Cancer of the descending ileum. Cancer of the small intestine: how to recognize it at an early stage? Also, the causes of the appearance of a tumor can be attributed

Cancer of the ileum is rare as an independent disease. As a rule, we are talking about metastases. Most often, malignant tumors are represented by adenocarcinoma. There may also be lymphomas and sarcomas.

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Symptoms of ileum cancer

Clinical manifestations of cancer develop gradually. The first symptoms are dyspeptic phenomena: nausea, vomiting, dysmotility and severe spastic colic. The result is a decrease in appetite (aversion to food), and a rapid decrease in 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. In sarcomas, intestinal bleeding is often observed. With the growth of the tumor, it can compress neighboring organs, which can be manifested by the development of pancreatitis, ascites, and intestinal ischemia.

Diagnosis of cancer of the ileum

endoscopy with biopsy;
fluoroscopy, MRI or CT scan with a contrast agent;
laparoscopic endoscopy;
For the diagnosis of tumors of the terminal ileum, colonoscopy and barium enema 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 ileum 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.

Oncology or cancer of the small intestine is characterized by the appearance of a malignant tumor lesion of certain parts of the small intestine (jejunum, ileum or duodenum). The main manifestations of the disease are dyspeptic disorders (flatulence, nausea, abdominal cramps, vomiting, etc.).

A late visit to the doctor threatens with a sharp weight loss against the background of gastric disorders, as well as intestinal stasis and, as a result, intestinal bleeding.

Statistics on the location of the cancerous process of tumor development in the small intestine is as follows:

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

Most often, oncology of the small intestine occurs in the body of older men aged about 60 years and older. As a rule, men are more prone to developing this disease than women, especially in the countries of Central Asia.

Reasons for the development of the disease

The mass number of cases of small intestine cancer occurs 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.

Predisposing factors may be the following diseases of the gastrointestinal tract:

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

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

It was found that cases of diffuse polyposis of a different nature in terms of pathology can be considered a contributing factor to the formation of small intestine cancer.

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

Fans of canned foods, well-done foods, and foods with a predominance of animal fats also fall under the category of people with an increased risk of developing small intestine cancer.

Classification

According to histology, malignant 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 oncology of the small intestine, which is formed within the major duodenal papilla. Such a tumor is usually ulcerated and has a fleecy surface.

Carcinoid- in structure it resembles the epithelial form of small intestine cancer, which is most common, because it is localized in any part of the intestine. The most common localization is in the appendix (vermiform appendix), less 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 is formed only in 18% of cases of small intestine cancer. In this group of the tumor-like process, lymphosarcomas and lymphogranulomatosis or Hodgkin's disease are distinguished.

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

Types of tumor growth

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

Exophytic character the tumor grows into the intestinal lumen, thereby causing stasis of a certain section of the small intestine, and further flowing into intestinal obstruction. In addition, an exophytic tumor is a formation with well-defined structured boundaries, having an external resemblance to polyps, fungi or plaques. In the case of ulceration of such a tumor, it becomes similar to a saucer in the central part.

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

This type of tumor growth is characterized by the penetration of the tumor into other organs without any visible borders. The tumor, as it were, spreads 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 pronounced boundaries. 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;
TK - penetration of the tumor into the subserous layer of the walls of the small intestine or the area located behind the peritoneum with a length of not more than 2 centimeters;
T4 - ingrowth of the formation in the peritoneum, as well as other parts of the intestine more than 2 cm long, the organs surrounding the intestine;
M0 and N0 - the tumor develops without metastasis;
N1 - metastasis to the surrounding lymph nodes (mesentery, gastric region, pancreatoduodenal region and liver);
detection of cancer carriers in the omentum, kidneys, peritoneum, adrenal glands, in the liver, lungs and bone tissue.

Diagnostics

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

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

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

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

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

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

pancreas;
liver;
adrenal glands;
kidneys.

The following research is also underway:

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

It is necessary to clearly contrast the oncology of the small intestine 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;
abruptly arising obstruction of the mesenteric vessels;
violation 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 is able to detect the initial stages of tumor growth in the intestine or implicit 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.

Small bowel cancer treatment

Depending on whether surgical intervention is possible at this stage of cancer of the small intestine, 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 site is restored artificially as a result of the imposition of enteroenteroanastamosis (surgical articulation between intestinal loops) or enterocoloanastomosis (connection between the loops of the large and small intestines).

In the case of duodenal cancer, therapy consists of duodenectomy with additional distal gastrectomy and pancreatic ectomy.

If the stage of small bowel cancer is started and extensive resection is unacceptable, then a bypass anastomosis is surgically implanted along 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 pain of the patient is the use of chemotherapy. Such treatment helps to slow down the growth of the neoplasm.

