Tumors of the ileum. Ileum intestine. Functions, diseases, treatment. Also, the causes of tumor appearance include:

Oncology is a dangerous disease that affects any part of the body. Often in medical practice, the development of small intestinal cancer occurs, the symptoms and manifestations of which are similar to other pathologies of the digestive organs.

Causes

Doctors have been noticing for many years that the disease is most often diagnosed in patients suffering from pathologies of the gastrointestinal tract. Therefore, some diseases of the digestive system are considered precancerous conditions.

Thus, the cause of small intestinal cancer can be colitis, ulcer, Crohn's disease, polyposis. The culprit may also be a primary malignant tumor located in another organ. In this case, the formation in the small intestine is a metastasis.

In addition to various gastrointestinal pathologies, the following factors can provoke the degeneration of healthy cells into cancerous ones:

Smoking and alcohol abuse.
Poor nutrition.
Contact with harmful substances or radiation.
Age-related changes in the body.
Hereditary predisposition.

Of these factors, the main attention is given to poor nutrition. After all, regular consumption of food containing carcinogens leads to irritation of the digestive tract and disruption of its functioning, which can subsequently provoke oncology.

Symptoms

Symptoms of small intestinal cancer vary slightly because the cancer can be located in different locations. After all, the small intestine consists of several sections: the duodenum, jejunum and ileum.

If the duodenum is affected, the symptoms will be very similar to a stomach ulcer. A person complains of aversion to food, dull pain in the intestinal area, which can radiate to the back. In severe form, signs of small intestine cancer appear in the form of such manifestations as:

Intestinal obstruction.
Nausea, vomiting.
Increased gas formation.
Yellowness of the skin.
General weakness.
Sudden loss of body weight.

In case of damage to the jejunum and ileum, the following symptoms occur:

Nausea, vomiting.
Pain syndrome in the intestines.
Spasms in the navel area.
Diarrhea.
The appearance of mucous discharge in the stool.
Bloating.
Fast fatiguability.

Symptoms of the development of malignant oncology become more intense and severe at a later stage. Patients often experience perforation of the intestinal wall, peritonitis develops, the body is poisoned by the decay products of the neoplasm, and signs of severe anemia appear.

Tumor detection

Diagnosis of small intestine cancer begins with a conversation with a doctor about complaints, existing diseases, and the presence of bad heredity. After collecting anamnesis, the doctor conducts an external examination of the patient, palpates the abdominal cavity and prescribes additional examination.

It includes the following methods:

Colonoscopy. The technique helps to detect the formation, its size, shape. To carry out diagnostics, an endoscopic device with a camera at the end is inserted through the rectum.
Fibrogastroscopy. The stomach is also further examined. This is also done endoscopically.
Biopsy and histological examination. They help determine whether a tumor in the small intestine has a malignant course, what type it is, and how aggressive it is.
CT scan. Allows you to identify metastases in internal organs.

Based on the diagnostic results obtained, the attending physician makes a diagnosis and selects a treatment regimen for each patient separately.

Treatment methods

The most acceptable treatment for small intestinal cancer is surgery. During the operation, the malignant tumor and nearby tissue are removed. If the lymph nodes are affected, they are also eliminated. Depending on the extent of the operation, it may be necessary to artificially restore the intestine.

Radiation therapy is the effect of influencing the formation of high-frequency X-rays. These methods are used before and after surgical removal of the tumor. Both treatments for small bowel cancer cause side effects, but chemotherapy is considered the most aggressive.

Chemotherapy and radiation are prescribed as an adjunct to surgery. The first technique involves introducing special aggressive drugs into the patient’s body that suppress atypical cells.

Diet

The diet for small intestine cancer involves following a split diet. The patient should eat 5 times a day with breaks of 2-3 hours. Portions should be small. This helps normalize the process of digestion and absorption of food.

The patient’s menu is designed so that the body receives a sufficient amount of vitamins and microelements every day. Therefore, the diet is enriched with vegetables, fruits, and berries. They are allowed to eat soups, cereals, dairy products, and fish.

During the first time of treatment, food is served in a ground form. They should also be warm, not hot or cold. Under no circumstances should you overeat. The diet also involves drinking a large amount of liquid in the form of plain water, compotes, and herbal decoctions.

Forecast

The prognosis for stage 1-2 small intestinal cancer is quite favorable. At these stages of development, the neoplasm develops within the digestive organ, the process of metastasis has not yet started, so surgery helps people get rid of the pathology.

The favorable prognosis for stage 3-4 small intestinal cancer is sharply reduced. In this case, the disease already affects the internal organs, spreading metastases. Survival in later stages cannot exceed 5 years.

Oncology is an insidious disease that poses a danger to human life. This is why prevention of small intestinal cancer is so important. A healthy lifestyle and regular gastrointestinal examinations will help reduce the risk of tumor development as much as possible.

The structure of the small intestine is divided into three sections:

the duodenum, the shortest, received its name because of its length, equal to the length of 12 fingers in diameter;
the jejunal section in the anatomy of the small intestine is due to its relatively small diameter;
The iliac region is located near the iliac fossa, and therefore is called so to speak because of the area of location.

