Surgery

Surgery is the primary treatment for cancer of the small intestine. The doctor may perform surgery to remove the cancerous section of the small intestine, and then reattach the two healthy sides. The doctor may also need to remove nearby lymph nodes and organs, depending on the location and size of the tumor. For tumors that can't be removed, the doctor may perform bypass surgery to relieve blockages in the small intestine. This will allow food to travel around the blockage.

Radiation Therapy

Radiation therapy uses waves of high-energy rays produced by a machine to destroy cancer cells. Radiation therapy is not commonly used as a primary treatment for small intestine cancer, but may be used after surgery or in combination with chemotherapy to make these treatments more effective for patients with cancers in the duodenal area of the small intestine. For cancers of the duodenum, radiation therapy may be administered after surgery to kill any remaining cancer cells in the area.

Chemotherapy

Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. Chemotherapy medications may be given through the vein (intravenously) or by mouth (orally). Chemotherapy for small intestine cancer may be used alone or in combination with surgery or radiation therapy. In more advanced stages in which the cancer has spread, chemotherapy may be the best treatment option. All patients with small bowel adenocarcinoma should be testing for mismatch repair protein expression or the presence of microsatellite instability high (MSI-I) as for this subset of small bowel adenocarcinoma immune therapy is a treatment option.

Clinical Trials

Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation. To further understand your clinical trial options, in particular for patients with metastatic or stage IV disease where clinical trials are more likely to exist, the clinical trial registry of the United States can be searched with your specific type of small bowel cancer at www.clinicaltrials.gov.

Currently, Biological Therapy is being tested in clinical trials. Biological testing is a treatment that uses the patient’s immune system to stop or fight the cancer. It should be noted that due to the rarity of small bowel adenocarcinoma, clinical trials for the cancer are rare, and often clinical trial options revolve around enrollment in early stage Phase I clinical trials that are open to all patients with cancer.