What is Duodenal Cancer?
Duodenal cancer is a malignancy in the duodenum, the initial part of the small intestine. This type of cancer is very rare and considered the rarest among the cancers in the gastrointestinal (GI) system, accounting for only 1% of the cases of GI malignancies.
Duodenal cancers take the form of adenocarcinoma, which constitutes 50% of the malignancies in the small intestines.
The duodenum is the area where food mixes with bile from the gall bladder and enzymes from the pancreas. The most common sites of malignancies in the duodenum include the periampullary and the ampullary portions of the duodenum.
Duodenal Cancer Location is at Duodenum Region
Signs and Symptoms
When the cancer cells grow, they block the passage of food from the stomach into the intestines, preventing food from being absorbed.
- Cramping pain on the abdomen
- Acid reflux
- Nausea and vomiting
- Mass in the abdomen
- Involuntary weight loss
- Blood in the stool because of chronic gastrointestinal bleeding
Almost all cases of duodenal cancer are diagnosed at a late stage because these symptoms usually appear only after the disease has been present for some time.
Causes and Risk Factors
- Exposure to carcinogens in the form of viruses, radiation and chemicals.
- Poor diets containing high amounts of fat.
- Gastrointestinal conditions including Celiac disease, familial adenomatous polyposis, juvenile polyposis syndrome, Lynche syndrome, Gardner syndrome, Crohn’s disease, and Puetz-Jeghers disease.
Stages of Duodenal Cancer
Stage 0- Carcinoma in situ
This involves the presence of cancer cells n the duodenal mucosa. It is a localized malignancy where the cells are contained only within the walls of the organ.
Stage I -Growth in the Duodenum
- Stage IA. Stage one involves the duodenum without serosal penetration and ascites.
- Stage IB. This stage involves the spread of the malignant cells in the subcutaneous fat and muscularis.
- Stage IC. This involves spread to the serosal area and the presence of ascites. Ascites are the accumulation of fluids in the peritoneal cavity as a result of an obstruction in circulation.
Stage II- Localized spread
The adjacent tissues, muscles, ligaments, fats and lymph nodes are now affected.
Stage III- Regional spread
Stage III of duodenal cancer involves spread to the adjacent organs such as the ileum, jejunum, colon, stomach and other abdominal structures.
- Stage IIIA. There are gross malignancies in the abdomen with microscopic seeding on abdominal structures.
- Stage IIIB. There are gross malignancies in the abdomen with less than 2 cm abdominal implants on abdominal structures. There inguinal or retroperitoneal nodes are not yet affected.
- Stage IIIC. There are gross malignancies in the abdomen with more than 2 cm abdominal implants on abdominal structures. The inguinal or retroperitoneal nodes are already affected.
Stage IV- Distant Metastases
There is widespread malignancy in the abdominal cavity with metastases to distant organs such as the lungs, liver, pancreas, bone and others. In this stage, the prognosis is usually poor because of extensive damage.
The diagnosis of duodenal cancer involves the following:
- Barium Swallow or Upper Gastrointestinal series. This procedure involves the ingestion of barium along with X-rays to determine any obstructions in the upper gastrointestinal tract.
- Imaging Tests. A CT-scan or MRI may be done to visualize the abdominal structures. Tumors are easily seen through these tests. An ultrasound may also be done, but is less definitive than theCT-scan and MRI.
- Endoscopy. This involves the insertion of a thin tube with a small camera from the mouth going to the duodenum. Endoscopy needs the administration of local anesthetics on the throat to eliminate the gag reflex. Through the endoscopy the physician is able to see the inside of the duodenum.
- Biopsy. A biopsy is the definitive diagnostic test to determine if a tumor is cancerous or benign. This test is not able to detect the stage of the malignancy. Surgery is usually done to remove the cancerous cells and to determine the stage of the disease, which will dictate any additional treatments.
Treatment for duodenal cancer is similar to other types of cancer and includes:
Resection is commonly employed for duodenal cancer, but tumors in this area are usually difficult to remove because of the huge blood vessel network present.
