Surgery for small bowel cancer
Small bowel cancer surgery
Adenocarcinoma is the most common type of small bowel cancer (small intestine cancer). Surgery is the main treatment for this type of small bowel cancer. Some people will have chemotherapy as well.
If you have a different type of small bowel cancer, such as lymphoma, you may have a different type of treatment.
Your doctors will explain the aim of the operation to you before your surgery. They will try to answer any questions you have.
Sometimes the surgeon may have to make decisions about surgery once the operation has started. This is because then they will know more about the size and position of the cancer. If this happens, they will talk you through possible outcomes beforehand.
The type of operation you have depends on:
Removing the cancer
During the operation, the surgeon will usually remove all the cancer and some surrounding healthy tissue. But if the cancer is affecting tissue or organs nearby, the surgeon may also need to remove part or all of the stomach or colon. They may also have to remove the gall bladder, pancreas or some of your lymph nodes.
Stomas
Sometimes the bowel cannot be joined together during the operation. If this happens, the surgeon may make an opening through the abdominal (tummy) wall during the operation. They then join the end of the bowel to the surface of the abdomen. This is called a stoma. You may also have a stoma to give the bowel time to heal. Your surgeon will be able to tell you if you need a stoma.
A stoma is round or oval, and it looks pink and moist. It has no nerve supply, so it does not hurt. A stoma made using the small bowel (ileum) is called an ileostomy.
If you have a stoma, stools (poo) will no longer pass out of the rectum and anus in the usual way. Instead they will pass out of the stoma, into a disposable bag that is worn over the stoma.
The stoma is usually temporary. People with a temporary stoma will have a second, smaller operation a few months later. This second operation is to close the stoma and re-join the bowel. It is called a stoma reversal.
Being told you need a stoma can be distressing. Most people find they get used to the stoma over time. The stoma care nurse at the hospital will help you look after the stoma for the first few days. They can give you support and information on caring for your stoma when you go home. Our cancer support specialists can give you more information about having a stoma.
Bypass surgery
If the cancer is large, it can cause a narrowing or blockage in the small bowel, called a bowel obstruction. It may cause tummy pain and vomiting and needs to be treated urgently.
Surgeons can sometimes do an operation to bypass the cancer, by re-routing the small bowel around the cancer.
If you are not able to have surgery, your cancer doctor may be able to pass a small metal tube into the small bowel. This is called a stent. Once it is in place, the tube can expand and open up the small bowel. This will relieve symptoms caused by an obstruction. The cancer can sometimes be removed later.
After your operation
After a major operation, you may have to stay in an intensive care or high dependency unit for a couple of days. When you are well enough, you can move back to a general ward.
When part of the small bowel has been removed or bypassed, you may need to have a special diet, supplements or medicines. This may help you digest and absorb food. It will depend on the type of surgery you have had. Your doctor or nurse will explain this to you.
About our information
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References
Below is a sample of the sources used in our small bowel cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Overman M et al. Epidemiology, clinical features, and types of small bowel neoplasms. www.uptodate.com/contents/epidemiology-clinical-features-and-types-of-small-bowel-neoplasms (accessed February 2019).
Cusack J et al. Treatment of small bowel neoplasms. www.uptodate.com/contents/treatment-of-small-bowel-neoplasms (accessed February 2019).
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
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Date reviewed
This content is currently being reviewed. New information will be coming soon.
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