The small intestine, in which food is exposed to intestinal juice, bile, and pancreatic juice, is located in the middle region of the abdomen, downward from the stomach and transverse colon. In the small intestine, digestion products are also absorbed into the blood and lymphatic vessels. The length of the small intestine ranges from 2.2 to 4.4 m, its thickness is from 4.5 to 6 cm. The small intestine begins from the pylorus of the stomach and flows into the cecum in the region of the right iliac fossa. The structure of the human small intestine is divided into the duodenum, jejunum and ileum.

Small intestine cancer and tumor location

Small intestine cancer accounts for 1-2% of malignant tumors of the digestive tract. According to ICD-10 it has code C17.

Due to the vagueness of the first symptoms, small intestine cancer is diagnosed accidentally, very often during an X-ray examination or surgery on the abdominal organs during the treatment of another disease. In this case, metastasis begins, due to which secondary intestinal cancer develops.

The most common tumors of the small intestine are:

duodenal cancer (about 50% of cases);
jejunal cancer (30%);
ileal cancer (20%).

It is worth noting! Small intestinal cancer primarily affects men over 60 years of age and almost never occurs in people under 50 years of age.

Why are malignant tumors in the small intestine so rare? The contents of the small intestine have a liquid consistency and move very quickly, so they do not irritate the mucous membrane. Carcinogens ingested from food do not have time to cause harm. The small intestine contains very few bacteria but a lot of lymphoid tissue. Alkaline pH and the enzyme benzopyrene hydroxylase are considered protective factors.

Metastases reach regional lymph nodes and other distant parts of the intestine, so the following may develop:

Causes of small intestine cancer

Specific direct causes of small intestinal cancer have not yet been discovered. Attention is always paid to chronic enzymatic or inflammatory bowel disease; cancer symptoms may be hidden behind signs of diseases such as diverticulitis, ulcerative colitis, enteritis, Crohn's disease, duodenal ulcer. Often a tumor develops against the background of adenomatous tumors, which are prone to degeneration into oncogenic ones.

The duodenum is often affected due to the irritating effect of bile. The initial part of the small intestine is due to the juice of the pancreas and active contact with carcinogenic substances from food, fried foods, alcohol and nicotine.

Other reasons for the appearance of a tumor include:

Peutz-Jeghers syndrome;
duodenitis;
celiac disease;
gene pathologies;
benign tumors;
metastasis of the malignant process of other organs.

The first symptoms and signs of small intestine cancer in men and women

If duodenal cancer is suspected, the first symptoms will be similar to gastric and duodenal ulcers and will manifest as aversion to food, dull pain in the epigastric zone radiating to the back. At a late stage, duodenal cancer exhibits symptoms associated with poor patency of the bile ducts and intestines due to tumor growth. The patient will suffer from endless nausea and vomiting, flatulence and manifestations of jaundice.

The jejunum and ileum signal about oncology with the first local signs and general dyspeptic disorders:

nausea and vomiting;
bloating;
pain in the intestines;
spasms in the navel and/or epigastrium;
frequent loose stools with mucus.

It has been proven that symptoms of small intestinal cancer appear more often in men than in women. This fact is associated with the lifestyle of men, nutrition and abuse of malicious habits: alcohol, smoking and drugs. In addition, small intestinal cancer develops slightly differently in men due to the different structure of the genitourinary system.

Very often, signs of bowel cancer appear in women. When the tumor metastasizes, symptoms of bowel cancer in men may appear. If the tumor compresses neighboring organs, this leads to the development of pancreatitis, jaundice, ascites, and intestinal ischemia.

The tumor grows, so the symptoms of cancer in the small intestine intensify:

pain during bowel movements;
intestinal patency is impaired;
obvious or hidden intestinal blood loss appears;
perforation of the intestinal wall develops;
the contents enter the peritoneal cavity and peritonitis begins;
intoxication (poisoning) of the body increases due to ulcers and intestinal fistulas;
iron deficiency increases;
the functions of the pancreas and liver are impaired.

Cancer is not gender specific, so the symptoms of bowel cancer in women and men are largely the same:

increasing weakness;
weight loss;
malaise;
anemia, rapid and unexplained fatigue;
neurosis;
anorexia;
difficulty with defecation accompanied by pain;
frequent urge to go to the toilet;
anemia;
pale skin;
dizziness and migraine;
temperature rise.

It is worth noting! Unlike small intestine cancer, symptoms of colon cancer can be detected in a person regardless of gender and age. The disease is diagnosed even in children, although it is quite rare.

Symptoms and signs of small intestine cancer in women and men

The development of tumors in the early stages in women and men occurs almost equally. The progression of the tumor and its growth into nearby organs makes a distinction in the symptoms. When cancer spreads, it initially affects the vagina of women and the prostate organs of men. Afterwards, the cancer affects the rectum and sphincter canal, causing complaints in both sexes. Pain appears in the area of the anus, lumbar spine, coccygeal region and sacrum. Men experience problems urinating, which indicates damage to the bladder. Body temperature rises significantly, and ureteral infections are likely to develop.

Symptoms at stages 3 and 4

Detection of cancer in the final stages of development significantly complicates the treatment process. The disintegration of the tumor leads to complete intoxication of the body. Patients feel severe pain that radiates to the lumbar region, sacrum, and anus.

At stage 4, symptoms appear such as:

incessant vomiting;
increased gas formation;
development of jaundice;
intestinal ischemia;
pancreatitis.

