

Small intestine cancer is a malignant tumor lesion of parts of the small intestine: duodenum, jejunum or ileum. Small intestinal cancer manifests itself as dyspeptic disorders (nausea, vomiting, flatulence, cramping abdominal pain), weight loss, bleeding, and intestinal obstruction. Diagnosis of cancer of the small intestine can be carried out using FGDS, radiography, capsule endoscopy, colonoscopy, gastrointestinal scintigraphy, tomography, endoscopic biopsy, laparoscopy. Treatment of small intestinal cancer consists of resection of the affected area of ​​the intestine, excision of regional lymph nodes and mesentery, and the application of enteroenteroanastomosis.

Small bowel cancer

In the structure of malignant tumors of the digestive tract, small intestinal cancer accounts for 1-2%. Among small intestinal neoplasms in gastroenterology, duodenal cancer is more common (about 50% of cases); less often - jejunal cancer (30%) and ileal cancer (20%). Small intestinal cancer is a disease that predominantly affects men over the age of 60.

Causes of small intestine cancer

In most cases, small intestinal cancer develops against the background of chronic enzymatic or inflammatory diseases Gastrointestinal tract (celiac disease, duodenitis, peptic ulcer, enteritis, Crohn's disease, ulcerative colitis, diverticulitis) or epithelial benign tumors intestines. The predominant damage to the duodenum is explained by the irritating effect of bile and pancreatic juice on the initial part of the small intestine, as well as its active contact with carcinogens entering the digestive tract with food.

Cases of sporadic or familial adenomatous polyposis are factors increased risk development of small intestine cancer. The risk of developing small intestinal cancer is higher in smokers, people exposed to radiation, and people with alcohol addiction; people whose diet is dominated by animal fats, canned foods, and fried foods.

There is a certain mutual relationship between colon cancer and tumor damage to the small intestine.

Classification of small intestinal cancer

Based on the nature of the growth of tumor tissue, exophytic and endophytic cancer of the small intestine are distinguished. Exophytic tumors grow into the intestinal lumen, causing its narrowing and the development of intestinal obstruction; macroscopically may resemble a polyp or cauliflower. Endophytic forms of cancer infiltrate the wall of the small intestine in depth, accompanied by intestinal bleeding, perforation and peritonitis.

According to the histological structure, malignant tumors of the small intestine are often represented by adenocarcinoma; Less common in oncological practice are sarcomas, carcinoids, and intestinal lymphoma.

According to the clinical and anatomical classification according to the international TNM system, the development of small intestine cancer is divided into stages:

• Tis - preinvasive cancer
• T1 – tumor invasion of the submucosal layer of the intestine
• T2 – tumor invasion of the muscular layer of the intestine
• T3 – tumor invasion of the subserous layer of the intestine or retroperitoneal space in an area of ​​no more than 2 cm
• T4 – tumor invasion of the visceral peritoneum, non-peritoneal areas more than 2 cm in length, structures or organs adjacent to the intestine.
• N0 and M0 – absence of regional and isolated metastasis
• N1 – metastatic lesion of regional lymph nodes (pancreaticoduodenal, pyloric, hepatic, mesenteric).
• Ml – the presence of distant metastases in the peritoneum, liver, omentum, lungs, kidneys, bones, adrenal glands.

Symptoms of small intestine cancer

Manifestations of small intestinal cancer are characterized by polymorphism, which is associated with variability in the location, histology and size of the tumor. In the initial stages, periodic spasmodic pain in the abdomen, stool instability (diarrhea and constipation), flatulence, nausea and vomiting are disturbing. Intoxication and progressive loss of body weight are noted, which is associated both with reduced nutrition, and with tumor growth.

Destructive processes in small intestinal cancer can lead to the development of intestinal bleeding, perforation of the intestinal wall, entry of contents into the abdominal cavity and peritonitis. Exophytic growth of tumors is often accompanied by obstructive intestinal obstruction with a corresponding clinical picture. When the tumor compresses neighboring organs, pancreatitis, jaundice, ascites, and intestinal ischemia can develop.