Another type of surgery that can be done is a Whipple procedure. This involves the removal of the duodenum, gall bladder, and the head of the pancreas. The resulting part of the small intestine is connected to the pylorus of the stomach and the bile duct and pancreatic duct are connected to the area below the pylorus.
Because a portion of the pancreas is removed, patients will be required take pancreatic enzymes.
Chemotherapy serves as an adjunct to surgery to completely eradicate the malignant cells. It is a systematic approach which reaches all areas in the body through the circulation. Chemotherapy is carefully administered to reduce side-effects and myelosuppression. Side-effects of chemotherapy include anorexia, hair loss (temporary), nausea and vomiting, fatigue, mouth sores, and increase in risk of infection.
Radiation therapy is sometimes employed although it may not be very beneficial for cancer of the small intestine. The mechanism involves exposure of the area to high-energy radiation to kill the cancer cells or shrink the tumor size. Radiation therapy can be administered internally or externally. Side-effects of radiation therapy include anorexia, fatigue, nausea or vomiting, bloating and gas pains.
Alternative medications that can be used to manage duodenal cancer include things such as garlic, ginseng, Echinacea and ginger. Studies in animals have proven that these herbal remedies reduce the size of tumors, but further tests must be made among humans before these findings are considered conclusive.
The prognosis of duodenal cancer depends on the progress of the malignancy. It is unfortunate, but duodenal cancer has a poorer prognosis than jejunum cancer or ileal cancer because tumors in the duodenum are usually much more difficult to remove.
According to studies, surgery has been the most effective way to manage intestinal cancers. Chemotherapy and radiation are less promising than surgical removal of the tumor. Older patients (above 75 years old) also have a poorer prognosis and lower survival rate than the younger population.
The survival rate for Duodenal Cancer decreases as the stage of the disease advances. Localized malignancies have almost 50% survival rate, regional malignancies have 30% survival rate, and distant metastases have 5% survival rate. It is indeed essential to detect cancer early and employ various types of management immediately in order to increase the survival rate.
Grammar check done by Andrea on 23/10/2012.
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my older sister has just been digose with this sort of cancer they were unable to operate we would appericate some advice on how we can help my sister at this time regards carmelita bierton
hi, so my mom diagnosed with this cancer a few weeks ago but she did have the whipple procedure done. All I can tell you is just be there for your sister, let her now that you are supporting her in every way possible. And if you are religious, pray, a lot. That’s what we did for my mom and now my mom is doing a lot better. I wish your sister the best because I know what she is going through.
Which hospital she took the surgery? Do you know any hospital in Asia? Thanks
Duodenalcancer.com Yahoo groups Duodenalcancer. There is a network that you can talk to.
I am 52 and diagnosed Aug 2012. Glad to converse with you.
My husband was just diagnosed with Duodenal cancer today and have a scheduled Whipple surgery on Friday 1/11.The doctors does not know yet thye cancer stage not until they operate. Can you tell me more about this type of cancer.
I hope your husband is doing well. We are facing the same thing. Surgery in two weeks. Husband only out of hospital four week from surgery in Jan. So weak.please comment as I really want know if everything is OK for you.
I hope you are well. My husband has this also and is having 7+ hour survey in 2 weeks. I will keep you also in my prayers. I am scared and so is he. How are you now.6
Hope you are doing well. Prayers are with you.
My friend is diagnosed with duodenal cancer and he is only 40 years old. He was advised to undergo Whipple surgery, but he has been too skeptical about getting some of his organs out. Aside from the possible intake of pancreatic enzymes, what other effects will the patient feel after undergoing such surgery? And what will be the remedy. Thank you for your correspondence. It will mean a lot to me coz I need to help my friend.
Mother Tinctue of Ornithogalum 10 drops morning and night ad infinitum.
Anyone advice or comments about duodenal cancer please reply.
Therre are hugely varying results youu will get from these treatments, some with horresndous
side-affects, others wih none. Mostt patients with bladder cancer first present with unexplained hematuria (blood in
the urine). If the plaque iis not removed frequently it becomes harder andd formss calcculus or tartar.
