How is duodenal cancer treated?<\/p>\n
Duodenal cancer is curable when it\u2019s caught early. The most common treatments are surgery<\/a>, chemotherapy<\/a> and radiation therapy<\/a>. You may have any combination of the three as part of your treatment plan.<\/p>\n Surgery: This is the standard curative treatment for duodenal cancer. A Whipple procedure<\/a> is the most common type of surgery to treat duodenal cancer. During this operation, a surgeon removes the duodenum, head of the pancreas, gallbladder, bile duct, nearby lymph nodes<\/a> and sometimes part of the stomach.<\/p>\n Chemotherapy: Chemotherapy may be given before or after surgery to kill cancer cells and stop them from growing. It is also the standard treatment for patients with metastatic disease<\/a>.<\/p>\n Radiation therapy: Radiation therapy may be used to shrink or slow tumor growth before surgery. It can also be given after surgery to destroy any remaining cancer cells.<\/p>\n Does duodenal cancer ever recur?<\/p>\n After treatment, duodenal has a chance of coming back<\/a>. Systemic recurrence, or distant metastasis, is a concern for duodenal cancer. This is when the cancer comes back far from the original site of the tumor. It\u2019s also known as stage 4 duodenal cancer.<\/p>\n Duodenal cancer can also recur locally, which is when the cancer comes back in the same location as the original tumor, or close to it.<\/p>\n What is the prognosis if you have duodenal cancer?<\/p>\n Of all gastrointestinal cancers, cancers in the small intestine \u2013 like duodenal cancer \u2013 tend to have a worse prognosis than colon cancer<\/a>.<\/p>\n Screening colonoscopies<\/a> can detect colorectal cancer<\/a> early, when the chance for successful treatment is higher. There is no screening test for duodenal cancer. This, along with the fact that symptoms may be non-specific or not show up right away, means most people are diagnosed when the cancer is stage 3 or stage 4. Generally speaking, the higher the cancer\u2019s stage<\/a>, the lower the survival rate.<\/p>\n Adequate lymph node removal also affects prognosis. People who do not have enough lymph nodes removed during surgery for duodenal cancer face less favorable outcomes than those who do have an adequate number of lymph nodes removed.<\/p>\n Early-stage duodenal cancer is curable with surgery, so it\u2019s very important to see a doctor as soon as you notice any concerning symptoms in your digestive tract. Data has shown that curative surgery is even possible in some patients with limited metastasis, though this is rare.<\/p>\n Seeking care at a cancer center like UT MD Anderson gives you a better chance for successful treatment. We see more cases of duodenal cancer than most institutions, and we\u2019re making new research advances that can potentially help extend patients\u2019 lives.<\/p>\n What research is UT MD Anderson doing to advance duodenal cancer treatment?<\/p>\n We\u2019ve conducted several clinical trials<\/a> for cancers of the small intestine. Two notable areas of research are:<\/p>\n Taxanes to treat metastatic small intestinal cancer<\/p>\n A previous clinical trial showed promising results using taxanes, a class of chemotherapy drugs given intravenously, to treat metastatic small intestinal cancer. Based on those findings, I\u2019m leading a Phase 2 clinical trial<\/a> that is studying whether it\u2019s better to give the targeted therapy<\/a> agent ramucirumab in combination with either the paclitaxel (taxane) or the chemotherapy regimen FOLFIRI to treat patients with metastatic small intestinal cancer or small intestinal cancer that is no longer responding to treatment.<\/p>\n We typically use taxanes to treat gastric cancer<\/a>, not colon cancer. And small intestinal cancer is often treated like colon cancer. So, this would be the first time we treat it more like gastric cancer.<\/p>\n Immunotherapy in MSI-high tumors<\/p>\n Similar to colorectal cancer, our research has shown that advanced small bowel adenocarcinomas that are microsatellite instability-high<\/a> (MSI-high) have better responses to immunotherapy<\/a> such as pembrolizumab. This means that immunotherapy can be an effective treatment for this particular molecular subset of advanced small intestinal cancers.<\/p>\n If you\u2019re diagnosed with a rare cancer<\/a> like duodenal cancer, I recommend seeking a center of excellence, like UT MD Anderson. We have experience in diagnosing and treating the rarest of cancers, and we\u2019re always researching new ways to better treat patients.\u00a0<\/p>\n Michael Overman, M.D.<\/a>, is a gastrointestinal medical oncologist at UT MD Anderson.<\/p>\n