Treatments for resectable small intestine adenocarcinoma
The following are treatment options for resectable small intestine adenocarcinoma. This means that the cancer can be completely removed with surgery. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Surgery is the main treatment for resectable small intestine adenocarcinoma. The type of surgery done will depend on where the tumour is in the small intestine.
Segmental bowel resection removes part of the small intestine. It is used for tumours in the lower part of the duodenum (the first part of the small intestine). It may also be used to remove tumours in the jejunum (the middle part of the small intestine) or the ileum (the last part of the small intestine) if they have not spread outside the small intestine.
The Whipple procedure (also called pancreaticoduodenectomy) removes part of the pancreas along with the duodenum. It also removes the lower part of the stomach, the gallbladder and part of the common bile duct. The Whipple procedure is used for tumours in the upper part of the duodenum near the stomach. It is also used for tumours near the ducts of the pancreas and liver.
Right hemicolectomy is a type of bowel resection that removes part of the ileum (the last part of the small intestine), the cecum (the first part of the large intestine) and parts of the colon (the longest part of the large intestine). It is used to remove tumours that are close to the colon or are where the small intestine joins the colon.
Researchers are still trying to find out if it is helpful to give chemotherapy after surgery to remove small intestine adenocarcinoma. You may be offered chemotherapy if there are cancer cells at the edges of the tissue that was removed along with the tumour during surgery (called positive surgical margins).
The chemotherapy drug most often used to treat small intestine adenocarcinoma is 5-fluororuracil (Adrucil, 5-FU).
The most common combinations of chemotherapy drugs used to treat small intestine adenocarcinoma are:
- FOLFOX – leucovorin (folinic acid), 5-fluorouracil and oxaliplatin (Eloxatin)
- CAPOX – capecitabine (Xeloda) and oxaliplatin
- 5-fluorouracil and cisplatin (Platinol AQ)
Clinical trials @(Model.HeadingTag)>
Very few clinical trials in Canada are open to people with small intestine adenocarcinoma because this type of cancer is so rare. Clinical trials look at new and better ways to prevent, find and treat cancer.
Find out more about clinical trials.
American Cancer Society. Small Intestine Cancer. 2015: http://www.cancer.org/acs/groups/cid/documents/webcontent/003140-pdf.pdf.
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Arber N, Moshkowitz M . Small intestinal cancers. Jankowiski J, Hawk E (eds.). Handbook of Gastrointestinal Cancer. Wiley-Blackwell; 2013: 4: 67-85.
Chamberlain RS, Mahendraraj K, Shah SA . Cancer of the small bowel. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 54: 734-744. http://lwwhealthlibrary.com/signin.aspx.
National Cancer Institute. Small Intestine Cancer Treatment (PDQ®) Health Professional Version. 2014: http://www.cancer.gov/cancertopics/pdq/treatment/smallintestine/HealthProfessional.
Overman MJ . Rare but real: management of small bowel adenocarcinoma. American Society of Clinical Oncology Educational Book. 2013: http://meetinglibrary.asco.org/content/171-132.