Sometimes there is fusion of the tumor with neighboring intestinal loops, the bladder, large intestine, and omentum with the formation of a single, sedentary conglomerate. When ulceration and decay of small intestinal cancer occurs, intestinal fistulas can occur.

Diagnosis of small intestine cancer

Diagnostic algorithm for small intestinal cancer various localizations has its own characteristics. Thus, in the recognition of tumors of the duodenum, fibrogastroduodenoscopy and contrast fluoroscopy play a leading role. Colonoscopy and irrigoscopy can be informative for diagnosing tumors of the terminal ileum.

An important role in the diagnosis of small intestinal cancer is played by barium passage radiography, which makes it possible to identify obstacles to the advancement of the contrast agent, areas of stenosis and suprastenotic dilatation of the intestine. The value of endoscopic studies lies in the possibility of performing a biopsy for subsequent morphological verification of the diagnosis. It may be of some diagnostic interest to carry out selective angiography abdominal cavity.

In order to detect metastases and germination of small intestinal cancer into the abdominal organs, ultrasound (liver, pancreas, kidneys, adrenal glands), MSCT of the abdominal cavity, chest radiography, and bone scintigraphy are performed. In unclear cases, diagnostic laparoscopy is advisable.

Small intestinal cancer must be differentiated from intestinal tuberculosis, occlusion of mesenteric vessels, benign tumors of the small intestine, Crohn's disease, renal dystopia, retroperitoneal tumors, and in women - from tumors of the appendages and uterus.

Treatment of small intestine cancer

When small intestinal cancer is operable, it is most effective to perform a wide resection of the affected area of ​​the intestine, lymph nodes and mesentery. The length of the small intestine allows radical removal of the tumor within the boundaries of healthy tissue. The integrity of the gastrointestinal tract is restored by applying enteroenteroanastomosis (small intestine to small intestine) or enterocoloanastomosis (small intestine to large intestine).

For duodenal cancer, duodenectomy is indicated, sometimes with distal gastrectomy or pancreatic resection (pancreaticoduodenectomy). For advanced small intestinal cancer that does not allow radical resection, a bypass anastomosis is performed between unaffected loops of intestine. Surgical stage treatment of small intestinal cancer is complemented by chemotherapy; this same method may be the only way to treat inoperable tumors.

Prognosis and prevention of small intestinal cancer

The long-term prognosis for small intestinal cancer is determined by the stage of the process and the histological structure of the tumor. For localized tumor processes without regional and distant metastases, radical resection allows to achieve 35-40% survival over the subsequent 5-year period.

Prevention of small intestinal cancer requires timely removal of benign intestinal tumors, observation by a gastroenterologist of patients with chronic inflammatory processes of the gastrointestinal tract, smoking cessation, and normalization of nutrition.

Small intestinal cancer is a malignant tumor of the digestive tract that develops from the epithelial cells of the small intestine. It is quite rare (2% of the total incidence of gastrointestinal cancer). It occurs twice as often in men as in women. also applies to types of small intestinal cancer, although in most cases it is considered separately.

Key points

• Occurs more often in men over 60 years of age
• Risk factors – alcohol consumption, smoking, a number of diseases
• The priority treatment method is surgical
• A fairly non-aggressive type of cancer, it metastasizes most often to regional lymph nodes and adjacent organs.

What causes small intestinal cancer

The causes of small intestinal cancer are currently unknown, but there are a number of risk factors and precancerous diseases that contribute to the development of this type of cancer. Risk factors for small intestine cancer:

• Regular alcohol consumption
• Smoking
• A large amount of spicy, coarse, salty foods in the diet
• Celiac disease (gluten intolerance)
• Hereditary predisposition

Precancerous conditions are considered:

• Polyposis
• Villous intestinal tumors
• Crohn's disease
• Ulcerative colitis

It should be noted that even a combination of several risk factors does not guarantee the occurrence of the disease, while their absence also does not protect against it 100%.