According to statistics, in 2/3 of cases of oncology of the small intestine resort to surgical intervention. A radical method of treatment helps to reduce symptoms and increase life expectancy. Often an ectomy is just a way to alleviate the suffering of the patient.

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Forecast

The prognosis as a whole depends on the timely visit to the oncologist and the stage of the developing cancer. Early diagnosis of the tumor and its removal can give the chance of a complete cure of the patient from cancer. It is much easier to perform an ectomy of an uncomplicated tumor than to perform operations on advanced stages of cancer.

It is important to undergo preventive examinations annually for the presence of neoplasms in the body, especially after 40 years. According to statistics, small intestine cancer is one of the curable types of colon 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 amounts.

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

This is one of the few forms of cancer that, with timely treatment, contributes to a full recovery.

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

Prevention

Under the condition of early surgical intervention, the development of the pathological process of small intestine cancer stops and the effect of the operation is fixed by ongoing chemotherapy.

A number of simple rules that help prevent the occurrence of small intestine cancer:

maintaining an active lifestyle, regardless of age;
the use of vegetable coarse fiber is more than animal fats;
conducting regular preventive examinations;
if you suspect a disease, immediately contact a specialist.

Take care of your health, conduct a complete examination of your body in time.

is a malignant tumor that develops from the tissues of the small intestine and can spread to neighboring organs and throughout the body.

Malignant tumors of the small intestine are a rare disease, accounting for approximately 1% of all malignant tumors of the gastrointestinal tract.

Unfortunately, the diagnosis is established in the later stages, when surgery is almost impossible. The reason for late diagnosis is the difficulty of instrumental examination of the small intestine, as well as the absence of specific symptoms, which leads to a late visit to the doctor.

The small intestine occupies most of the abdominal cavity and is located there in the form of loops. Its length reaches 4.5 m. The small intestine is divided into the duodenum, jejunum and ileum. A cancerous tumor can develop in any part of the small intestine. Most often, cancer affects the duodenum.

Causes of neoplasms of the small intestine

The causes of small bowel cancer have not been definitively established. In most cases, the tumor develops against the background of chronic enzymatic or inflammatory diseases of the gastrointestinal tract (celiac disease, duodenitis, duodenal ulcer, enteritis, Crohn's disease, ulcerative colitis, diverticulitis) or epithelial benign intestinal tumors, such as adenomatous polyps.

More frequent damage to the duodenum is due to the irritating effect of bile and pancreatic juice on the initial section of the small intestine, as well as its active contact with carcinogens that enter the digestive tract with food.

Other causes may be smoking, alcohol abuse, fried foods, as well as oncological diseases of other organs that metastasize to the tissues of the small intestine.

Types of small bowel cancer

Adenocarcinoma.
Mucous adenocarcinoma.
Ring cell carcinoma.
Undifferentiated and unclassified cancer.

Cancer growth form may be exophytic or endophytic.

Stages of development of small intestine cancer

1 stage. A cancerous tumor does not extend beyond the walls of the small intestine, does not penetrate into other organs, and does not have metastases.

2 stage. A cancerous tumor extends beyond the walls of the small intestine and begins to grow into neighboring organs, but has not yet metastasized.

3 stage. The cancerous tumor has metastasized to several lymph nodes near the small intestine, but has not yet metastasized to distant organs.

4 stage. A cancerous tumor of the small intestine has metastasized to distant organs (liver, lungs, bones, etc.).

Symptoms of small intestine cancer

In the beginning, small bowel cancer does not show up. The first signs occur with the development of a more pronounced narrowing of the intestine or ulceration of the tumor.

The clinic of duodenal cancer resembles peptic ulcer of the stomach and duodenum, but aversion to food is characteristic. Most often, a symptom of cancer of this department is dull pain in the epigastric region. Irradiation of pain in the back is characteristic. Late symptoms (jaundice, nausea and vomiting) are associated with an increase in obstruction of the biliary tract and closure of the intestinal lumen by a tumor.

The clinical picture of cancer of the jejunum and ileum consists of local symptoms and general disorders. The most common initial symptoms are dyspeptic disorders - nausea, vomiting, bloating, spastic pain in the intestines, navel or epigastrium. In the future, there is a decrease in body weight, which can be associated with both reduced nutrition and rapid tumor growth. Frequent loose stools with a lot of mucus and spasms are also among the early symptoms.

Violation of intestinal patency - a set of symptoms characteristic of varying degrees of intestinal obstruction, is observed in most patients with tumors of the small intestine.

