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Cancer of the Small Intestine

The small intestine, or small bowel, lies between the stomach and the colon. The small intestine is about 6 m (20 ft) long. Its primary function is to digest and absorb nutrients. The small intestine makes up more than 70% of the length and 90% of the surface area of the gastrointestinal (GI) tract.

The most common cancerous (malignant) tumors of the small bowel include adenocarcinoma, lymphoma, sarcoma, and carcinoids.
  • In industrialized countries, adenocarcinomas occur most often.
  • In developing countries, lymphomas are much more common.
  • All these tumors have the potential to invade the bowel wall, spread into adjoining lymph nodes, and move to distant organs (metastasize).

Risk Factors

Each year, US doctors diagnose about 1200 malignant small intestine tumors. This is a small number relative to the frequency of tumors in other parts of the GI tract.
  • It has been proposed that the liquid nature of the small intestinal contents may be less irritating to the mucosa, the innermost lining of the small bowel.
  • Rapid transit time in the small bowel may reduce exposure of the intestinal wall to cancer-inducing agents found in the intestinal contents.
  • Other factors that might limit the presence or impact of potential cancer-inducing agents include the following:
    • A low bacterial count
    • A large lymphoid tissue component in the wall of the small intestine
    • An alkaline pH inside the small intestine
    • The presence of the enzyme benzpyrene hydroxylase
  • Adenocarcinoma of the small bowel is associated with the following underlying conditions: -
    • Crohn disease - An inflammation in the small intestine. Crohn disease usually occurs in the lower part of the small intestine, called the ileum. The inflammation extends deep into the lining of the affected organ, causing pain and making the intestines empty frequently, resulting in diarrhea.
    • Celiac disease - Gluten intolerance
    • Familial polyposis syndromes - An inherited disease in which the large bowel becomes carpeted by polyps of various dimensions during the second or third decade of life.
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Definition of Diagnosis

Diagnosis: 1 The nature of a disease; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies. 3 The identification of any problem. The diagnosis was a plugged IV.

The word diagnosis comes directly from the Greek, but the meaning has been changed. To the Greeks a diagnosis meant specifically a "discrimination, a distinguishing, or a discerning between two possibilities." Today, in medicine that corresponds more closely to a differential diagnosis.

Cancer of the Small Intestine Symptoms

  • Like most GI cancers, early symptoms of small bowel cancer tend to be vague and nonspecific.
    They may include abdominal discomfort associated with the following : -
    • Nausea
    • Bloating
    • Loss of appetite
  • The following symptoms may indicate advanced disease and should be signs to seek medical attention: -
    • Fatigue
    • Weight loss
    • Iron deficiency anemia
    • Visible blood loss: Blood or a material that looks like coffee grounds may be vomited, or black stools may be passed.
    • Severe nausea and vomiting because of a blockage in the small bowel by the enlarging cancer: Doctors frequently diagnose small intestine cancer during surgery for unexplained bowel obstruction.
    • Jaundice (yellowish skin): This is a symptom in people with cancer that involves the upper small intestine because of blockage of the bile ducts draining the liver.

Cancer of the Small Intestine Treatment

  • Surgical removal is the primary treatment for cancer of the small intestine.
  • Chemotherapy or radiation therapy may be useful if the cancer is widespread.
  • Radiation therapy may also be helpful if the disease is widespread or if local tumors come back.
  • Surgery may also relieve symptoms when the cancer has caused a bowel obstruction. In this case, doctors may perform a bypass procedure or limited tumor removal.

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