To determine the best treatment options, physicians at Mayo Clinic use the latest diagnostic techniques to identify the type of tumor cells and the tumor's stage of development.
A first step toward diagnosing small bowel cancer is an in-depth interview with the patient. A physician gathers details about the patient's symptoms and when they first appeared.
After the physician has taken the patient's medical history, the next step is a physical examination. The physician will feel the abdomen for lumps, swelling, and areas where the patient reports pain. The physician may also order a blood test and ask the patient to provide a stool sample for testing.
High-resolution imaging studies help Mayo Clinic specialists diagnose small bowel cancer.
Specialists can examine the interior of the duodenum, the upper part of the jejunum (proximal jejunum), and the lowest parts of the small intestine (terminal ileum) using an endoscope or colonoscope. For these procedures, physicians give patients a mild sedative before passing a thin tube either down the throat and through the stomach (endoscopy), or up through the rectum (colonoscopy). A light inside the tube helps the doctor see abnormal areas in the small intestine. If necessary, a small sample of the cells can be taken for examination under a microscope by a pathologist, a procedure known as biopsy. Mayo Clinic physicians use two newer methods of endoscopic evaluation, wireless capsule endoscopy and double-balloon enteroscopy (DBE), which allow complete endoscopic examination (and in the case of DBE, biopsy) of the small bowel. Unfortunately neither test reaches the entire small bowel.
Before planning or recommending treatment, physicians at Mayo Clinic may wish to examine tissue from the small bowel in a laboratory. They often use fine-needle aspiration to gather a small sample of cells from the small intestine. Experienced pathologists examine the tissue under a microscope. In most cancer cases, pathologists classify the abnormal tissue as adenocarcinomas, carcinoid tumors, sarcomas, or lymphomas.