Often, small bowel cancer is accompanied by overt or covert blood loss.

Of the symptoms of general disorders, it should be noted increasing weakness, weight loss, malaise, weakness, fatigue, anemia.

A complication of small intestine cancer is metastases to the retroperitoneal lymph nodes, distant metastases are observed in the liver, ovaries.

Diagnosis of small bowel cancer

For the diagnosis of oncological diseases of the small intestine, the following methods are most often used:

Angiography of the vessels of the abdominal cavity.
Laparoscopy.
CT scan.
Magnetic resonance imaging.
Biopsy to determine the type of cells and their degree of malignancy.
Electrogastroenterography- allows you to identify violations of the motility of the small intestine, which often occur with malignant neoplasms in this section of the intestine.

Small bowel cancer treatment

Treatment for small bowel cancer depends on the stage of the disease and the type of tumor. In most cases, they resort to surgical removal of an oncological neoplasm, which often leads to a decrease in symptoms and helps to increase life expectancy.

In some cases, the operation is palliative in nature, that is, it is carried out only to alleviate the suffering of the patient.

If surgery is not possible or if there is a tumor that is sensitive to chemotherapeutic agents, therapy is used using drugs that inhibit growth and prevent the development of tumor cells.

In the postoperative period, it is important not to miss a dangerous complication - intestinal paresis. To do this, it is necessary to diagnose intestinal motility using electrogastroenterography .

Doctors classify malignant neoplasms of the small intestine as C17 in the International Classification of Diseases ICD-10.

Professional articles related to small bowel cancer:

Firsova L.D., Masharova A.A., Bordin D.S., Yanova O.B. Diseases of the stomach and duodenum // - M: Planida. - 2011. - 52 p.

Cancer is a dangerous disease that affects any part of the body. Often in medical practice, the development of small intestine cancer is also encountered, the symptoms and manifestations of which are similar to other pathologies of the digestive system.

Causes

Doctors have noticed for many years that the disease is diagnosed most often 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 intestine cancer can be colitis, ulcers, Crohn's disease, polyposis. Also, the culprit may 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 pathologies of the gastrointestinal tract, the following factors can provoke the degeneration of healthy cells into cancer cells:

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

Of these factors, the main attention is given to malnutrition. After all, regular intake of food containing carcinogens leads to irritation of the digestive tract and disruption of its functioning, which in the future can provoke oncology.

Symptoms

Symptoms of small intestine 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, then the symptoms will be very similar to a stomach ulcer. A person complains of aversion to food, soreness in the intestinal area of a blunt nature, which can radiate to the back. In severe form, the signs of small intestine cancer are manifested 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 umbilical region.
Diarrhea.
The appearance of mucous secretions in the feces.
Bloating.
Fast fatiguability.

Symptoms of the development of malignant oncology become more intense and severe at a later stage. In patients, perforation of the intestinal wall often occurs, peritonitis develops, poisoning of the body with decay products of the neoplasm occurs, and signs of severe anemia appear.

Tumor detection

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

It includes the following methods:

Colonoscopy. The technique helps to detect the formation, its size, shape. For diagnostics, an endoscopic device with a camera at the end is inserted through the rectum.
Fibrogastroscopy. The stomach is also 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, how aggressive it is.
CT scan. Allows you to identify metastases in the internal organs.

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

Therapeutic methods

The most acceptable treatment for small bowel cancer is surgery. During the operation, a malignant tumor and adjacent tissues are removed. In case of damage to the lymph nodes, they are also eliminated. Depending on the extent of the operation, it may be necessary to artificially reconstruct the bowel.

Radiation therapy is an effect on the production of high-frequency x-rays. Apply these methods before and after surgical removal of the tumor. Both treatments for small bowel cancer cause side effects, but chemotherapy is considered the most aggressive.

As an addition to surgery, chemotherapy and radiation are prescribed. The first technique consists in introducing into the patient's body special aggressive drugs that suppress atypical cells.

Diet

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

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

At the first time of treatment, dishes are served grated. They should also be warm, not hot or cold. Under no circumstances should you overeat. The diet also involves the use of a large amount of liquid in the form of ordinary water, compotes, herbal decoctions.

Forecast

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

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

Oncology is an insidious disease that poses a threat to human life. This is why the prevention of small bowel cancer is so important. A healthy lifestyle and regular examination of the gastrointestinal tract will help to minimize the risk of developing a tumor.

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

the denudal part, the shortest, got its name because of its length, equal to the length of 12 fingers in diameter;
the lean 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 bears the name, so to speak, because of the location area.

