Cancer of the Small Bowel

This is a rare malignant tumor originating from the mucosa of the duodenum or the small intestine.

What are the causes of small bowel cancer ?

The reason(s) for the development of this malignant tumor could not be clarified until to day. But there do exist other concomitant -apparently predisposing- disorders like Morbus Crohn (a special form of a chronic inflammation of the intestine), certain hereditary disorders of the intestine, congenital or aquired defects of the immune system (HIV infection, previous organ transplantation, treatment with immunosuppressive drugs).

What are the symptoms of small bowel cancer ?

This tumor usually develops very slowy during the course of several years. There are some warning signs one shoud be aware of. The problem is, however, that all complaints associated with this tumor are uncharacteristic, and that accordingly the diagnosis can only be done in advanced stage disease. Clinical symptoms comprise nausea, vomiting, constipation or diarrhea. In addition, abdominal pain, weight loss and gastrointestinal bleeding can occur. Rarely there is a palpable abdominal mass, an obstruction of the intestines or jaundice (due to a tumor-related occlusion of the biliary tract).

How can I help ?

Contact me via my mobile phone 0664 206 74 80 and fix an appointment in my private praxis. During our first meeting we will talk about your symptoms and what diagnostic steps will be required. I will examine you physically. In case of existent complaints I will prescribe you effective symptromatic medications. As it concerns further diagnostic steps, I will refer you to examinations in order to verify the diagnosis and to assess the stage of the disease (CT scan of the abdomen, gastroscopy and an X-ray of the stomach and small intestine with contrast medium). In certain cases additional examinations will be required, like an angiography, endosonography of the duodenum with biopsy, or a capsule endoscopy of the small intestine (you will have to swallow a small camera, which will send pictures from the small intestine).

Depending on the results of these examinations, the best treatment strategy for you will be defined.

The next steps after diagnosis of small bowel cancer

If the tumor is localised (involves only the small interstine ± lymph nodes close by), a radical surgical removal of the tumor (resection of the involved segment of the small bowel plus of the lymph nodes) is indicated. I will refer you to an experienced surgeon.

Depending on the tumor stage, in many patients a postoperative adjuvant chemotherapy will be required to minimise the risk of recurrence. This will take 3 to 6 months. Only in early tumor stages without lymph node involvement and perforation of the bowel wall surgery alone will be sufficient.

In patients with advanced tumor stage in whom an operation seems not (yet) possible or when metastases have occurred in other organs, the treatment of choice is chemotherapy ± immunotherapy. This treatment is usually well tolerated, and I will coordinate it for you.

What are the costs ?

The costs for diagnosis and treatment at the Medical University in the AKH, in another public hospital or in a private clinic will be payed by your public or a private health insurance. My honorarium will be agreed upon individually, for a first consultation I will charge an amount of 180 Euro. The public health insurance usually refunds up to 80% of the honorarium a physician with a health insurance contract would request for the same treatment. Private insurances usually refund the entire honorarium of the doctor of your choice.