Small Bowel Cancer

Small bowel cancers are difficult to diagnose. For this reason, people suspected of having small bowel cancer often need multiple tests and procedures to locate the cancer or rule out a cancer. These may include:

• Blood tests. Blood tests can’t detect small bowel cancer, but they can give clues about your health. A blood test called a complete blood count can detect a low red blood cell count. The red blood cells could be low if small bowel cancer is causing bleeding. Blood tests also can show how well the organs are working. For example, results on kidney or liver function tests could be a clue that the cancer has spread to those organs.
• Imaging tests. Imaging tests create pictures of the body. They can show the location and size of small bowel cancer. Tests might include MRI, CT and positron emission tomography, also called a PET scan.
• Removing a sample of tissue for testing, also called a biopsy. A biopsy is a procedure to remove a sample of tissue for testing in a lab. The tissue might be removed during a procedure to see inside the small intestine. During this type of procedure, special tools can be put into the small intestine to collect the sample. Sometimes surgery is needed to get the tissue sample. The sample is tested in a lab to see if it is cancer. Other special tests give more details about the cancer cells. Your health care team uses this information to make a treatment plan.

Tests to see inside your small intestine

Several tests allow doctors to examine the inside of the small intestine. Often, a sample of tissue is collected during these tests. Which test you need depends on where in the small intestine your cancer is located. Options include:

• Upper endoscopy. Upper endoscopy is a procedure to look at the inside of the esophagus, stomach and first part of the small intestine. A thin, tube-like instrument with a light and a lens for viewing, called an endoscope, is inserted through the mouth and passed down the throat. Tools are passed through the tube to remove a sample of tissue for testing.
• Capsule endoscopy. In a capsule endoscopy, also called a pill camera, a pill-sized capsule that has a camera and a light is swallowed. It takes pictures as it moves through the digestive system. The capsule then exits the body during a bowel movement. This test can’t collect a sample of tissue for testing. If something is found on a capsule endoscopy, you might need other tests to find out what it is.
• Enteroscopy. Enteroscopy uses special devices to guide an endoscope into the small intestine. It helps doctors to see more of the small intestine than can be seen with upper endoscopy. A tissue sample might be collected during enteroscopy. To get to the cancer, the scope may be passed down the throat or through the rectum and colon. How your enteroscopy is performed will depend on the cancer’s location. Sometimes you need medicine to put you in a sleep-like state during enteroscopy.

Surgery

Sometimes small bowel cancers are in places that make them hard to see with other tests. If this happens, your health care team may suggest surgery to look at your small intestine and the surrounding area for signs of cancer.

Surgery can involve one large incision in your abdomen, called a laparotomy. It also can involve several small incisions, called a laparoscopy. During laparoscopy, a surgeon passes special tools through the incisions, as well as a video camera. The camera allows the surgeon to guide the tools and see inside your abdomen. The tools may be used to collect a sample of tissue for testing. Often, the cancer is removed during this procedure.