Duodenal Cancer

What is duodenal cancer?

Duodenal cancer is a mass of irregular, fast-growing cells (tumor) in the first portion of your small intestine. This tumor may prevent the intestine from properly digesting food and block food from passing through your intestines.

In early stages, you may have no symptoms of duodenal cancer. If the intestinal tumor grows, you may have symptoms that affect your digestive system, such as nausea, constipation or abdominal cramps.

What is the duodenum?

The duodenum is a small, horseshoe-shaped part of your small intestine. It receives food from your stomach during digestion.

The chemicals and enzymes in your duodenum break down food and send vitamins and other nutrients from the food to your body. Then, your duodenum passes the food to the next part of your small intestine, the jejunum.

What are the types of duodenal cancer?

Your duodenum contains a variety of types of cells, so there are a variety of cancers that could start there. The four main types of duodenal cancer are:

• Adenocarcinoma affects the cells that produce the chemicals, enzymes and other fluids that break down food.
• Carcinoid tumors are slow-growing tumors that often start in your gastrointestinal (GI) tract and spread throughout your body.
• Lymphoma starts in the immune system cells that fight infection.
• Sarcoma starts in your bones or soft tissues, such as your muscles or blood vessels. The most common type of GI sarcoma is a gastrointestinal stromal tumor.

Who is more likely to get duodenal cancer?

Experts don’t know exactly why some people get duodenal cancer. But some factors can increase your risk, including:

• Age: Most duodenal cancers are in people ages 60 to 80.
• Ethnicity: In the United States, Black people are more likely to get duodenal cancer.
• Health conditions: Certain intestinal conditions, such as celiac disease or Crohn’s disease, can increase your risk.
• Health habits: Smoking, drinking alcohol and eating a high-salt diet may increase your risk of duodenal cancer.
• Inherited diseases: Certain genetic disorders increase your risk of duodenal cancer, including familial adenomatous polyposis (FAP), Lynch syndrome and cystic fibrosis.
• Sex: Duodenal cancer is slightly more common in men or people designated male at birth than women or people designated female at birth.

What are the symptoms of duodenal cancer?

Often, you don’t have any symptoms of duodenal cancer when the tumor is small. As the tumor grows, you may have:

• Abdominal pain.
• Acid reflux.
• Blood in your stool.
• Constipation.
• Nausea or vomiting.
• Unexplained weight loss.

What causes duodenal cancer?

Experts don’t know exactly what causes duodenal cancer. They think that duodenal cancer starts as small growths (polyps) that form in your intestine’s inner lining. They don’t know what causes these polyps.

How is duodenal cancer diagnosed?

Healthcare providers use a process called staging to diagnose cancer:

• Stages 0 to 1 mean you only have cancer in one part of your body.
• Stages 2 to 3 mean cancer has spread through the muscle and/or invades into nearby organs/structures including regional lymph nodes.
• Stage 4 means cancer is widespread to distant parts of your body.

To diagnose cancer and determine its stage, your healthcare provider may use several tests, including:

• Imaging tests, such as MRIs and CT scans, to get a detailed picture of your GI tract.
• Upper endoscopy, using a small, flexible tube with a camera to look inside your GI tract.
• Barium swallow test, swallowing a small amount of a chemical called barium that shows up brightly on X-rays to get a detailed look at your upper GI tract.
• Biopsy, removing a small portion of tissue from your GI tract to examine in a lab for signs of cancer.

How is duodenal cancer treated?

Your treatment plan varies depending on the cancer stage. Your healthcare provider may recommend:

• Surgery: A surgeon removes as much of the tumor as possible while keeping healthy tissue intact. In severe cases, you may have a Whipple procedure, where the surgeon removes your duodenum, gallbladder and a small part of your pancreas.
• Chemotherapy: You take medications to destroy fast-growing cells in the body, such as cancer cells. You may have chemotherapy in several rounds of treatment with rest periods in between.
• Radiation therapy: A radiation oncologist directs high doses of radiation beams to your GI tract. Radiation therapy shrinks or destroys tumor cells.

How can I prevent duodenal cancer?

There’s no guaranteed way to prevent duodenal cancer. But some steps can decrease your overall risk of GI cancer, such as:

• Eating a diet low in red meats and high in lean protein, fruits, vegetables and whole grains.
• Quitting smoking and using tobacco products.
• Reducing your alcohol consumption.

What is the outlook for duodenal cancer?

In general, the outlook for cancer is better when you detect it in early stages. It can be harder to treat if you find duodenal cancer in later stages.

Visit your healthcare provider regularly to increase your chances of finding duodenal cancer early. If you have any GI symptoms or changes in your digestive habits, see your healthcare provider right away. Your provider may also recommend screening tests to increase your chances of early detection if you have a family history of cancer.

What questions should I ask my doctor?

If you have suspected or diagnosed duodenal cancer, you may also want to ask your healthcare provider:

• What is the most likely cause of my GI symptoms?
• What stage is the duodenal cancer?
• What are the treatment options for duodenal cancer?
• What could happen if I don’t get treatment?
• What lifestyle changes should I make to lower my risk of duodenal cancer?

Can you live without a duodenum?

Yes. If you have a Whipple operation, your surgeon removes your duodenum. Without your duodenum, you may have trouble with digestion or nutrient absorption. Your provider may prescribe nutritional supplements or nutrition through an intravenous (IV) line (parenteral nutrition) to prevent malnutrition.

Is duodenal cancer the same as pancreatic cancer?

No. Duodenal cancer occurs in the first portion of your small intestine. Pancreatic cancer occurs in your pancreas, the organ behind the lower part of your stomach.

A note from Cleveland Clinic

Duodenal cancer is cancer in the first portion of your small intestine. It may interfere with digestion and nutrient absorption. In early stages, you often have no symptoms of duodenal cancer. As cancer progresses, you may have constipation, abdominal pain, nausea or vomiting. Treatment options may include surgery, chemotherapy or radiation therapy.