Compression of neighboring organs by the tumor leads to the formation of fistulas and provokes the appearance of the following symptoms of cancer:

intestinal bleeding;
pain during bowel movements;
disruption of the gastrointestinal tract;
sudden changes in mood and neuroses;
severe fatigue;
peritonitis;
exhaustion;
dry skin;
disorders of the functioning of neighboring organs;
low protein levels in the blood.

Where does small intestinal cancer metastasize?

There are many important organs near the small intestine, and when the cancer spreads, their damage begins.

Also, cancer cells spread through the blood throughout the body to distant lymph nodes; in this case, the following are affected:

lungs;
ovaries and uterus in women;
mammary gland;
prostate;
kidneys and adrenal glands;
bladder;
pancreas;
colon;
liver;
peritoneum.

Classification of small intestine cancer

Depending on their growth characteristics, malignant neoplasms are conventionally divided into the following types:

Exophytic - grows inside the intestinal lumen. Cancer processes provoke stagnation of feces in the affected areas of the jejunum, which, with the development of the disease, turns into obstruction. The tumors resemble fungi or polyps with well-defined, structured boundaries, becoming saucer-shaped when ulcerated.
Endophytic, or infiltrative. Neoplasms without clearly defined edges are distributed along the walls of the intestine, gradually growing into a distant organ through the lymphatic system. Tumors can lead to rupture of the intestinal wall and hemorrhage.

According to histological classification, oncological formations of the small intestine are:

- develops from glandular tissue next to the major papilla of the duodenum. The tumor is ulcerated and covered with a fleecy surface.
– develops in any part of the intestine, most often in the appendix. Less often - in the ileum, very rarely - in the rectum. The structure is similar to the epithelial form of cancer.
– a rare tumor formation (18%) and combines lymphosarcoma and ().
– large tumor formation, more than 5 cm in diameter, can be palpated through the peritoneal wall. The tumor creates intestinal obstruction and wall perforation.

Lymphoma of the small intestine can be primary or secondary. If primary lymphoma of the small intestine is confirmed, the symptoms are characterized by the absence of hepatosplenomegaly, enlarged lymph nodes, changes on the sternum x-ray, CT scan, in the blood and bone marrow. If the tumor is large, disturbances in the absorption of food will be observed.

If the retroperitoneal and mesenteric lymph nodes spread tumor cells, then a secondary lymphoma forms in the small intestine. Types of small intestinal cancer include signet ring cell, undifferentiated and unclassified cancer. Growth form – exophytic and endophytic.

Classification of colon cancer according to the TNM system

According to the clinical and anatomical classification according to the international TNM system, the following stages are distinguished in the development of small intestinal cancer:

T - tumor:

Tis - preinvasive cancer;
T1 – tumor invasion of the submucosal layer of the intestine;
T2 – tumor invasion of the muscular layer of the intestine;
T3 is tumor invasion of the subserous layer of the intestine or retroperitoneal space. The tumor is no more than 2 cm;
T4 – tumor invasion of the visceral peritoneum, non-peritoneal areas over an extended period. The tumor is more than 2 cm.

N - damage to lymph nodes:

N0 - no lymph node involvement.
N1 – metastatic lesion of regional lymph nodes.

M – presence of distant metastases:

M0 – absence of isolated metastasis;
M1 - distant metastasis is present.

Stages of small intestine cancer

There are five stages of intestinal adenocarcinoma:

Stage 0 or cancer in situ. A single small tumor that is located on the surface of the mucous membrane and does not grow deeper. There are no metastases.
Stage 1 - the tumor has grown deeply into the intestinal wall, but has not spread to neighboring organs. There are no metastases.
At stage 2 of intestinal cancer, the tumor has grown through the entire thickness of the intestinal wall and has spread to neighboring organs.
At stage 3 of small intestine cancer, cancer cells have spread to regional lymph nodes. There is no growth into other organs or distant metastases.
At stage 4 of small intestine cancer there are distant metastases. Most often they are found in the lungs and liver. bones and other organs.

Diagnosis of small intestine cancer

To recognize intestinal cancer at an early stage, it is necessary to conduct a number of diagnostic studies, which will determine what treatment will be used, the patient’s condition and the prognosis for survival.

Diagnosis of small intestine cancer depends on the location of the tumor in the intestine itself:

Fibrogastroduodenoscopy and contrast fluoroscopy, using these methods, diagnose the duodenum.
Irrigoscopy and colonoscopy - performed to diagnose the ileum.
To identify stenosis and the presence of obstacles to the movement of barium sulfate suspension, the method of barium passage in the lumen of the tract is used.

During an endoscopy, samples of cancer cells are taken for further laboratory examination to confirm or refute the diagnosis.

Metastasis and spread of a cancerous tumor is detected using:

Ultrasound of the peritoneum;
CT scan of the intestinal tract;
chest x-ray;
bone scintigraphy.

If there is any doubt about the diagnosis, laparoscopy is performed along with surgical intervention.

For malignant tumors, the following laboratory tests are performed:

A blood test reveals a decrease in hemoglobin and an increase in ESR, which is typical for any cancer.
Biochemistry – when carcinoembryonic antigen is detected in the plasma, a tumor is diagnosed and its stage of development is established.
A toxic compound occurs in the intestinal tract - the substance indican; it can be detected using a urine test.
Blood for the presence of jejunal cancer is likely to be accompanied by markers,.

Based on stool analysis, the presence of occult blood in the patient’s waste products is revealed.

