Your small bowel is an important part of your digestive system. It’s a long tube that connects your stomach to the larger intestine and it helps to break down the food you eat and absorb vital nutrients and water. Over 46,000 people in the UK are diagnosed with bowel cancer every year making it the fourth most common cancer - however, because it is unusual for cancer to start in the small bowel, only around 2,200 of these people will have small bowel cancer.
What is the small bowel?
There are three different parts of the small bowel, which is also called your small intestine:
The duodenum, where food from your stomach first enters.
The jejunum, in the middle.
The ileum, which connects the small bowel to the large bowel.
What are the different types of small bowel cancer?
Cancer develops when cells grow and divide uncontrollably, so the different types of small bowel cancer develop in different cells:
Adenocarcinoma starts in epithelial cells that line the inside of your small bowel.
Neuroendocrine tumours (NETs) develop in cells that make up a system of glands and nerves.
Sarcomas can grow in various connective tissues that support your small bowel.
Lymphomas form in part of your immune system called lymph tissue.
Is small bowel cancer curable?
If small bowel cancer is detected and treated early then patients can sometimes be cured. However, like a lot of cancers, the later it is diagnosed and the more it spreads, the harder it is to treat and cure small bowel cancer.
The likelihood of being cured depends on a number of factors including the stage of the cancer, the specific type of cancer and your overall health. If you or a family member has been diagnosed with small bowel cancer your oncology team can advise you about the best treatment options.
What causes small bowel cancer?
Small bowel cancer occurs when cells in your small intestine grow out of control. We still don't fully understand what causes this to happen, so researchers are investigating to find out more so that we can better prevent, diagnose, and treat small bowel cancer.
What research has already shown are a few factors which can increase your risk of developing small bowel cancer:
Other bowel conditions like Chrohn's disease, coeliac disease or Peutz-Jeghers syndrome.
Genetics conditions like Lynch syndrome or familiar adenomatous polyposis.
Environmental factors such as consuming a diet high in red meat, smoking, or consuming alcohol - though more research is needed to fully understand this link.
Age and ethnicity - most people diagnosed are over 60, and small bowel cancer affects more Black people than people of other ethnicities.
Symptoms, diagnosis and treatment of small bowel cancer:
What are the symptoms of small bowel cancer?
It can be difficult to spot the symptoms of small bowel cancer, and they can be vague since they overlap with the symptoms of other digestive conditions.
Small bowel cancer symptoms can include:
• Pain in your tummy
• Unexplained weight loss
• A lump in your belly
• Blood in your stools
• Changes to your bowel habits
• Feeling or being sick
• Tiredness
• Jaundice
How is small bowel cancer diagnosed?
It can also be tricky to diagnose small bowel cancer, since your small intestine is in the middle of your body and hard to access. A combination of tests are usually used to help work out if you have small bowel cancer, which specific type of cancer you have and how best to treat it.
Tests may include:
• Blood tests: looking at the levels of different cells and chemical in your blood.
• Urine test: looking for any signs of cancer in your urine.
• Endoscopy: using a flexible tube with a camera on the end to view your digestive system
• Capsule endoscopy: swallowing a capsule containing a tiny camera which transmits footage from your intestine
• Imaging: using CT, MRI or PET scans to create a picture of the inside of your body.
• Biopsy: removing a small part of the small bowel and investigating it under a microscope.
How is small bowel cancer treated?
Your treatment will depend on a number of factors and your oncology team can advise the best treatment for you. Surgery is the most common treatment for small bowel cancer. This involves removing all of, or part of, the cancer. Chemotherapy, targeted therapy, immunotherapy or radiotherapy can also sometimes be used to treat small bowel cancer and often patients receive a combination of treatments.
Why is small bowel cancer so difficult to detect?
Your small bowel is right in the middle of your digestive system, so it can be challenging to examine, and it is harder to screen for than other digestive system cancers such as colon cancer.
Plus it is hard to spot symptoms of small bowel cancer since it can be easily mistaken for other digestive conditions. All of this means that patients often don’t receive an early diagnosis of small bowel cancer.
Why do we need more research into small bowel cancer?
The more research helps us understand about small bowel cancer, the more ways we will have to diagnose it quickly and accurately, so that patients can receive the treatment they need as soon as possible. For example, capsule endoscopy involves swallowing a small capsule that takes images of your gut as it travels through it. Innovative technologies like this are helping to detect small bowel cancer sooner and save lives.
Because small bowel cancer is rare, that means that unfortunately there is less existing research about small bowel cancer. Understanding more about it will not only help people affected by this disease, but it may also give us clues about how to prevent other bowel cancers.
How can we make a difference for small bowel cancer patients?
We need scientists to help answer some of the big questions we still have about this disease: how can we spot it sooner, who is most at risk from it, and how can we help more patients live for longer? International cancer research matters because the more we know, the better we can answer these questions.
For example, with the support of our Curestarters, Dr Jeroen van Bergen in the Netherlands made an exciting breakthrough about the role of gluten in the development of a small bowel cancer called enteropathy-associated T-cell lymphoma (EATL). His findings could pave the way towards new ways to treat patients with this cancer and better understand its association with celiac disease.
All new cures start with discovery research like this, and by supporting it you are creating a pipeline for future breakthroughs.
Your small bowel cancer FAQs:
Is small bowel cancer the same as bowel cancer?
Your small bowel, also called your small intestine, is part of your digestive system. Bowel cancer is an umbrella term for cancers that develop anywhere in your bowel, whereas small bowel cancer is much rarer and specifically forms in the small intestine.
What are the early warning signs of small bowel cancer?
Small bowel cancer can be difficult to spot. Symptoms vary but can include pain or a lump in your stomach, unexplained weight loss, changes to your bowel habits or blood in your stools, feeling or being sick and tiredness. If you are worried about any symptoms please contact your doctor.
What causes small bowel cancer?
Cancer happens when the cells in your body start to misbehave and grow out of control. In small bowel cancer this starts in the cells in your small bowel, also called your small intestine.
We don’t yet fully know what causes cancer to start in the small bowel. Certain other conditions, genetic factors and lifestyle may all play a role but further research is needed to better understand the causes of small bowel cancer. Ther more we understand about it, the easier we can stop it.
What research is being done into small bowel cancer?
Small bowel cancer is relatively rare compared to other bowel cancers and so has traditionally not had as much research. However, thanks to you we are making progress.
Curestarter researchers in the Netherlands have shown that gluten is involved in the development of an extremely small bowel cancer called enteropathy-associated T-cell lymphoma (EATL). Research like this to better understand the causes of small bowel cancer will accelerate the discovery of new small bowel cancer cures.
Why does rare cancer research need funding?
Rare and less common cancers, such as small bowel cancer, collectively cause 55% of cancer deaths in the UK. We urgently need more funding into rare cancers to help everyone affected.
You can help us reach the point where no-one has to say goodbye too soon, by becoming a Curestarter today. We are proud that as a cancer research charity we support research into any cancer, from the ones you have never heard of to the ones you know too well.
Donate today to start new cures
Be part of the united effort to stop lives being cut short by cancer.