Treatments

Surgery

Surgery is the most common treatment for small intestine cancer and may involve:

• Resection: Removing part or all of the small intestine or nearby organs if the cancer has spread. Lymph nodes near the cancer may also be removed for examination.
• Bypass: Creating an alternative pathway around a tumor that cannot be removed.

Other forms of treating the cancer may include: Radiation Therapy, Chemotherapy, Immunotherapy, Radiation with Radiosensitizers (drugs that make cancer cells more sensitive to radiation).

Radiotherapy

Small-bowel adenocarcinoma is generally radioresistant, and the small bowel has limited tolerance to radiation. However, radiation may provide palliative relief for pain or obstruction. Intraoperative radiotherapy, where a single radiation dose is applied to the tumour bed. Whole-abdominal irradiation as adjuvant therapy for stage C disease may be beneficial but requires clinical trials for confirmation.

Chemotherapy

Due to the rarity of small-bowel adenocarcinoma, chemotherapy data is limited. Most regimens involve 5-FU, alone or in combination with agents like doxorubicin, cisplatin, or cyclophosphamide. Chemotherapy is mostly reserved for metastatic disease, with some benefit in extending survival compared to no treatment. Adjuvant chemotherapy has been less studied, and outcomes remain unclear, with isolated cases showing mixed results. Newer agents, such as irinotecan, warrant exploration in both metastatic and adjuvant settings.