How to identify intestinal cancer, the symptoms of which do not manifest themselves in anything specific? During this period, it is very important to confirm or refute the suspicion of cancer, because the sooner treatment begins, the easier it is for the patient to endure its stages, the greater the chance of a positive result. When symptoms appear, the oncological process can be considered advanced, and the moment of early treatment will be missed.

Important! Early symptoms include a “young” state, which should alert any person - this is a reluctance to work or do household chores due to increased weakness and fatigue. The skin becomes pale and “transparent”. The patient constantly has heaviness in his stomach, he does not feel like eating at all. Following this, dyspeptic disorders appear: nausea, vomiting, pain and heartburn even from water.

Where does the diagnosis of small intestinal cancer begin?

When visiting a doctor, a blood test is immediately prescribed and examined, which is mandatory if bowel cancer is suspected. A general basic blood test can reveal anemia, the patient's condition, and the presence of inflammation.

Then, based on the results of the blood test, a blood test for small intestinal cancer is performed, if necessary. The most informative and common tumor markers are alpha-fetoprotein, total/free PSA, CEA, CA 19-9, and cytokeratin.

For example, with the help of tumor markers CA 19-9 and CEA (carcinoembryonic antigen), screening diagnostics of colon cancer is carried out. If CEA is determined, then you can find out the staging before surgery and monitor the patient diagnosed with colorectal cancer after it. If the disease progresses, then the level of CEA in the serum will increase. Although it may grow not in connection with a tumor, in later stages colorectal cancer can be detected without an increase in CEA in the blood.

Endoscopic diagnosis and open intestinal biopsy are the main methods for confirming small intestinal oncology.

Treatment of small intestine cancer

Treatment of cancer of the small intestine, namely the duodenum, jejunum and ileum, is carried out depending on the type of tumor and stage. The main method is bowel resection and removal of tumor formation.

The extent of surgical intervention depends on the stage of tumor development, its location and the degree of damage to surrounding tissues, organs and systems. Early stage cancers are removed using laparoscopic surgery. Surgery to remove a tumor of the small intestine is performed through several punctures in the anterior abdominal wall. A laparoscope with an LED is inserted through the puncture; a video camera is also inserted into the puncture, transmitting the entire operation process to the computer screen, with its help the surgeon performs surgical manipulations.

If the tumors are large, which indicates late stages of cancer development, then in this case extensive operations are used, which include:

resection of the small intestine, in which the affected part of the small intestine is removed along with the lymph nodes and part of the healthy surrounding tissue;
radical surgery in which huge tumors and all tissues affected by metastases are removed;
contactless operation. It is carried out by blocking all blood and lymphatic vessels around the tumor. Resection is performed to prevent malignant cells from dispersing throughout the body;
duodenectomy, an operation that is performed for duodenal cancer by resection of the affected area of the small intestine with the subsequent restoration of continuous intestinal patency. The operation is performed independently, as well as in combination with pancreatoduodenectomy, when resection of the pancreas is performed for cancer of the head of the pancreas. Along with surgery on a segment of the small intestine, gastrectomy can be performed. For advanced ileal cancer, a hemicolectomy of the right side of the colon is performed.

With a confirmed diagnosis of small intestinal cancer, surgery reduces symptoms and increases life expectancy. If it is not possible to remove a late-stage malignant tumor of the small intestine or it is determined that the tumor is sensitive to chemotherapy, drugs that prevent the growth of cancer cells are used.

Chemotherapy for small intestinal cancer

Chemotherapy for small intestine cancer as an independent method of therapy is considered ineffective. It is prescribed as an additional treatment to reduce the risk of developing metastases and as for. Chemotherapy is used before surgery to reduce tumor size and inhibit the development of cancer cells, and after surgery to reduce the risk of tumor recurrence.

After palliative surgery (alleviating the patient's suffering), treatment is carried out with chemotherapy (polychemotherapy), but without radiation.

After the operation, intestinal motility is additionally diagnosed using electrogastroenterography to prevent the development of a dangerous complication - intestinal paresis.

To alleviate the patient's condition after surgery and chemotherapy, the following are introduced into complex therapy: alcohol tinctures, infusions and decoctions of medicinal herbs, mushrooms and berries. The corresponding prevents paresis, nausea and vomiting, improves gastrointestinal motility.

Prevention of small intestine (bowel) cancer

It is impossible to reduce the risk of small intestinal cancer, but there are a number of preventive measures that help avoid the formation of tumors in the intestine:

undergo regular preventive examinations;
adhere to the principles of a healthy lifestyle and proper nutrition;
promptly treat diseases of the gastrointestinal tract;
have an annual stool test for occult blood (the Colon View test, which can detect occult blood in the stool and detect bowel cancer at an early stage);
do not delay and consult a doctor if any alarming symptoms from the digestive system appear.

What is the prognosis for life with small intestinal cancer?

A favorable outcome of the disease directly depends on the stage at which the diagnosis was made, as well as on the location of the tumor in the intestine.

If the tumor is located regionally and does not have metastases, then after surgery the number of survivors for 5 years is 40 - 50%. Each subsequent stage reduces the percentage of positive outcomes in patients by 15 - 20%.

Small intestinal cancer is a type of oncology that is not one of the common types. It accounts for no more than 3% of lesions from malignant tumors of the gastrointestinal tract. Symptoms and manifestations of small intestinal cancer in women develop much less frequently, and therefore the disease is mainly diagnosed in older men, that is, over 60 years of age.