The small intestine, in which food is exposed to the action of intestinal juice, bile, 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, flows into the caecum in the region of the right iliac fossa. In the structure of the human small intestine, the duodenum, jejunum and ileum are distinguished.

Small intestine cancer and tumor localization

Small intestine cancer in the structure of malignant tumors of the digestive tract is 1-2%. According to ICD-10, it has the code C17.

Due to the blurring of the first symptoms, small intestine cancer is diagnosed by chance, very often during an X-ray examination or abdominal surgery during treatment for another disease. At the same time, metastasis begins, due to which secondary intestinal cancer develops.

The most common neoplasms of the small intestine are:

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

It is worth noting! Small bowel cancer mostly affects men over the age of 60 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 it does not irritate the mucous membrane. Carcinogens ingested with food do not have time to harm. There are very few bacteria in the small intestine, but a lot of lymphoid tissue. Alkaline pH and the enzyme benzpyrene hydroxylase are considered as protective factors.

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

Causes of small intestine cancer

No specific direct cause of oncology of the small intestine has yet been found. Attention is always drawn to chronic enzymatic or inflammatory bowel disease, cancer symptoms can hide behind signs of diseases such as diverticulitis, ulcerative colitis, enteritis, Crohn's disease, duodenal ulcer. Often, the tumor develops against the background of adenomatous, prone to degeneration into oncogenic.

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

Also, the causes of the appearance of a tumor include:

Peutz-Jeghers syndrome;
duodenitis;
celiac disease;
genetic pathologies;
benign tumors;
metastasis of the malignant process to 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 peptic ulcer of the stomach and duodenum and will manifest as an aversion to food, dull pain in the epigastric zone with irradiation to the back. At a late stage, duodenal cancer shows symptoms associated with poor patency of the biliary tract and intestines due to tumor growth. The patient will suffer from endless nausea and vomiting, flatulence and manifestations of jaundice.

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

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

It has been proven that the symptoms of small intestine cancer are more common in men than in women. This fact is associated with the way of life of men, nutrition and abuse of malicious habits: alcohol, smoking and drugs. In addition, small intestine cancer develops in men somewhat differently due to the different structure of the genitourinary system.

Very often with, there are signs of bowel cancer in women. With tumor metastases, symptoms of bowel cancer in men may appear. If the tumor compresses neighboring organs, then this leads to the development of pancreatitis, jaundice, ascites, intestinal ischemia.

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

pain during bowel movements;
intestinal patency is disturbed;
there is a clear or hidden intestinal blood loss;
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;
impaired function of the pancreas and liver.

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

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

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

Symptoms and signs of small intestine cancer in women and men

The development of the tumor in the early stages in women and men is almost the same. The progression of the tumor and its growth on nearby organs makes a distinction in the symptoms. As the cancer spreads, it primarily affects the vagina in women and the prostate in men. After cancer affects the rectum and sphincter canal, causing complaints in both sexes. There are pains in the anus, lumbar spine, coccygeal region and sacrum. Men experience problems with urination, which indicates damage to the bladder. The body temperature rises significantly, the development of ureteral infections is likely.

Symptoms in stages 3 and 4

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

At stage 4, symptoms such as:

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

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

intestinal bleeding;
pain during bowel movements;
violations of the digestive tract;
a sharp change in mood and neuroses;
severe fatigue;
peritonitis;
exhaustion;
dry skin;
dysfunction of neighboring organs;
low levels of protein in the blood.

Where does small intestine cancer metastasize?

Near the small intestine there are many important organs and when the oncotumor 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 the characteristics of growth, malignant neoplasms are conditionally divided into the following types:

Exophytic - grow inside the intestinal lumen. Cancer processes provoke stagnation of feces in the affected areas of the jejunum, with the development of the disease turning into obstruction. Tumors look like fungi or polyps with well-defined structured borders, becoming saucer-shaped when ulcerated.
Endophytic, or infiltrative. Neoplasms without clearly marked 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 the histological classification, oncological formations of the small intestine are:

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

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 chest x-ray, CT, in the blood and bone marrow. If the tumor is large, there will be disturbances in the absorption of food.

If the retroperitoneal and mesenteric lymph nodes spread tumor cells, then a secondary lymphoma is formed in the small intestine. Small bowel cancers include ring cell, undifferentiated, and unclassified cancers. The growth form is exophytic and endophytic.

Classification of cancer of the horse intestine 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 intestine 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;
TK - tumor invasion of the subserous layer of the intestine or retroperitoneal space. The tumor is not more than 2 cm;
T4 - germination of the tumor of the visceral peritoneum, non-peritoneal areas with a length. Tumor more than 2 cm.

