Tumor of the Small Intestine and Its Signs

The tumors originating from the small intestine are relatively rare and account for only 5% of gastrointestinal tumors. There are various types of these tumors, and the outcome of the disease greatly depends on the histological type and stage of the tumor. The occurrence of small bowel cancer is primarily characteristic of older age groups, as most diagnosed cases occur in patients over 60, while it is rarer in younger populations.

Several factors can play a role in the development of the disease. Although the causes leading to small bowel cancer are not as clear-cut as those for other malignancies, certain risk factors have been identified. Genetic predisposition, various bowel diseases such as Crohn’s disease or celiac disease, can all contribute to the development of neoplastic changes. Lifestyle factors, such as the consumption of processed meats, high animal fat content, lack of physical activity, smoking, and alcohol consumption, can also increase the risk.

Types of Small Bowel Cancer

It can be said that several types of malignant tumors can arise from the small intestine, and the origin and course of each tumor type can vary. Adenocarcinoma is the most common type of tumor originating from the small intestine’s mucosa, accounting for nearly half of the cases. It most frequently occurs in the first third of the small intestine. This tumor grows aggressively and often metastasizes, making early detection crucial for successful treatment.

Carcinoid tumors, which develop from neuroendocrine cells, are the second most common type and spread more slowly. The formation of metastases is rarer, resulting in a more favorable prognosis. Lymphomas account for 20% of small bowel neoplastic changes, and these tumors can also develop rapidly, particularly in the surrounding lymph nodes.

Rare types include GIST (gastrointestinal stromal tumors), which originate from the deeper layers of the bowel wall, as well as sarcomas, such as leiomyosarcoma, which have an aggressive course and can metastasize quickly. The type and stage of the tumors influence treatment options, and early diagnosis is extremely important for successful therapy.

Symptoms of Small Bowel Cancer

Small bowel tumors are often asymptomatic initially; however, later they may present with nonspecific abdominal complaints. These include abdominal discomfort, bloating, loss of appetite, nausea, and vomiting. Malabsorption issues may also arise, changing the consistency and odor of the stool.

As the disease progresses, the symptoms caused by the tumor often intensify. Abdominal pain may worsen, and patients may experience partial bowel obstruction, which can present with transient and recurring symptoms. Specific symptoms may also be associated with certain types of tumors. For example, in the case of adenocarcinoma, lesions occurring in the area between the pancreas and the gallbladder can cause bleeding, leading to discoloration of the stool. In carcinoid tumors, carcinoid syndrome is typical, characterized by sudden hot flashes and rapid heartbeat.

Anatomy of the Small Bowel

The small intestine is located in the middle part of the digestive tract and is approximately 6-7 meters long. It consists of three main sections: the duodenum, jejunum, and ileum. It is responsible for the absorption of nutrients created during the digestive process, and the inner surface of the intestine is lined with villi, which help in the more efficient utilization of nutrients.

The mucosa of the small intestine contains enteroendocrine cells that produce hormones, aiding in the regulation of bowel function. The mucosa of the ileum also contains lymphoid follicles, which play an important role in the body’s immune response.

Investigation of Small Bowel Cancer

In cases where small bowel cancer is suspected, the diagnostic process begins with a thorough physical examination, during which the doctor may palpate the abdominal area. Imaging tests, such as CT or MRI, play a key role in identifying the tumor and determining its extent.

Endoscopic examinations can visualize the upper part of the small intestine, while specialized tools are required for the more distant sections. Laboratory tests, such as blood and urine analysis, can also be useful, as levels of substances produced by the tumor can provide information about the type of disease.

The definitive diagnosis is made based on biopsy sampling, during which the histological examination determines the type of tumor and its characteristics. Additionally, further tests may be conducted to more accurately determine the stage of the disease.

Treatment Options for Small Bowel Cancer

The treatment of small bowel cancer is a complex task that depends on the type and stage of the tumor, as well as the overall health status of the patient. The first step is usually surgical intervention aimed at the complete removal of the tumor. In early stages, surgery can be curative.

In certain cases, temporary diversion of the bowel may be necessary if the tumor cannot be completely removed. Chemotherapy and medication treatments are often applied in advanced cases, especially if surgery is not possible or if the tumor has recurred.

Special targeted therapies and immunotherapies are available for carcinoid tumors and GISTs. Combining different treatment modalities is also common, and within the framework of palliative therapy, alleviating symptoms plays an important role in improving the quality of life for the patient.