Duodenal cancer is cancer that starts in the first part of the small intestine, known as the duodenum. It may also be referred to as small bowel cancer and is a rare form of gastrointestinal cancer. Gastrointestinal cancer can develop anywhere in the gastrointestinal track, including the stomach, esophagus, and small bowel.
Although duodenal cancer is considered rare, there are certain risk factors associated with developing this cancer. People who have celiac disease or Crohn’s disease are at increased risk. Having colonic polyps also increases the chances of developing duodenal cancer. Eating a diet high in fat is also a risk factor.
Symptoms may include stomach pain, vomiting, loss of appetite, and weight loss. Some people can feel a lump in the abdomen. Duodenal cancer interferes with digestion, and heartburn and acid reflux may develop. Bleeding from the gastrointestinal track may also develop, resulting in bloody stools. Fatigue is also a common symptom, especially as the cancer progresses.
Most duodenal cancers are adenocarcinomas. Other tumor types are carcinoid and sarcomas. Although carcinoid and sarcomas can develop in the duodenum, they are more common in other parts of the small intestine.
Because many of the symptoms are similar to other types of gastrointestinal diseases, various medical tests may be needed to make a diagnosis. A physical exam is performed to check for lumps in the abdomen. A stool sample may be recommended to check for blood in the stool.
Additional tests that may be recommended include a CT scan or x-ray of the abdomen. A barium enema may be done, which involves putting a liquid form of barium into the rectum. The barium coats the intestines and this allows for the intestines to viewed by an x-ray. A liver function test, which measures substance released by the liver, can also be used to help make a diagnosis.
Treatment for duodenal cancer often includes chemotherapy and possibly radiation therapy. The type of treatment will depend on the age of the patient, stage of the cancer, and other health conditions that may be present. Surgery may be an option in some cases.
When surgery does occur, a method known as the Whipple procedure may be performed. During a Whipple, the duodenum is removed along with a part of the stomach. The stomach and pancreas are than attached to a different section of the small intestine called the jejunum. This is considered a major surgery and may not be recommended in all cases.