Symptoms

Small intestinal cancer can be asymptomatic for a long time and early diagnosis is random. In most cases, the tumor is found during surgery or x-ray examination for other diseases. Gradually developing functional disorders, which depend on the size of the tumor focus and its location. The starting symptoms of small intestine cancer are as follows:

• Pain in the upper abdomen
• Feeling of tightness
• Nausea
• Bloating
• Anemia
• Jaundice
• Decreased appetite
• Fast weight loss

The first symptoms are nonspecific and may be characteristic of other gastrointestinal diseases.

Diagnosis of small intestine cancer

During the initial diagnosis of small intestinal cancer, the gastroenterologist collects the patient’s medical history and asks about general symptoms. If you suspect cancer in most cases it is prescribed:

• X-ray examination of the small intestine with barium contrast
• Ultrasound examination (ultrasound) of the abdominal organs
• Colonoscopy
• Endoscopic examination of the small intestine (fibrogastroscopy) with tissue biopsy

When a tumor is detected, the doctor orders a magnetic resonance imaging (MRI) to determine the stage of the disease and its extent.

Treatment of small intestine cancer

The main treatment method for small intestine cancer is surgical, in which the surgeon removes the affected part of the intestine, reconstructing its integrity with healthy intestinal anastomoses. In cases where the size of the tumor, its location, germination or distant metastases do not allow radical resection, the obstruction is eliminated by creating a palliative bypass of the intestine. Courses are also held before and/or after surgery chemotherapy in order to reduce the risk of colonization of the abdominal cavity with cancer cells.

In most cases, operations are performed using minimally invasive methods - laparoscopically or using the Da Vinci surgical robot. Robotic surgery on the small intestine has its advantages:

• Reduced pain levels during and after surgery
• Reducing the risk of infections and/or complications
• Reducing organ trauma during surgery
• Minimizing blood loss during surgery
• Fast recovery after surgery, reduction of required hospitalization time
• Reducing the number of postoperative scars, including external ones
• Rapid recovery of the patient's performance

In addition to surgery, various strategies are used in Israel chemotherapy And radiotherapy. Widely used immunotherapy, helping to slow down the growth of cancer cells. Targeted therapy used in inoperable cases to act directly on cancer cells and reduce symptoms. In addition, a variety of treatment techniques and strategies are considered depending on the general condition the patient's health, age and other factors. One of the most important parameters when choosing a treatment strategy is the ability to achieve and maintain the highest possible quality of life for the patient after treatment.

How does small intestinal cancer spread?

Small intestinal cancer cells are quite non-aggressive, but the tumor often grows into nearby organs - the bladder, large intestine, and peritoneum. Metastases mainly appear in regional lymph nodes and pancreas, which is why in some cases this type of cancer may be mistaken for primary pancreatic cancer.

Small intestinal cancer cells can spread throughout the body in three ways:

• Through tissue: cancer begins to invade the tissues of nearby organs, primarily the large intestine and bladder;
• Through the lymphatic system: cancer enters the lymph and spreads throughout the body through the lymph nodes;
• Through the blood: Cancer cells move throughout the body through the blood.

Prognosis and survival statistics

Content

The appearance of tumors in organs digestive system provokes chronic diseases and inflammatory processes. Since men often exhibit risk factors such as smoking and alcohol, small intestinal cancer is more common among them, especially after 60 years of age. You need to know the symptoms of the pathology in order to detect the disease in a timely manner.

Tumor localization

The loop-shaped small intestine is about 4.5 meters long. The tumor develops in its epithelial and glandular tissues. Based on the location of the cancerous tumor, three sections are distinguished:

• duodenum – affected in almost half of the cases;
• jejunum part of the intestine – cancer is less common;
• ileum – isolated episodes of pathology.

