The small bowel is part of our digestive system – the bowel is split into two parts, the small bowel and large bowel, and the small bowel helps the body to digest food and absorb nutrients.
Cancer that starts in the small bowel is rare, with approximately 1,700 people in the UK diagnosed with small bowel cancer every year, compared to around 42,000 cases of large bowel cancer.
The small bowel is composed of the duodenum, that connects the small bowel to the stomach, and the lower parts of the small bowel called the jejunum and ileum. The ileum is the lower part that connects the small bowel to the large bowel or colon. Most small bowel cancers start in the jejunum or ileum.
Symptoms of small bowel cancer can include the following:
- Pain in the abdomen
- Unexplained weight loss
- Dark black stools or anaemia as a result of bleeding in the small bowel
- Blockages in the bowel
Although the cause of small bowel cancer is often unknown, there are certain factors which may increase your risk:
- Your age – small bowel cancer is more common in the elderly
- Genetics – certain rare conditions can cause polyps to develop in the bowel lining
- Crohn’s disease – a small proportion of Crohn’s disease sufferers can develop adenocarcinomas of the ileum
- Diet – a high fat diet or diet rich in red meat or smoked foods
Treatment will depend on the type of small bowel cancer; for example, if it’s caused by a neuroendocrine tumour or lymphoma. It will also depend on where the cancer is located and how much it has spread.
If the cancer hasn’t spread to other organs or parts of the body, Prof Jamie Murphy will surgically remove the cancer and any nearby lymph nodes. Chemotherapy and radiotherapy may then be performed.
For cancer that is located at the top of the duodenum you might have a pancreaticoduodenectomy which involves removing part of your pancreas, your gallbladder and possibly part of your stomach. For cancer in the ileum, part of the large bowel might also be removed.
How is small bowel cancer diagnosed?
The small bowel is difficult to examine, so tests may be performed to diagnose small bowel cancer including a barium x-ray, blood tests to assess your red cell count and certain substances that could indicate cancer, and investigative tests such as an endoscopy, CT or MRI scan or capsule endoscopy.