Etiology of the disease

The term “intestinal cancer” refers to a malignant tumor that affects the tissue of the intestine with mutagenic cells that begin to divide uncontrollably. Affected cells fill the area, disrupt its functioning, spread to adjacent areas, healthy tissues, and over time infect the entire body. In the absence of necessary treatment, intestinal pathology leads to death.

The length of the loop-shaped small intestine reaches 4.5 m. It consists of several sections: duodenum, jejunum, ileum. Each of them can develop a malignant tumor.

Intestinal cancer is a disease whose exact causes have not yet been established by medical science. There is a list of intestinal pathologies, damage to which provokes an increased risk of developing cancer. This:

the presence of non-polyposis hereditary colorectal cancer;
celiac disease;
congenital anomalies of the structure of the gastrointestinal tract;
Crohn's disease.

Oncology of the small intestine can also occur under the influence of such factors on the human body:

eating foods high in carcinogens;
abuse of alcohol, nicotine;
radiation exposure.

Most often, a malignant tumor begins to affect the cylindrical epithelium of the intestinal glands, and therefore, according to histology, it is classified as carcinoma. Predispose to the occurrence of intestinal disease:

intestinal ulcers;
BPH;
chronic inflammatory processes in the intestines;
diagnosis of diverticulitis.

An intestinal tumor almost always grows into the intestinal lumen, and in isolated cases it is exophytic. Oncology, which expands into the lumen, greatly narrows the intestine in a ring-shaped manner.

The loop of intestine, which is located above the site of narrowing, often expands and its muscles hypertrophy. With severe and long-term stenosis of the lumen, the loop in the intestine stretches, becomes thinner, and perforates, causing peritonitis. This is how patency is impaired due to intussusception.

Oncology rarely undergoes ulceration. It is characterized by metastases to the following organs:

retroperitoneal and mesenteric lymph nodes;
liver;
abdominal region;
lungs;
adrenal glands;
bones;
dura mater.

As a rule, metastases from the intestines spread throughout the body with lymph.

A neoplasm in the intestine can grow together with a nearby loop of intestine, bladder, colon, female genitals, and enlarged regional lymph nodes.

Equally important information about symptoms

Kinds

A malignant tumor can form anywhere in the small intestine. Oncology is classified into exophytic and endophytic in accordance with the nature of tumor growth. ICD disease code C17 malignant neoplasms of the small intestine.

An exophytic tumor in the intestine grows inside the intestinal lumen. At the very beginning, it provokes stagnation of content in this department. After a certain time, stagnation turns into obstruction.

Endophytic neoplasms do not have clear boundaries. They begin to spread into the intestinal tissue, affecting its layers one by one, gradually affecting all the membranes. With further progression, oncology affects neighboring organs.

An endophytic tumor is more dangerous, and the prognosis for life expectancy and recovery in this case is negative. Intestinal diagnostics helps determine the exact nature of the tumor.

In accordance with the histological structure of tumor neoplasms, they are classified into the following types:

adenocarcinoma is a tumor that affects the glandular tissues of the intestine; it does not form often in the intestine, mainly affecting the duodenum;

carcinoid is a malignant tumor that is formed from epithelial cells, it mainly affects the small and large intestines;
lymphoma is a rare type of ileal cancer;
leiomyosarcoma is a malignant tumor that can reach large sizes, is detected even through the abdominal wall, and often provokes intestinal obstruction.

Reasons for development

The reliable reasons that cause the formation of oncology have not been established. In accordance with the surveys and statistics, the risk of contracting pathology increases in the following situations:

when a small intestine tumor is diagnosed in a person’s immediate relatives;
with chronic infectious inflammation of the small intestine, which can destroy mucous surfaces;
polyps in the intestine;
oncology of other organs;
radiation exposure;
abuse of alcoholic beverages, smoking;
constant inclusion in the diet of salted, dried, smoked foods, which contain a lot of animal fats, as well as frequent consumption of lard and fatty meats.

Important! Most often, oncology of the small intestine is detected in men after 60 years of age.

Characteristic symptoms

A malignant tumor in the small intestine at the very beginning of the lesion does not provoke any symptoms. The first signs develop only at the stage when the course of the disease leads to a narrowing of the lumen in the affected area of the small intestine.

The very first symptoms that should alert a person and become a reason to visit a doctor include complex dyspeptic problems in the intestines:

persistent nausea;
vomit;
bloating;
spastic pain in the epigastrium, in the navel area.

Also, in the first stages of tumor damage, patients experience the following characteristic manifestations:

loose stools with tenesmus - a false urge to defecate with pain, after which there is copious discharge of mucus;
alternating diarrhea and constipation;
intestinal obstruction of varying severity;
pain during bowel movements.

Common signs of bowel disease include:

rapidly increasing weakness;
frequent ailments;
rapid fatigue even after light work;
loss of appetite;
sudden, seemingly causeless weight loss;
low protein content in blood plasma;
anemia;
pale tint of blood and mucous surfaces that line the oral and nasal cavity;
frequent dizziness, headaches;
persistent increase in body temperature to subfebrile.

In men and women, a tumor in the small intestine develops in the first stages of the lesion almost equally. But at the time of active progression and influence on nearby organs, some differences arise.