In January 2012 I had a central pancreactomy due to a neuroendocrine tumor. I just found out that I now have a tumor in my duodenum. They are going to schedule me for an endoscopy and I am very nervous. I have been on pancreatic enzymes for 22 months.
Its not my first time to go to see this website, i am visiting
this website dailly aand get nice infrmation rom here all the time.
My cousin was diagnosed Sept. 11, 2014 after they made an attempt to do the Whipple surgery. They could not do the surgery to remove the turmor due to the cancer they found and told us that she was in Stage 4. They put a pic line in and will she will start chemo in three weeks. What should we expect and how can we help her??
Hello, my father in law was just diagnosed and had the same result from the attempted surgery. How is your cousin doing?
My husband had a whipple operation for duodenal cancer Aug11,2011. He is feeling very well, so far. He didn’t have chemo or radiation after the operation. I think that is why he is doing so well. The oncologist told us that this cancer is so rare that they really don’t know what kind of results that chemo or radiation will have. After the operation he had a few ups and downs but that we expected. His age is 75. My husband also has other health issues to go along with the Cancer, so we consider him to be very lucky.
My husband may need the whipple surgery. results are not back yet. but I was wondering who was your husband Surgen his phone # and hospital?
PRAYERS ARE SENT YOUR WAY
A good friend of mine, age 68, was recently diagnosed with this Cancer. They remove a large contained tumor, finding it attached to both the spleen and pancreas. However, it had not invaded these organs, so they were left intact. They did, however, find a small speck,of the cancer in one of his lymph modes. Consequently, the med heads have recommended 6 months of chemotherapy followed by 6 weeks of daily radiation treatments. The cancer was determined to be stage III. The med heads also say his prognosis is good.
my husband had wipple surgery for duodenum cancer. removed gall bladder and head of
pancreas, on Dec, 2013, It took the doctors 6 months to find his cancer…If they had found
the cancer 6 months earlier, would the cancer be smaller, it was a stage 4…..after surgery
and months of chemo…..my husband passed away after one year of surgery…..
thank you for your answer.
I was found to have cancer in my duodenum in April 2015. I had the polup removed by endoscopy and the cancer was confirmed. I then had a whipple in May 2015 procedure and gall bladder, commom bile duct , head of pancreas, some of the stomach, some of small intestine duodenum and including the lymph nodes. It was done by a surgeon using a robot. Surgery was about 10 hours, was in hospital for 25 days mostly in icu units. It was found by accident, stage 1A. All was removed,. Don’t need chemo or radiation. I was told numerous times how lucky it was that it was found when it was. I ‘ve had numerous scans,test etc And was told it was all healed.
My questions to people who have had a whipple are , did you have stomach pain afterwards ? If so, how long did it take to stop hurting in your stomach? My surgery was 4 1/2 months ago.
Do you take pancreatic enzymes ? If so, how many times a day ?
My cancer was adenocarcinoma. I was not diabetic prior to surgery and my sugar level is back to 100. It was a little higher when I was in the hospital.
If you had a whipple and doing well, how long ago did you have the whipple ?
In May 2015 I had a polyp removed from my duodenum, luckily it was benign. In January 2012 I had a tumor in my pancreas (also benign) and had a central pancreatectomy. My recovery took several months and I’m doing well now. I do still have pain every now and then, but it’s tolerable. My reason for writing is that I take enzymes (Creon) with each meal to help with digestion, will probably be on that forever. Take care and I will keep you in my prayers.
Hello, my father in law was diagnosed with duodenal cancer a month ago. They attempted Whipple surgery but found that the cancer had spread and couldn’t do it, just removed the gallbladder and redirected the stomach and small intestines to avoid the tumor. He read his surgical report and it stated stage 4 but his doctors office said the PET scan didn’t alert to other organs with cancer. Either way the doctors says it is treatable and he is going to do 6 months of chemo followed by immunotherapy. Has anyone else had these treatmeants?
My mum was diagnosed in April 2014 . Unfortunately it was too late and she passed away the following December.
Can this be hereditary?