N - damage to the lymph nodes:

N0 - no lymph nodes affected.
N1 - metastatic lesion of regional lymph nodes.

M - the presence of distant metastases:

M0 - no separated 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 solitary small tumor that is located on the surface of the mucous membrane and does not grow deeper. Metastases are absent.
Stage 1 - the tumor has grown deep into the intestinal wall, but has not spread to neighboring organs. Metastases are absent.
In stage 2 bowel cancer, the tumor has grown through the entire thickness of the intestinal wall and spread to neighboring organs.
in stage 3 small bowel cancer, cancer cells have spread to regional lymph nodes. Germination in other organs and distant metastases are absent.
In stage 4 small bowel cancer, there are distant metastases. Most often they are found in the lungs, liver. bones and other organs.

Diagnosis of small bowel cancer

To recognize bowel cancer at an early stage, it is necessary to conduct a series of diagnostic studies that 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, with the help of these methods, the diagnosis of the duodenum is carried out.
Irrigoscopy and colonoscopy - performed to diagnose the ileum.
To detect stenosis and the presence of barriers to the movement of barium sulfate suspension, the method of barium passage in the lumen of the tract is used.

During endoscopy, samples of cancer cells are taken for further laboratory study and confirmation or refutation of 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 surgery.

For malignant tumors, the following laboratory tests are performed:

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

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

How to identify bowel 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 transfer its stages, the greater the chance of a positive result. When the symptoms appear, the oncoprocess can be considered neglected, and the moment of early treatment will be missed.

Important! Early symptoms include a “malicious” condition that should alert any person - this is an unwillingness to work or do household chores due to increased weakness and fatigue. The skin becomes pale and "transparent". The patient constantly has heaviness in the stomach, he does not want to eat at all. Following this, dyspeptic disorders appear: nausea, vomiting, pain and heartburn, even from water.

What is the diagnosis of small intestine cancer?

When contacting a doctor, a blood test is immediately prescribed and examined, which is necessarily carried out if bowel cancer is suspected. According to the general basic blood test, anemia, the patient's condition, and the presence of inflammation can be detected.

Then, based on the results of the blood test, if necessary, a blood test for small intestine cancer is performed. The most informative and common oncomarkers 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 (cancer-embryonic antigen), screening diagnostics of colon cancer is carried out. If CEA is determined, then you can find out the staging before the operation and monitor the patient with a diagnosis of colorectal cancer after it. As the disease progresses, the serum CEA level will rise. Although it may grow and not in connection with the tumor, and in the later stages, colorectal cancer can be detected without an increase in CEA in the blood.

Endoscopic diagnosis, open biopsy of the intestine are the main methods for confirming oncology of the small intestine.

Small bowel cancer treatment

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 oncology.

The volume of surgical intervention depends on the stage of tumor development, its localization and the degree of damage to surrounding tissues, organs and systems. Cancerous tumors at the initial stage are removed using laparoscopic surgery. The operation 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 the late stages of cancer development, then in this case, extensive operations are used, which include:

resection of the small intestine, in which the affected section of the small intestine is removed along with the lymph nodes and part of the healthy surrounding tissues;
a radical operation in which tumors of a huge size and all tissues affected by metastases are subject to removal;
contactless operation. Carried out by overlapping all blood and lymphatic vessels around the tumor. Resection is performed to prevent the dispersion of malignant cells 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 pancreatic resection is performed for cancer of the pancreatic head. Along with surgery on a segment of the small intestine, gastrectomy can be performed. In advanced ileal cancer, a hemicolectomy is performed on the right side of the large intestine.

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

Chemotherapy for small intestine cancer

Chemotherapy for cancer of the small intestine, 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 with. Chemotherapy is used before surgery to reduce the size of the tumor and inhibit the development of cancer cells, after surgery to reduce the risk of tumor recurrence.

After a palliative operation (which alleviates the suffering of the patient), chemotherapy (polychemotherapy) is carried out, but without radiation.

After the operation, an additional diagnosis of intestinal motility is carried out using the method of electrogastroenterography, so that a dangerous complication does not develop - intestinal paresis.

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

Prevention of cancer of the small intestine (colon)

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

regularly undergo preventive examinations;
adhere to the principles of a healthy lifestyle and proper nutrition;
timely treat diseases of the gastrointestinal tract;
annually take a fecal occult blood test (Colon View test, with which you can determine the occult blood in the feces and detect bowel cancer at an early stage);
do not delay and consult a doctor if any alarming symptoms appear on the part of the digestive system.

What is the life expectancy for small intestine 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 the operation the number of survivors for 5 years is 40-50%. Each subsequent stage reduces the percentage of positive outcomes in patients by 15 - 20%.