Small intestine cancer overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
In oncology, small intestine cancer, also small bowel cancer and cancer of the small bowel, 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. Small intestine cancer can be subdivided into duodenal cancer (the first part of the small intestine) and cancer of the jejunum and ileum (the later two parts of the small intestine).
Several different subtypes of small intestine cancer exist. These include:
Surgery is the most common treatment. Additional options include chemotherapy, radiation therapy or a combination.
Overview
Historical Perspective
Small intestine cancer is a rare presentation and recent increase in its incident compelled the researchers to study it further. There is no significant information about intestinal cancers in history.
Classification
Small intestine cancer may be classified into adenocarcinoma, gastrointestinal stromal tumor, lymphoma, ileal carcinoid tumor, and sarcoma (most commonly leiomyosarcoma and rarely angiosarcoma or liposarcoma).
Pathophysiology
Adenocarcinoma is the most common sub-type of small intestine cancer. Second most common is carcinoid tumor. Adenocarcinomas can be polypoid, infiltrating or they appear as annular constricting lesions in small intestine. On gross pathology, napkin ring appearance or polypoidal fungatining mass are characteristic findings of small intestine cancer. Carcinoid tumors of the smalls intestine are mostly associated with malignant tumors of the other sites. Gastrointestinal stromal tumors (GISTs) are the most common benign tumors of the gastrointestinal (GI) tract. Small intestinal lymphomas are of low-grade histology and arise from mucosal-associated lymphoid tissues (MALT)..
Causes
There are no established causes for small intestine cancer. Cancer can arise in genetically predisposed people or they can arise sporadically. Environmental factors can play a role as well; but there is no study demonstrating established risk factors.
Differentiating Xyz from Other Diseases
Small intestine cancer must be differentiated from Crohn's disease, intestinal tuberculosis, ulcerative colitis, large intestine cancer, peptic ulcer disease, and irritable bowel syndrome (IBS).
Epidemiology and Demographics
Males are more commonly affected with small intestine cancer than females. Male to female ratio is approximately 1.4 to 1. Small intestine cancer usually affects individuals of the African Americans race. Caucasian individuals are less likely to develop small intestine cancer.
Risk Factors
Common risk factors in the development of small intestine cancer are Crohn's disease, celiac disease, radiation exposure, hereditary cancer syndromes, smoking, and alcohol.
Screening
There are no screening protocols for small intestinal cancer detection.
Natural History, Complications, and Prognosis
Clinical features and natural history of small intestinal tumors have not been clearly studied, as its a rare condition. Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor. Small intestine adenocarcinoma is associated with a 5 year survival rate of 20%