Duodenal Cancer

In the human digestive system, the organ that follows the stomach is the small intestine. It is divided into three parts: the duodenum (9.8 in), jejunum (2.5 m), and the ileum (3.5 m). Duodenal cancer is a rare disease that affects the first part of the small intestine. It makes up only 1 to 2% of all gastrointestinal cancers.

Causes
Duodenum cancer is a rarely observed gastrointestinal cancer. There are certain risk factors that makes one prone to this cancer. Some of the risk factors that increase the chances of developing duodenum cancer are:

  • High fat diet
  • Celiac disease
  • Crohn’s disease
  • Familial adenomatous polyposis ((FAP) infection)
  • Muir-Torre syndrome
  • Peutz-Jeghers syndrome
  • Duodenal ulcer
  • Juvenile polyposis syndrome

It does not mean that every one who has been diagnosed with either of these conditions will develop this form of cancer. Rather, these risk factors just indicate that they are mostly the causes of developing duodenum cancer.

Symptoms
The symptoms seen in most of the individuals affected by this disease are as follows:

  • Pain below the breast bone
  • Nausea
  • Vomiting
  • Bloating of abdomen after consumption of food
  • Blood in stool
  • Abdominal swelling
  • Unexplained weight loss
  • Abdominal pain in the middle region
  • Heartburn
  • Acid reflux
  • Fatigue

The most common types are found to be adenocarcinomas. In some cases, one can develop sarcomas as well as carcinoids of the pudendum.

Diagnosis
Most of the symptoms are similar to other gastrointestinal disorders. Therefore, one needs to carry out specific diagnosis to be sure. The doctor may carry out a physical examination that helps detect lumps in the abdomen. Stool samples may be taken to detect the presence of blood cells. Other examinations include CT scan, X-ray of the abdomen, barium enema, liver function test, etc. Upper endoscopy, biopsy, laparotomy, etc., also helps with the diagnosis.

Treatment
The treatment depends upon the stage of cancer, health and age of the patient, and other related factors. The most common line of treatment for duodenum cancer is chemotherapy as well as radiation therapy. If chemotherapy does not work, then surgery is carried out. In most cases, surgery is difficult as there are many blood vessels present in this part of the body. One of the most widely used surgical method is the ‘Whipple’ procedure. In this procedure, a feeding tube or drainage tube may be fitted to allow the movement of food that cannot pass through the small intestine blockage.

Prognosis
The prognosis depends on different factors like the depth of cancer invasion, the spread of metastasis to other organs, involvement of lymph nodes, overall health of patient, age, etc. It has been found that patients with duodenal cancer of the third part have better prognosis. The survival rate is better in younger patients. It has been seen that the survival rate of adenocarcinoma for five years is less than 35%.

One needs to undergo lifestyle changes to avoid this cancer, especially, when one is diagnosed with pre-existing conditions that increase the risk.