Diagnosing Small Intestine Cancer

About Small Intestine Cancer

At Penn Medicine, patients with small intestine cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of gastrointestinal cancer.

Also known as the small bowel, the small intestine is the portion of the digestive tract that connects the stomach with the large bowl, or colon. The small intestine is critical in the breakdown and absorption of food so the body can absorb nutrients.

The small intestine can be divided into three areas:

  • Duodenum
  • Jejunum
  • Ileum

Cancer of the small intestine is rare. There are five main types of intestinal cancer, differentiated by their appearance under a microscope:

  • Adenocarcinoma
  • Gastrointestinal stromal tumor
  • Carciniod tumors
  • Lymphoma
  • Sarcoma
    • Leiomyosarcoma

Penn Medicine's multidisciplinary approach to cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.

Read more About Small Intestine Cancer

Diagnosing Small Intestine Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat small intestine cancer.

Patients who choose Penn’s Abramson Cancer Center, benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and treatment plan custom designed for each patient with small intestine cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing small intestine cancer and are actively researching better and more precise ways to detect small intestine cancer.

Because an accurate diagnosis is a critical step in planning cancer treatment, it’s important patients know that when they come to Penn Medicine’s Abramson Cancer Center, they are taking an important step in getting the best cancer treatment.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.


Screening for Small Intestine Cancer

Currently, there are no standard intestinal cancer screening recommendations for the general public like there mammograms for breast cancer and colonoscopy for colon cancer.

Diagnostic Tools for Small Intestine Cancer

When physicians suspect intestinal cancer, they may order several tests to make a diagnosis.

  • Medical history and physical exam. A physician may examine the patient for general health, and to see if there are any signs of the disease.
  • Lab tests. Basic blood tests to measure levels of proteins and enzymes in the blood, as well as liver function.
  • Imaging tests. Pictures of the inside of the body can help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread, and to help determine if treatment is working.
    • Computed tomography (CT). A CT scan creates a three-dimensional X-ray of the inside of the body. A computer combines the images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (dye) is used to provide better detail.
    • Magnetic resonance imaging (MRI). Magnetic fields are used to create detailed images of the body. A contrast medium may be injected into a vein to create a clearer picture.
    • Upper GI series with small intestine follow-through. A series of X-rays of the esophagus, stomach, and small bowel. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus, stomach, and small bowel. X-rays are taken at different times as the barium travels through the upper GI tract and small intestine.
    • Upper endoscopy. Endoscopy allows the doctor to see the lining of the upper digestive system with a thin, lighted, flexible tube called an endoscope. A patient may be sedated as the tube is inserted through the mouth, down the esophagus, and into the stomach and small intestine. If an abnormality is found, a biopsy is performed.
    • Capsule endoscopy: Capsule endoscopy allows the doctor to examine the lining of the small intestine. A small pill-sized video camera is swallowed. The camera captures thousands of images as it passes through the small intestine. These images are later reviewed by the doctor to evaluate for abnormalities in the small bowel.
    • Double balloon enteroscopy. This is an endoscopic technique for visualization of the entire small bowel. The small bowel is examined  by slowly advancing a flexible endoscope with a tube on it (about the thickness of a finger) throughout the small bowel. The endoscope may be inserted orally or rectally to give the physician the best access to the intestine. If an abnormality is found, a biopsy is performed.
    • Laparotomy. A procedure in which an incision is made into the wall of the abdomen to view the inside of the abdomen for signs of disease. Sometmes, a tissue sample is taken at the time of the procedure.
  • Biopsy. A sample of the suspicious area is removed and viewed under a microscope. Penn Medicine surgeons perform several different types of biopsies based on the amount of tissue being removed. Some biopsies use a small forceps or a needle, while others require a small surgical procedure to remove more tissue.
    • Lymph node biopsy. The removal of all or part of a lymph node. The tissue is then checked for cancer.

Staging Small Intestine Cancer

Staging systems provide doctors with a common language for describing tumors. After cancer is first diagnosed, a series of tests are used to investigate the extent of the cancer and to see whether it has spread to other parts of the body from where it started. Staging is a way of recording the size and growth of a cancer, and determining the plan for treatment. By understanding the stage of their cancer, patients can make informed decisions about treatment.

The “staging diagnosis” depends on the type of cancer and the staging system the doctor is using, but in general there are four stages of intestinal cancer:

  • Stage I. Cancer contained within the small bowel lining or spread into the muscle wall, but not yet involving the lymph nodes or other parts of the body
  • Stage II. Cancer spread through the muscle wall, possibly involving other nearby organs (like the pancreas)
  • Stage III. Cancer spread to nearby lymph nodes.
  • Stage IV. The cancer has spread (metastasized) from where it started to other organs, such as the liver, bones or lungs.

Physicians also group small intestine cancer based on whether or not it can be surgically removed, or resected.  If the cancer can be surgically removed, the prognosis and outcome for a patient is improved.

Small Intestine Cancer Treatments

Following the diagnosis and staging of small intestine cancer, cancer specialists at Penn’s Abramson Cancer Center develop a personalized treatment plan. Penn’s treatment options for small intestine cancer include:

  • Surgery
    • Resection
    • Surgical bypass
  • Radiation therapy
    • 3-D conformal radiation therapy
    • Intensity-modulated radiation treatment (IMRT)
    • Proton therapy
    • Volumetric-modulated arc therapy (VMAT)
  • Chemotherapy
    • Chemotherapy
  • Other treatments
    • Integrative medicine and wellness
    • Palliative care
    • Penn Home Care and Hospice

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN.

Read more Small Intestine Cancer Treatments

Small Intestine Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of intestinal cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle. There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Small Intestine Cancer Survivorship


Kristi Elder

Kristi Elder lived cancer free for 12 years after treatments in her mid-20s for a rare cancer. While coming to Penn for routine follow-up, a staff member recognized that Kristi could benefit from our survivorship program. In Kristi's first visit with o

Stand Up to Cancer

Peter O'Dwyer, MD, professor of Hematology-Oncology and program director of Development Therapeutics in the Abramson Cancer Center, was interviewed on NBC10's 10! Show about Penn's work as part of the Stand Up to Cancer Dream Team... Read more

Clinical Trials