In women, during the process of tumor growth into the tissue of neighboring organs, the vagina is injured, and in males, the prostate is injured. When the disease affects the rectum and anal area, women and men complain of intense pain in the anus, in the area of the coccyx, sacrum, and lumbar spine.

Men are especially prone to urinary problems. This indicates tumor growth into the walls of the bladder. This process provokes a rise in temperature to high numbers, infection of the urinary tract in an ascending manner.

Important! Oncology can progress for a long time without provoking complaints at all, and first manifest itself only after the occurrence of serious irreversible complications.

A tumor of the small intestine is characterized by a gradual increase in symptoms, and therefore people do not take them seriously. Over time, the tumor grows and has a negative impact on the functions of neighboring organs. In this case, victims have complaints that indicate the following dangerous conditions of the intestine:

intestinal ischemia;
pancreatitis;
obstructive jaundice.

In especially severe cases, serious disruptions already occur in the functioning of other organs that are located closer to the tumor - pancreas, liver, etc.

Degrees

1st degree. At this stage, the diameter of the tumor does not exceed 2 cm, it does not extend beyond the boundaries of the small intestine and does not grow into the tissue of nearby organs, and no metastases have yet formed.
2nd degree. At this stage of the progression of the malignant tumor, it grows a little more, begins to extend beyond the boundaries of the intestinal wall and affect nearby organs, but there are no metastases. At this stage, the pathological process often involves the cecum, large intestine, and more specifically its part - the sigmoid colon.
3rd degree - the tumor increases greatly and can send metastases to the lymph nodes near the small intestine, but distant metastases have not yet been observed.
4th degree - the tumor has already affected tissues located nearby and provokes multiple metastases to distant systems and organs.

Oncology of the small intestine is characterized by metastasis to the following organs:

abdomen;
liver;
ovaries;
lungs;
pancreas;
bladder;
adrenal glands;
pelvic organs;
lymph nodes in the retroperitoneal region.

To make a correct diagnosis, the doctor conducts a comprehensive study of the patient’s condition. It includes several methods to increase the accuracy of the results:

Clinical method. The patient is interviewed, visually examined and palpated to establish the circumstances of the development of the disease and the location of the malignant tumor. If the tumor is large, then it can be detected already at this stage of diagnosis.
Laboratory method. Diagnostic tests are carried out to detect anemia, increased ESR, abnormalities in liver tests, and digestive disorders. The presence of indicators of intestinal cancer in the blood - tumor markers - is also checked.

Tumor markers in the intestines are produced in response to the aggressive influence of a malignant neoplasm on the body. They can be of two types. The first are organ-specific, which are produced by affected cells immediately after damage by pathology; in the normal state they are not present in the body. The second type is enzymes, hormones and other biological substances that produce remaining healthy cells.

Endoscopy. Capsule and laparoscopic techniques are implemented.
X-ray with the introduction of a contrast agent. This method allows you to establish the localization of the tumor and diagnose the direction of its growth - into the thickness of the intestine, into the lumen.

Treatment

Treatment of a malignant tumor in the small intestine depends on the degree of damage to the organ and the type of oncology. In approximately 2/3 of all cases, surgery is performed to remove cancer cells. This helps reduce the intensity of symptoms and increase the patient's life expectancy.

Important! Sometimes the operation has only palliative value, that is, it is performed with the sole purpose of alleviating the patient’s suffering.

When the operation is impossible or the tumor formation is sensitive to the effects of chemotherapy, it is performed. Chemotherapy drugs inhibit the growth of cancer cells, preventing them from multiplying and developing normally.

Radiation therapy is ineffective for small intestinal cancer, which is why it is not performed. This can take place immediately after or during surgery to improve positive results. Radiation therapy is also used when surgery is impossible for some reason.

After surgery is completed, the patient is advised to undergo rehabilitation to eliminate the symptoms of cancer and try to completely get rid of cancer cells. Your doctor may prescribe the following medications:

"Oxaliplatin";
"Leucovorin";
"Fluorouracil."

At the same time, radiation therapy is implemented. But all of the above procedures can cause a large number of side effects:

poor health and weakness;
nausea with vomiting;
diarrhea;
constant headaches;
hair loss;
disruption of hematopoietic processes;
mouth ulcers;
dysfunctions of the immune system.

Due to the fact that the patient’s body is difficult to tolerate treatment, he requires the organization of adequate nutrition, which presupposes compliance with the following conditions:

Refusal of products with a high concentration of animal fats;
Consuming fiber in sufficient quantities - fish oil, soy;
Complete cessation of alcoholic beverages and smoking;
To strengthen the immune system, you can use decoctions of medicinal herbs according to folk recipes.

Rejection of bad habits

Important! In severe stages of the pathology, when surgery is not practical, only radiation and chemotherapy are performed to relieve pain and other severe manifestations of oncology.

Forecast

Early diagnosis of the disease is the key to success in treatment. Long-term prognosis for small intestinal cancer depends on the stage at which the diagnosis was made and the histological nature of the malignant tumor. If the pathological process is clearly localized and does not produce regional or distant metastases, then radical resection makes it possible to achieve survival in 35-40% of cases over the next 5 years.

Patients who have been diagnosed with a precancerous disorder must be registered with a doctor and constantly monitor their own health in order to prevent a serious condition. Oncology of the small intestine is a dangerous disease, so if you develop incomprehensible dyspeptic symptoms, you need to seek advice and recommendations from a doctor.

