Duodenum starts where stomach ends. It is first part of the small intestine and ends in jejunum. The draining channel to drain bile from liver also ends in duodenum - called as common bile duct. Cancer arising from duodenum is duodenal cancer. It is a very rare kind of cancer. Less than one percent of all cancers arise from duodenum. This cancer can occur in anybody, however it is most commonly seen above 60 years of age.
Initial symptoms can be nonspecific and vague- making early diagnosis difficult. Symptoms of duodenal cancer will depend on the part of duodenum involved. So if cancer is starting from part close to stomach-it causes obstruction resulting in vomiting. Tumorous growth in other parts also causes obstruction but if it close to stomach, these symptoms are much common.
If it starts from part close to bile duct, it leads to bile duct obstruction causing jaundice.
If there is ulcer in cancer there could be bleeding and pain. Bleeding manifests more commonly as anemia and weakness.
If duodenal cancer has spread to other organs then presentation could be specific organ involvement like liver dysfunction in case of liver involvement.
Weight loss, weakness, abdominal pain and anemia are common symptoms. Having these symptoms does not mean necessarily that patient has duodenal cancer. There are few other intestinal disorders causing these symptoms. Irritable bowel syndrome, inflammatory bowel disease, tuberculosis of intestine can cause such manifestations too.
Once your treating doctor suspect presence of duodenal cancer based on the signs and symptoms, he or she will order certain investigations to confirm the diagnosis and to see the extent of disease. These include
Treatment depends on the extent of the disease. If localized disease, surgery is done to remove part of intestine containing tumor. Surgery to remove cancers are generally more extensive than non-cancer surgeries. This resected specimen is sent to lab for detailed analysis.
Based on these finding some times chemotherapy is administered after surgery to prevent cancer from recurring.
In metastatic disease, mainstay of treatment is chemotherapy.
Duodenal cancer are very rare. Cancer occurring from large intestines or colon are much more common than small intestine. Hence small intestinal cancer including duodenal cancers are treated on the line of colon cancers