Treatment of duodenal cancer

Duodenal cancer is a malignant tumor that develops in the initial part of the small intestine. As an independent disease, it is rare - in most cases it is a metastasis of cancer of another location.

Oxford Medical has a modern oncology department and a high-tech surgical hospital. The clinic has new expert-class equipment that allows for thorough diagnostics, as well as medical and surgical manipulations of any degree of complexity.

We employ some of the best oncologists and surgeons in Kyiv and Ukraine with many years of experience, who have all the modern methods of cancer treatment, including targeted and immunotherapy. By contacting Oxford Medical, you can be sure that you are in safe hands.

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The most common risk factors are:

• ulcer disease;
• Crohn's disease;
• duodenitis;
• Helicobacter pylori infection;
• intestinal polyps;
• hereditary predisposition;
• history of cancer;
• unbalanced diet;
• diabetes;
• obesity;
• weakened immunity;
• smoking;
• alcohol abuse;
• age over 40 years.

According to the World Health Organization, the greatest risk is posed by benign neoplasms in the intestine (adenoma, polyps) and inflammatory diseases that are not treated in a timely manner. Another important factor is the prevalence of red meat products, fatty and high-calorie foods in the diet with insufficient consumption of fresh vegetables and fruits.

All symptoms are non-specific and can occur with various diseases. If several appear, you should consult a doctor and undergo an examination.

In the early stages, duodenal cancer develops asymptomatically. Signs of the disease occur with an increase in the size of the tumor. One of the first may be discomfort, heaviness or pain in the middle of the abdomen. Also, due to the functional features of the duodenum (production of enzymes and continuation of food digestion started in the stomach), many patients experience nausea, belching and decreased appetite. As cancer progresses, intoxication of the body occurs and general well-being worsens.

Since many diseases of the gastrointestinal tract manifest themselves in a similar way, a comprehensive diagnosis is necessary to make an accurate diagnosis.

After examining the patient, studying his symptoms and medical history, the doctor may prescribe some of the following tests:

• general blood and urine tests;
• stool analysis for microflora and occult blood;
• blood test for tumor markers REA, CA 242, CA 72-4;
• duodenoscopy - endoscopic examination of the duodenum;
• esophagogastroduodenoscopy (EGD) - endoscopic examination of the esophagus, stomach and duodenum;
• colonoscopy - endoscopic examination of the rectum;
• sigmoidoscopy - endoscopic examination of the rectum and distal sigmoid colon;
• irrigoscopy - X-ray examination of the intestine with the introduction of a contrast agent;
• biopsy of the neoplasm with histological analysis of the sample;
• immunohistochemical analysis - is performed when confirming the malignant nature of the tumor to determine its characteristics;
• Ultrasound, CT or MRI of various parts of the body to assess the spread of cancer and detect metastases.

Endoscopic examinations of various parts of the digestive system play a key role in diagnosis. During the examination, a thin elastic tube equipped with an optical system and surgical microinstruments is inserted into the gastrointestinal tract. The image from the video camera is transmitted to a computer screen and magnified many times, which allows the specialist to assess the condition of the mucous membranes, detect neoplasms and determine their localization as accurately as possible.

When tumors are detected, a biopsy is necessarily performed. During endoscopy, a small tissue sample is taken, which is then sent to the laboratory for histological analysis. It determines whether the tumor is benign or malignant. In the second case, an immunohistochemical analysis is immediately performed to assess the aggressiveness and other characteristics of the neoplasm.

To determine the stage of cancer and the presence of other foci, CT scans of the abdomen, chest, head, and other areas are most often performed.

The treatment tactics for duodenal cancer depend on the stage at which the disease is diagnosed. If it is stage 1, surgery is performed first. In some cases, this is sufficient, while in others, radiation or chemotherapy is required to reduce the risk of recurrence and the development of metastases.

At stages 2, 3 and 4, surgical, radiation and chemotherapy treatment are used. The sequence and duration of the courses are determined individually.

Radiation therapy has a local effect. It slows down the development of the tumor and causes tissue destruction. Chemotherapy has a systemic effect, therefore it is effective in the prevention and treatment of metastases.

Surgery for duodenal cancer is most often performed laparoscopically. This is a minimally invasive intervention, which is performed using special equipment. 3 small punctures are made in the abdominal cavity. Optical devices that transmit images to the screen and miniature surgical instruments are inserted through them. Using them, the surgeon removes the tumor and part of the intestine, and then stitches its fragments together to restore integrity.

If the cancer has spread to other parts of the intestine, adjacent organs or lymph nodes, the scope of the operation increases. The surgeon's task is to remove all foci of the neoplasm, preserving as much healthy tissue as possible.

At Oxford Medical, surgical treatment is performed in a modern high-tech surgical hospital with its own intensive care and resuscitation department. The clinic is equipped with the latest equipment and employs experienced surgeons, thanks to which all patients receive medical care in accordance with the highest quality standards.