Oncologists distinguish two options for the development of malignant neoplasms in the small intestine:

• Exophytic tumor. Causes cancer cells to grow inside the intestines. The growth looks like polyps, plaques, and causes obstruction.
• Endophytic formations. They affect intestinal tissues and compress neighboring organs. This causes pancreatitis, intestinal ischemia, and jaundice. There is a tendency for fusion with the bladder, uterus, large intestine, and neighboring loops, which ends in disruption of organ function. When cancer disintegrates, the formation of fistulas cannot be ruled out.

Clinical picture

Symptoms of intestinal tumors rarely appear early. The patient comes to the doctor at stages 3-4 of pathology development. The clinical picture depends on the degree of small intestinal cancer. The patient may experience the following symptoms of the disease:

• stomach ache;
• a coppery taste in the mouth;
• sudden weight loss;
• nausea;
• liver dysfunction;
• decrease in hemoglobin;
• vomit;
• anemia.

As the tumor grows, the lumen of the small intestine is blocked, which leads to obstruction. The clinical picture is complemented by the following symptoms:

• perforation of walls;
• intestinal bleeding;
• intoxication of the body with tumor decay products;
• entry of intestinal contents into the peritoneum;
• development of peritonitis;
• dysfunction of the pancreas;
• difficulty defecation;
• anorexia;
• rapid fatigue.

The first signs of bowel cancer

The disease can develop asymptomatically over a long period of time. The first signs appear as small intestinal cancer grows; the patient seeks help when he is concerned about:

• recurring abdominal pain;
• stool disorders - alternating constipation and diarrhea;
• increased gas formation;
• nausea;
• flatulence;
• bloating;
• spasms in the navel area.

A person begins to worry about sudden weight loss. As a result of impaired lymph flow, ascites (fluid accumulation in the abdominal cavity) is observed. Possible symptoms of bowel cancer at an early stage:

• intoxication of the body - increased body temperature, vomiting, weakness;
• false urge to defecate;
• the appearance of mucus and blood in the stool;
• aversion to food;
• irritability;
• chills;
• heartburn;
• vomit.

General symptoms

With the development of small intestinal cancer, the clinical picture of the disease includes general symptoms. They occur at all stages of the development of the tumor process. The following signs of pathology appear:

• pallor of the skin, mucous membranes;
• increase in body temperature to subfebrile values;
• constant malaise;
• headaches;
• loss of appetite;
• giving up meat.

With intestinal cancer, the following symptoms of neoplasm development are observed:

• increasing weakness;
• sudden weight loss;
• rapid fatigue;
• stool disorder;
• aching bones;
• hard breath;
• excretion of urine during defecation;
• the appearance of mucus and blood in the stool;
• dizziness;
• persistent hyperthermia;
• pain syndrome in the epigastric region.

In later stages

Diagnosing cancer in the final stages of development complicates the treatment process. The disintegration of the tumor leads to general poisoning of the body. Patients at this stage feel severe pain, which radiates to the lumbar region, sacrum, and anus. Poor permeability of the small intestine and bile ducts causes the following symptoms:

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

Compression of neighboring organs by a malignant neoplasm, the occurrence of fistulas provokes the appearance of cancer symptoms:

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

When the tumor metastasizes

The small intestine is located so that many important organs are nearby. At the stage of metastasis, their damage begins. In addition, through the blood, malignant cells spread throughout the body to distant lymph nodes. The following organs are affected by cancer:

• lungs;
• ovaries;
• prostate;
• kidney;
• uterus;
• adrenal glands;
• mammary glands;
• Bladder;
• pancreas;
• sections of the colon;
• liver;
• peritoneum.

Distinctive signs of cancer in men and women

According to medical observations, the general symptoms of the development of a malignant neoplasm are similar for men and women. female body. There are some minor peculiarities in the course of this dangerous disease. If the small intestine is damaged, the following signs can be noted:

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Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only qualified doctor can make a diagnosis and make treatment recommendations based on individual characteristics specific patient.

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