The small-bowel takes up around 75% of the digestive tract however it is an area in which cases of cancer are fairly rare, with around 1000 people diagnosed with this disease every year. Read on to found out about what it is and how it is treated.

The small bowel is around 5m in length and is found inside your abdomen; it is responsible for food break down and extracting the nutrients, vitamins and minerals that you need from your food. It is made up of 3 parts, the duodenum, the jejunum and the ileum. Even though it is not commonly affected by cancer, there are in fact 4 different types of cancer that can affect the small bowel. These are adenocarcinoma, sarcoma, neuroendocrine tumors and lymphoma.

Adenocarcinoma is one of the most common forms of small-bowel cancer representing around 40% of all cases. It is begins in the lining of the bowel and generally develops in the duodenum. Sarcoma grows in the soft tissue of the small bowel and, and there are even different types of this although the most common is leiomyosarcoma which is a cancer of the smooth muscle. Next up are neuroendocrine tumours which also have an incidence of around 40% and are normally found in the ileum having formed from hormone producing cells. Finally lymphoma affecting around 10% of cases is a cancer of the lymph nodes which is usually found in the jejunum. It is of course also possible to have secondary cancer of the small bowel too.

So how exactly is this this cancer treated when there are several different forms of it? Since there are varying forms, there are various treatments that are employed accordingly. Generally surgery is the most common form of treatment during which the surgeon will remove the tumour as well as the healthy tissue surrounding it to help ensure there are no cancerous cells remaining. The amount of bowel that will be removed will be dependent on the size and the position of the tumor. Sometimes depending on the positioning of the tumor, the surgeon will have to remove other organs as well such as the pancreas or any lymph nodes in the area. Having removed the cancerous part of the bowel, the surgeon will then reattach the 2 remaining parts of the small bowel. In cases where this is not possible, the remaining piece of the small bowel will be brought to the surface to form a stoma over which you will need to wear a special bag. In cases where the cancer is too advanced to remove, surgery is still sometimes performed to remove blockages and as a pain reliever.

Chemotherapy is usually used to treat sarcomas of the small bowel or after surgery if the cancer has spread to the lymph nodes. The combinations of drugs used during the chemotherapy treatment are generally the same as those used to treat the more common cancer of the large bowel. You may also have radiotherapy treatment after surgery if the cancer comes back. If your cancer is a gastro intestinal stromal tumor, then biological therapy is sometimes used too to block or change how cells within the body signal each other.

Since this is a less common cancer type, it can be difficult for researchers to gain an insight into what treatments work best for it, so currently there is ongoing research in the UK into whether or not varying types of chemotherapy or none at all following surgery reduces the risk of the cancer returning. Known as the BALLAD trial, follow that link to find out if you are eligible. Otherwise your small bowel cancer specialist may refer you if they think you will fit the criteria. For American clinical trials, please visit here.