Oncology or cancer of the small intestine is characterized by the appearance of low-quality tumor lesions of certain areas of the small intestine (jejunum, ileum or duodenum). The main manifestations of the disease are dyspeptic disorders (flatulence, nausea, spasmodic abdominal pain, vomiting, etc.).

A late visit to the doctor threatens sudden weight loss due to gastric disorders, as well as intestinal stasis and, as a result, intestinal bleeding.

Statistics on the location of the cancer process of tumor development in the small intestine are as follows:

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duodenal oncology accounts for approximately 48% of cases;
Oncology of the jejunum was detected in 30% of the disease;
Oncology of the ileum accounts for 20% of cases.

Most often, small intestinal cancer occurs in older men aged approximately 60 years and older. As a rule, men are more likely than women to develop this disease, especially in Central Asian countries.

Reasons for the development of the disease

A large number of cases of small intestinal cancer occur in the presence of obvious chronic diseases of the gastrointestinal tract, as well as against the background of inflammatory and enzymatic processes localized in the small intestine.

The following gastrointestinal diseases may be predisposing factors:

duodenitis;
peptic ulcer;
Crohn's disease;
enteritis;
diverticulitis;
colitis;
celiac disease;
genetic abnormalities;
benign intestinal processes;
malignant tumor processes of other organs that metastasize throughout the body.

The predominant high percentage of damage to the initial section of the small intestine is determined by the irritating effect of bile and food blastimogens supplied with food from outside, as well as gastric juice on the above section of the small intestine.

It was revealed that cases of diffuse polyposis of varying pathology can be considered a contributing factor to the formation of small intestinal cancer.

There is a high probability of the prevalence of small intestinal cancer in chronic smokers, people with alcohol and drug addictions, as well as in people exposed to radioactive components.

Fans of canned foods, well-fried foods, and foods with a predominance of animal fats also fall into the category of people with an increased risk of small intestinal cancer.

Classification

According to histology, low-quality neoplasms of the small intestine are represented by the following types:

By histological type

Adenocarcinoma– is a cancer that develops from the glandular tissue of the body. A rare form of small intestinal cancer that develops within the major duodenal papilla. This tumor is usually ulcerated and has a fleecy surface.

Carcinoid– in structure it resembles the epithelial form of small intestinal cancer, which occurs most often, because it is localized in any part of the intestine. The most common location is in the appendix (vermiform appendix), less often in the ileum and even less often in the rectum.

Lymphoma– a relatively rare type of tumor formation in the small intestine. According to statistics, lymphoma forms only in 18% of cases of small intestinal cancer. In this group of tumor processes, lymphosarcoma and lymphogranulomatosis or Hodgkin's disease are distinguished.

Leiomyosarcoma– a fairly large tumor, more than 5 centimeters in diameter. This type of tumor-like formation is easily palpable through the abdominal wall and is the main cause of intestinal obstruction, followed by perforation of the intestinal wall and bleeding.

Types of Tumor Growth

Depending on the characteristic development of the existing tumor, small intestinal cancer is divided into two types: exophytic and endophytic.

Exophytic nature the tumor grows into the intestinal lumen, thereby causing stasis of a certain part of the small intestine, and subsequently flowing into intestinal obstruction. In addition, an exophytic tumor is a formation with clearly defined structured boundaries, having an external resemblance to polyps, fungi or plaques. If such a tumor ulcerates, it becomes saucer-like in the central part.

The most dangerous and malignant is the endophytic (infiltrative) tumor.

This type of tumor growth is characterized by the tumor extending into other organs without any visible boundaries. The tumor seems to spread along the walls, flowing over the membranes of the organs and penetrating into other areas of the body through the lymphatic vessels and plexuses.

This type of tumor does not grow into the lumen of the organ and does not have certain defined boundaries. The endophytic type of tumor growth is accompanied by perforation of the small intestine and subsequent bleeding.

The worldwide systematization of the statistics of tumor formations in the small intestine according to the TNM classification looks like this:

Tis – pre-invasive oncology;
T1 – growth of cancer in the submucosal layer of the intestinal wall;
T2 – tumor growth in the muscle tissue layer of the small intestine;
T3 – penetration of the tumor into the subserous layer of the walls of the small intestine or the area located behind the peritoneum for a length of no more than 2 centimeters;
T4 – ingrowth of the formation into parts of the peritoneum, as well as other parts of the intestine more than 2 cm long, organs surrounding the intestine;
M0 and N0 – the tumor develops without metastasis;
N1 – metastasis to surrounding lymph nodes (mesentery, gastric area, pancreaticoduodenal region and liver);
detection of cancer carriers in the omentum, kidneys, peritoneum, adrenal glands, liver, lungs and bone tissue.

Diagnostics

The system of diagnostic procedures for the manifestation of cancer of the small intestine has its own characteristics and uniqueness.

In order to identify and recognize a tumor of the duodenum, it is necessary to perform a gastroduodenoscopy procedure, as well as fluoroscopy using a contrast agent. Diagnosis of oncology of the ileum involves the use of irrigoscopy and colonoscopy.

Video: Colonoscopy of the intestine

The main role in identifying obstacles in the form of narrowing in the passage of the small intestine, as well as stenosis and dilatation of the intestines, is played by radiography using a barium passage.

