Staging and Detection Tests
Once a cancer has been diagnosed, it is very important for doctors to find out where the cancer may have spread (the “stage” of the cancer) to determine the best possible treatment plan for you. To find out, doctors use staging tests, which include:
- Different types of scans
- Different ways to take tissue samples to look for tumor cells microscopically (biopsy tests)
Scans and other tests may also be used:
- In a “surveillance program” looking for any signs of relapse after treatment
- In a “screening program” to detect cancer early in individuals at high-risk
- To monitor responses to treatment
Tests that may be used include:
Blood chemistry studies – A blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body.
Liver function tests – A blood sample is checked to measure the amounts of certain substances released into the blood by the liver.
Fecal occult blood test – A test to check stool (solid waste) for blood that can only be seen with a microscope.
Biopsy – The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.
Types of scans and procedures include:
Abdominal X-ray – An X-ray of the organs in the abdomen.
Barium enema – As you lie on an X-ray table, barium liquid is put into the rectum and flows through the colon. A radiologist takes X-rays to look for abnormal areas.
Upper GI series with small bowel follow-through – A series of X-rays of the esophagus, stomach and small bowel. Before the test, you drink drinks a liquid that contains barium, which highlights affected areas.
Upper endoscopy – A thin, lighted tube called an endoscope is inserted through the mouth to look at the esophagus, stomach and first part of the small intestine (duodenum). Tissue samples may be taken for biopsy.
Capsule endoscopy (pill endoscopy) – The patient swallows a small pill, which identifies sources of bleeding that can’t be found in any other way.
Laparotomy/laparoscopy – A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease.
CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.
PET scan (positron emission tomography) – An imaging test used to light up cancer in different parts of the body. You get an injection of a short-lived radioactive substance before having the scan. Cancerous tissue will build up more of the substance and appear brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, can also sometimes “light up.”
Lymph node biopsy – The removal of all or part of a lymph node. A doctor, called a pathologist, views the tissue under a microscope to look for cancer cells.
Treatment and Therapies
The following treatments may be used alone or in combination to treat small intestine cancer.
A surgical oncologist may remove all or part of the pancreas, depending on:
- How big the tumor is and where it is
- How far the cancer has spread
- Your general health
Some of the possible operations involved include:
Surgical bypass – If the tumor is blocking the small intestine, but it can’t be removed, surgical oncologists will create a new pathway around the blocked area to let food pass through the digestive tract.
Resection – A surgical oncologist removes part or all of the small intestine and nearby organs if the cancer has spread.
Radiation Therapy (“Radiotherapy”):
Radiation therapy involves using X-rays and other types of medical radiation aimed at specific parts of the body to:
- Kill cancer cells
- Prevent cancer cells from developing or recurring
- Improve many of the symptoms caused by cancer
Radiation therapy can be:
- Used before surgery to make the operation easier (this is called “neoadjuvant” treatment)
- Used after surgery to reduce the chances of the cancer coming back (this is called “adjuvant treatment”)
- Almost as effective as surgery in people who are not fit enough for an operation
- Better than surgery when used together with chemotherapy for certain cancers (this is called “chemo-radiotherapy”)
Chemotherapy and other drug-based treatments:
Anti-cancer drug treatments – Chemotherapy—and new “targeted therapies”—involve using drugs that kill, slow down or damage cancer cells. Many new drugs are being developed.
View current small intestine cancer clinical trials available at UCCC.
Anti-cancer drug treatments may involve:
- Single drugs or combinations of drugs
- Intravenous injections or tablets/capsules
- Taking the drugs in repeating patterns, called “cycles”, that usually last three to four weeks
- Taking some drugs every day or only on a few days within the cycles
- Taking other medicines to reduce or eliminate side effects associated with chemotherapy
- Taking targeted therapies, often with very little side effects, on their own or in combination with standard chemotherapy
- Access to new drugs or vaccines on their own, or added into standard treatments, in clinical trials
Chemotherapy and targeted therapies can:
- Be given before surgery to make the operation easier
- Be given in combination with radiotherapy to make both treatments more effective
- Be given after surgery to reduce the chances of cancer coming back
- Successfully control advanced cancer and many cancer-related symptoms
The goal of clinical research is to improve treatment outcomes and reduce treatment side effects or long-term toxicities. Clinical trials provide the latest treatments because they evaluate:
- New drugs
- New combinations of therapies
- New treatment delivery methods
Because we’re the Rocky Mountain region's only National Cancer Institute (NCI)-designated Comprehensive Cancer Center—one of only 39 in the United States—your treatment will always include the latest and most comprehensive care options.
Learn more about clinical trials at UCCC.
Other types of treatments being tested in clinical trials:
Biologic therapy (biotherapy or immunotherapy) – Uses the patient’s immune system to fight cancer. Substances made by the body or in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer.
Radiation therapy with radiosensitizers – Drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells.