There are different types of treatment for patients with small bowel cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Types of treatments
Three types of standard treatment are used:
- Surgery: Surgery is the most common treatment of small intestine cancer. One of the following types of surgery may be done:
- Resection: Surgery to remove part or all of an organ that contains cancer. The resection may include the small intestine and nearby organs (if the cancer has spread). The doctor may remove the section of the small intestine that contains cancer and perform an anastomosis (joining the cut ends of the intestine together). The doctor will usually remove lymph nodes near the small intestine and examine them under a microscope to see whether they contain cancer.
- Bypass: Surgery to allow food in the small intestine to go around (bypass) a tumor that is blocking the intestine but cannot be removed. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery to increase the chances of a cure is called adjuvant therapy.
- Radiation therapy: Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
- Chemotherapy: Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Treatments by stage
Small intestine adenocarcinoma
When possible, treatment of small intestine adenocarcinoma will be surgery to remove the tumor and some of the normal tissue around it.
Treatment of small intestine adenocarcinoma that cannot be removed by surgery may include the following:
- Surgery to bypass the tumor
- Radiation therapy as palliative therapy to relieve symptoms and improve the patient's quality of life
- A clinical trial of radiation therapy with radiosensitizers, with or without chemotherapy
- A clinical trial of new anticancer drugs
- A clinical trial of biologic therapy
Small intestine leiomyosarcoma
When possible, treatment of small intestine leiomyosarcoma will be surgery to remove the tumor and some of the normal tissue around it.
Treatment of small intestine leiomyosarcoma that cannot be removed by surgery may include the following:
- Surgery (to bypass the tumor) and radiation therapy
- Surgery, radiation therapy, or chemotherapy as palliative therapy to relieve symptoms and improve the patient's quality of life
- A clinical trial of new anticancer drugs
- A clinical trial of biologic therapy
Recurrent small intestine cancer
Treatment of recurrent small intestine cancer that has spread to other parts of the body is usually a candidate for a clinical trial of new anticancer drugs or biologic therapy.
Treatment of locally recurrent small intestine cancer may include the following:
- Surgery
- Radiation therapy or chemotherapy as palliative therapy to relieve symptoms and improve the patient's quality of life
- A clinical trial of radiation therapy with radiosensitizers, with or without chemotherapy
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