Often, a specific diagnostic approach can begin with the use of a selective angiography procedure of the intestinal cavity.

Each of the endoscopic methods used to diagnose the disease provides the opportunity to take the necessary biopsy to obtain the morphological composition of the tumor and a clear diagnosis and, as a result, appropriate cancer treatment. Based on the biopsy result, it is possible to determine the type of tumor growth, type and degree of malignancy of the formation.

To diagnose and detect metastasis, ultrasound examination (ultrasound) is performed:

pancreas;
liver;
adrenal glands;
kidney

The following series of studies are also being conducted:

multislice CT of the abdominal cavity;
bone tissue scintigraphy;
chest x-ray;
diagnostic laparoscopy;

It is necessary to clearly contrast small intestinal oncology with the following diseases:

inflammatory but benign processes in the small intestine;
scrofuloderma of the small intestine;
enteritis (Crohn's disease);
tumors localized in the retroperitoneal regions;
sudden obstruction of mesenteric vessels;
disturbance in the correct physiological position of the kidneys;
tumors of the ovaries and uterus in women;
congenital stasis of the small intestine;
colon oncology.

The colonoscopy method can detect the initial stages of tumor growth in the intestines or subtle changes in the internal structure of the intestinal wall. And with the help of chromoscopy, you can examine the inner lining of the small intestine and diagnose neoplasms with their subsequent removal.

Treatment of small intestine cancer

Depending on whether surgical intervention is possible at a given stage of small intestinal cancer, it is highly effective to perform an extensive ectomy of the entire cancerous area of the small intestine together with the surrounding mesentery and lymph nodes.

It is possible to radically remove the tumor, including healthy tissue, because the length of the small intestine is sufficient for such an extensive operation to remove tissue.

In addition, the removed area is restored artificially as a result of the imposition of enteroenteroanastamosis (surgical joint between intestinal loops) or enterocoloanastomosis (connection between loops of the large and small intestines).

In the case of duodenal cancer, therapy consists of duodenectomy with additional distal gastricectomy and pancreaticectomy.

If the stage of small intestine cancer is advanced and extensive resection is unacceptable, then surgical implantation of a bypass anastomosis is performed in a healthy area of the small intestine.

In addition to surgery, chemotherapy is also used. By the way, often with inoperable stages of cancer, the only way to alleviate the patient’s suffering is the use of chemotherapy. This treatment helps slow down the growth of the tumor.

According to statistics, 2/3 of cases of small intestinal oncology require surgical intervention. A radical method of treatment helps reduce symptoms and increases life expectancy. Often an ectomy is just a way to alleviate the patient's suffering.

Video: A new method in the treatment of oncology - small intestine transplant

Forecast

The prognosis generally depends on timely contact with an oncologist and the stage of developing cancer. Early diagnosis of the tumor and its removal can give the patient a chance of complete recovery from cancer. It is much easier to perform an ectomy on an uncomplicated tumor than to perform operations on severe stages of cancer.

It is important to undergo annual preventive examinations regarding the presence of neoplasms in the body, especially after 40 years. According to statistics, small intestinal cancer is one of the most curable types of intestinal cancer. Due to the fact that the small intestine is poorly supplied with blood, therefore, metastasis develops very slowly and infected blood enters the body in negligible quantities.

Therefore, the prognosis for patients with small intestinal cancer is in many cases very good.

This is one of the few forms of cancer that, if treated promptly, promotes full recovery.

Many patients, after intestinal cancer is cured, continue to live a full life and only remember their illness at annual examinations.

Prevention

Provided early surgical intervention, the development of the pathological process of small intestinal cancer is stopped and the effect of the operation is consolidated by chemotherapy.

A number of simple rules to help prevent the occurrence of small intestinal cancer:

maintaining an active lifestyle, despite age;
consumption of vegetable coarse fiber more than animal fats;
conducting regular preventive examinations;
If you suspect a disease, immediately contact a specialist.

Take care of your health, conduct a full examination of your body on time.

Ileal cancer is rare as an independent disease. As a rule, we are talking about metastases. Most often, malignant formations are represented by adenocarcinoma. There may also be lymphomas and sarcomas.

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Symptoms of ileal cancer

Clinical manifestations of cancer develop gradually. The first symptoms are dyspeptic symptoms: nausea, vomiting, impaired motor skills and severe spasmodic colic. The consequence is a decrease in appetite (aversion to food), and a rapid loss of body weight due to intoxication.

With multiple tumors, intestinal obstruction may occur, characterized by abdominal pain, vomiting, first gastric contents and then intestinal contents, bloating, dry skin and dehydration. With sarcomas, intestinal bleeding is often observed. As the tumor grows, it can compress neighboring organs, which can manifest itself in the development of pancreatitis, ascites, and intestinal ischemia.

Diagnosis of ileal cancer

endoscopy with biopsy;
fluoroscopy, MRI or CT scan with contrast agent;
laparoscopic endoscopy;
To diagnose tumors of the terminal ileum, colonoscopy and irrigoscopy can also be informative;
Ultrasound of the OBP is also performed.

Treatment of the disease

The approaches are standard: the tumor is removed, after which the remaining tumor cells are “polished” with chemotherapy.

Treatment of ileal cancer is usually surgical, that is, removal of the tumor. For inoperable tumors, chemotherapy is used with drugs that suppress the growth and further development of malignant cells.