Duodenal Cancer

Duodenal cancer is a rare tumor in your duodenum. This is the first part of your small intestine. Your duodenum helps turn partially digested food into nutrients your body needs. Duodenal cancer disrupts this process.

There are different types of this disease. This article focuses on adenocarcinoma, the most common type. Surgery and other treatments may cure duodenal cancer, but it may come back.

Types

Cancer doctors (oncologists) classify this disease by the type of cells where tumors develop:

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

Duodenal cancer symptoms

This disease may not cause symptoms until the tumor grows large enough to block your small intestine. Your body can’t digest food when something blocks your small intestine. When that happens, you may have symptoms like:

• Abdominal pain
• Blood in your poop
• Burning stomach pain (acid reflux)
• Constipation
• Nausea or vomiting
• Unexplained weight loss

Duodenal cancer causes

Experts believe the disease starts in small growths (polyps) in your intestine lining. They don’t know why these polyps develop or why they become cancerous.

Risk factors

Certain factors may increase your risk:

• Age: Most cases affect people age 60 to 80.
• Health conditions: Celiac disease or Crohn’s disease may increase your risk.
• Lifestyle habits: Smoking, drinking alcohol and eating a high-salt diet are common risk factors.
• Inherited disorders: Having familial adenomatous polyposis (FAP), Lynch syndrome or cystic fibrosis increases your risk.
• Race: Black people have a higher risk.
• Sex: Duodenal cancer is slightly more common in males.

Complications

Duodenal cancer may lead to:

• Metastatic cancer: It can spread beyond your duodenum.
• Cancer recurrence: You may have duodenal cancer come back after treatment.
• Colon cancer: People with duodenal cancer can be at increased risk for developing colon cancer as well.
• Anxiety and depression: Having a rare disease like duodenal cancer may cause social isolation that leads to depression. The disease can come back, so not knowing if or when that may happen may cause anxiety.

How doctors diagnose this condition

A healthcare provider will check your symptoms and health history. They’ll do a physical exam and tests, including:

• Imaging tests: CT scans or MRIs give providers a detailed view of your duodenum and small intestine.
• Upper endoscopy: This test uses a flexible tube with a camera to check your duodenum.
• Biopsy: A provider will take tissue samples during the endoscopy. A medical pathologist will check the samples for cancer.

Cancer staging

Cancer staging helps your oncologist plan treatment. In this case, they’ll stage cancer by checking how far the disease spreads through tissue layers, muscles in your duodenum and beyond. The five cancer stages are:

• Stage 0: Abnormal cells are in a top layer of tissue.
• Stage I: Cancer has spread to deeper layers of tissue or muscle.
• Stage II: Cancer affects nearby organs or muscles.
• Stage III: Cancer is in nearby lymph nodes.
• Stage IV: Cancer has spread to distant areas of your body, like your liver or abdomen.

How is duodenal cancer treated?

Common treatments include:

• Surgery: A surgeon may remove all or part of your duodenum. They may do a Whipple procedure. This removes your duodenum, gallbladder and part of your pancreas.
• Chemotherapy: Oncologists may use this treatment after surgery to reduce the chances of the cancer coming back. They may also use it to treat cancer that has spread.
• Radiation therapy: This treatment targets any cancer cells left after surgery.

When should I seek care?

Symptoms, like abdominal pain that doesn’t go away, blood in your poop or losing weight, are reasons to talk to a healthcare provider. Duodenal cancer may not be the cause. But checking with a provider is the only way to find out what’s going on in your gut.

What’s the survival rate for this condition?

Cancer survival rates are estimates of how long people may live after a cancer diagnosis. As duodenal cancer is rare, most data refer to survival rates for small intestine cancer. The American Cancer Society provides information on five-year relative survival rates:

• Localized cancer: 86%, or more than 8 of 10 people who have cancer within the small intestine
• Regional cancer: 80%, or 8 of 10 people with cancer in nearby lymph nodes
• Distant: 47%, or nearly 5 of 10 people with cancer that’s spread outside the small intestine

Relative survival rates compare the survival rate of people with a specific type and stage of cancer with people who don’t have cancer.

Is there anything I can do to feel better?

Duodenal cancer symptoms can make you feel weak just when you need all of your strength to manage surgery and treatment side effects. And it can come back after successful treatment. Your healthcare team will be glad to recommend support, like:

• Cancer rehabilitation: Preventive rehabilitation is support before you start treatment. You may work with nutritionists, physical therapists and counselors so you’re in the best mental and physical shape possible.
• Palliative care: This is a healthcare team to help you manage cancer symptoms and treatment side effects. Just as important, this care provides emotional and spiritual support.
• Cancer survivorship: Duodenal cancer can come back after surgery and other cancer treatments. Living with uncertainty can be stressful. Cancer survivorship provides support to help you manage anxiety and stress.

Prevention

You can’t prevent duodenal cancer. But you may lower your risk by:

• Improving your what you eat: Eat lean protein instead of red meat. Fill your plate with vegetables, fruits and whole grains.
• Avoiding tobacco products: Don’t smoke or vape. If you need help quitting, contact a healthcare provider.
• Limiting alcohol: Stick to one drink daily for women or two for men.

Can you live without a duodenum?

Sometimes, treatment for duodenal cancer involves surgery to remove your duodenum. You can live without this part of your small intestine. But the surgery may affect how you digest food. Your healthcare provider may prescribe nutritional supplements or IV nutrition to help you get the nutrition you need.

Is duodenal cancer the same as pancreatic cancer?

No. Duodenal cancer affects your small intestine. Pancreatic cancer develops in your pancreas, which is behind your stomach.